Dropout from exercise randomized controlled trials among people with anxiety and stress-related disorders: A meta-analysis and meta-regression

JOURNAL OF AFFECTIVE DISORDERS

卷:282

Review

Vancampfort, Davy^1,2  Sanchez, Carlos Pelayo Ramos¹  Hallgren, Mats³  Schuch, Felipe⁴  Firth, Joseph^5,6  Rosenbaum, Simon^7,8  Van Damme, Tine^1,2  Stubbs, Brendon^9,10 

[1] Katholieke Univ Leuven, Dept Rehabil Sci, Tervuursevest 101, B-3001 Leuven, Belgium

[2] Katholieke Univ Leuven, Univ Psychiat Ctr, Leuven, Kortenberg, Belgium

[3] Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden

[4] Univ Fed Santa Maria, Dept Sports Methods & Tech, Santa Maria, RS, Brazil

[5] Univ Manchester, Div Psychol & Mental Hlth, Manchester, Lancs, England

[6] Western Sydney Univ, NICM Hlth Res Inst, Westmead, NSW, Australia

[7] Univ New South Wales, Sch Psychiat, Sydney, NSW, Australia

[8] Black Dog Inst, Sydney, NSW, Australia

[9] South London & Maudsley NHS Fdn Trust, Physiotherapy Dept, London, England

[10] Kings Coll London, Inst Psychiat, Hlth Serv & Populat Res Dept, London, England

关键词: Anxiety;    Dropout;    Exercise;    Physical activity;    PTSD;    Stress;   

DOI  :  10.1016/j.jad.2021.01.003

来源: Elsevier

【 摘 要 】

Objective:. Exercise has established efficacy in people with anxiety and stress-related disorders. Dropouts from randomized controlled trials (RCT's) pose a threat to the validity of the evidence, with dropout rates varying across studies. We conducted a meta-analysis to investigate the prevalence and predictors of dropout rates among adults with anxiety and stress-related disorders participating in exercise RCT's. Methods:. Two authors searched major electronic databases up to 07/2020. We included RCT's of exercise interventions in people with anxiety and stress-related disorders that reported dropout rates. A random effects meta-analysis and meta-regression were conducted. Results:. Fourteen RCT's involving 16 exercise interventions (n=369, mean age 20.7 to 67.7years; 38.4% male) were included. The trim-and-fill-adjusted prevalence of dropout across all studies was 22.4% (95%CI = 15.0% to 32.0%). Applying controlled motivation strategies (P<0.001) predicted higher dropout. Supervision during all sessions and by an expert in exercise prescription and applying autonomous motivation strategies predicted lower dropout (all P<0.001). Dropout was similar in exercise versus control conditions (OR = 0.84, 95%CI = 0.54 to 1.29, p = 0.42, I-2 = 0%; N=16). Limitations:. Potentially important moderators of dropout, such as the severity of mental health symptoms and illness duration were insufficiently available. Conclusions:. Exercise is well tolerated by people with anxiety and stress-related disorders and drop out in RCT's is comparable to control conditions. Thus, exercise is a feasible treatment, in particular when autonomous motivation strategies are included and when the intervention is delivered by healthcare professionals with expertise in exercise prescription.

【 授权许可】

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