Exercise-based interventions for substance abuse populations are a topic of research and clinical practice. However, a new scientific review suggests that a number of methodological problems and knowledge gaps in the literature prevent the development of clinical guidelines. The article was published in the journal Mental Health and Physical Activity.
The aim of the new scientific review was to summarize the evidence on the effectiveness of exercise-based interventions in changing psychological symptoms, substance use outcomes, and quality of life in adults who abuse or are dependent on substances. Substance abuse and dependence are major public health concerns, with prevalence and alarming rates of suicide and mortality.
These conditions are characterized by abuse and chronic relapse and often co-occur with other disorders such as chronic pain or mental illness. The psychological symptoms and consequences of substance abuse are difficult to manage in these populations, which negatively impacts their quality of life as well as the economic, judicial, and health systems.
Exercise has been suggested as a potential intervention to help individuals suffering from abuse or addiction. Regular physical activity can improve their self-discipline and help them manage their symptoms.
“My main research interests are related to the role of psychological (i.e., self-efficacy) and spiritual (i.e., meaning in life) factors in the self-perception that people with chronic pain, cancer, or mental health problems have in their lives. well-being, including factors such as self-perceived happiness and life satisfaction,” said study author Javier Martínez-Calderón, associate professor at the University of Seville and founder of Uncertainty, Mindfulness, Self, and Spirituality (UMSS). Research Group.
“In that sense, I strongly believe that exercise-based interventions, such as mind-body exercises or any type of exercise that we can practice, can be very helpful for people to become more aware of their physical bodies, which I think can help them be more.” connect with yourself and improve your mental health. In fact, I am very interested in the field of addictions because many people with any of these chronic disorders often turn to substance abuse (i.e., opioids) in an attempt to manage the course of their illness.
Previous systematic reviews have examined the effectiveness of exercise-based interventions, with some showing promising results. However, it remains unclear what type of exercise is most beneficial for specific populations and what psychological symptoms or consequences of substance abuse can be effectively addressed with exercise.
The researchers conducted a comprehensive search of several databases. Eligibility criteria were based on the PICO framework (patient, intervention, comparison, outcome, study design). They included systematic reviews that evaluated exercise-based interventions for adults with substance abuse, dependence, and co-occurring disorders using any type of exercise.
The researchers screened 314 titles and abstracts and selected 18 systematic reviews that met the eligibility criteria. These systematic reviews included 53 meta-analyses and 103 different clinical trials.
“Many clinical trials have evaluated the potential effectiveness of exercise interventions in this population.” I felt very surprised and happy to see how clinical trials prove the potential benefits that physical activity can offer to people with mental health problems,” Martínez-Calderón told PsyPost.
Exercise-based interventions were often presented using generic terms such as ‘exercise’ or ‘physical activity’, while populations and outcomes of interest were described using terms such as mental health, anxiety, depression, or smoking.
It remained unclear which type of exercise (e.g., aerobic exercise, yoga interventions, strength training, or resistance exercise) was most effective for each substance abuse population and which specific exercise interventions produced the greatest benefits for various psychological symptoms or substance abuse. the results. “In this context, it is practically impossible to recommend a particular type of exercise to health professionals,” the researchers wrote.
The researchers also identified several methodological problems and knowledge gaps. The methodological quality of the systematic reviews was generally rated as critically low, with issues such as a lack of transparency in the selection of studies and the need for additional files listing excluded studies.
“Clinical studies covering this topic seem to show promising results in improving some outcomes (i.e., psychological symptoms) in individuals who abuse or depend on substances,” explained Martínez-Calderón. “However, systematic reviews summarizing this primary evidence have shown many methodological weaknesses, and readers should be very cautious about the conclusions drawn from these systematic reviews.
The researchers emphasized that future research needs to focus on improving the quality of systematic reviews and increasing the number of high-quality clinical trials. They also called for the use of the GRADE approach in all meta-analyses to better understand the conditions under which clinical recommendations are made.
“Generally, systematic reviews need to add an assessment of the certainty of the evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach,” Martínez-Calderón told PsyPost. “This is probably the gold standard tool for assessing the certainty of outcomes that are evaluated in systematic reviews, which is essential for conducting clinical trials in a clinical setting.”
“The synthesis of evidence on mental health and physical activity needs to be improved,” added the researcher. “Specifically, the methodological quality of systematic reviews with meta-analyses. We conducted two other reviews covering exercise in schizophrenia and exercise for post-traumatic stress disorder, which we attempted to publish when we found similar methodological problems to those noted in this review.
In the article “Physical exercise levels in the treatment of substance abuse and dependence: a review of systematic reviews including 53 meta-analyses covering 103 different clinical trials” by Javier Martinez-Calderon, Olga Villar-Alises, Cristina. García-Muñoz, and Javier Matias-Soto.