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de Ternay J, Larrieu A, Sauvestre L, Montègue S, Guénin M, Icard C, Rolland B. Insufficient Physical Activity Is a Global Marker of Severity in Alcohol Use Disorder: Results from a Cross-Sectional Study in 382 Treatment-Seeking Patients. Nutrients 2022; 14:nu14234958. [PMID: 36500988 PMCID: PMC9739230 DOI: 10.3390/nu14234958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/19/2022] [Accepted: 11/20/2022] [Indexed: 11/24/2022] Open
Abstract
Improving physical activity (PA) in patients with alcohol use disorder (AUD) has recently emerged as an important component of the global treatment strategy to improve drinking outcomes and quality of life. However, this new approach should focus on AUD patients with insufficient baseline PA and requires this subgroup to be better characterized. In a population of 382 treatment-seeking AUD patients, PA was assessed using the International Physical Activity Questionnaire, and participants were divided into two groups: insufficient PA group and sufficient PA group. The severity of the AUD was assessed using the DSM-5 criteria, the Alcohol Use Disorder Identification Test, and the Severity of Alcohol Dependence Questionnaire. In logistic regression models, individuals with insufficient PA were more likely than other AUD individuals to present a higher Body Mass Index (p < 0.001), a higher number of AUD DSM-5 criteria (p < 0.05), more frequent opioid use (p < 0.05), higher scores at the Fagerström Test for Nicotine Dependence (p < 0.001), State-Trait Anxiety Inventory (p < 0.001), impulsivity scale (p < 0.05), Pittsburgh Sleep Quality Inventory (p < 0.05), and lower WHO Quality of Life (p < 0.001) scores. In AUD, an insufficient baseline PA is associated with several markers of severity, and physical exercise interventions should be part of a multimodal treatment program integrating the global impairments of patients.
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Affiliation(s)
- Julia de Ternay
- Service Universitaire d’Addictologie de Lyon (SUAL), Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
- Correspondence:
| | - Agathe Larrieu
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69678 Lyon, France
| | - Laura Sauvestre
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69678 Lyon, France
| | - Solène Montègue
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69678 Lyon, France
| | - Monique Guénin
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69678 Lyon, France
| | - Christophe Icard
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69678 Lyon, France
| | - Benjamin Rolland
- Service Universitaire d’Addictologie de Lyon (SUAL), Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69678 Lyon, France
- Centre de Recherche en Neurosciences de Lyon (Psychiatric Disorders, PSYR2), Université Claude Bernard Lyon 1, Inserm U1028, CNRS UMR 5292, 69100 Lyon, France
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Bulvestre M, Mastour M, Leprêtre P. La condition physique fonctionnelle chez des patients présentant une addiction à l’alcool et son évolution après 4 semaines de réadaptation. Sci Sports 2022. [DOI: 10.1016/j.scispo.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Gür F, Can Gür G. Is Exercise a Useful Intervention in the Treatment of Alcohol Use Disorder? Systematic Review and Meta-Analysis. Am J Health Promot 2020; 34:520-537. [PMID: 32212949 DOI: 10.1177/0890117120913169] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES This systematic review and meta-analysis examined the effects of exercise on individuals with alcohol use disorders (AUDs) across multiple health outcomes. DATA SOURCES PubMed, Medline, Web of Science, Scopus, Academic Search complete, Sport Discuss, and ERIC databases. STUDY INCLUSION AND EXCLUSION CRITERIA Interventional studies published between 2000 and 2018 focused on evaluating the effectiveness of exercise interventions in adults with AUD. DATA EXTRACTION This protocol was prepared using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols standard and the Meta-Analyses and Systematic Reviews of Observational Studies guidelines. DATA SYNTHESIS Physical activity levels/fitness [VO2 max (Oxygen Uptake) and HRmax (Maximum Heart Rate)], levels of depression, anxiety, self-efficacy, quality of life, and alcohol consumption (number of standard drinks consumed per day and per week). RESULTS The findings indicated that exercise significantly improved physical fitness as assessed by VO2 max (standardized mean difference [SMD]: 0.487, P < .05) and HRmax (SMD: 0.717, P < .05). Similarly, exercise significantly improved mental health as assessed by quality of life (SMD: 0.425, P < .05), but levels of depression, anxiety, self-efficacy, and alcohol consumption did not change significantly. Aerobic exercise alleviated depression and anxiety symptoms more than that of yoga and mixed types. Duration of exercise also had a similar effect on anxiety and depression. CONCLUSIONS Exercise can be an effective and persistent adjunctive treatment for individuals with AUDs.
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Affiliation(s)
- Fatih Gür
- Faculty of Sport Science, University of Pamukkale, Pamukkale, Turkey
| | - Ganime Can Gür
- Faculty of Sport Science, University of Pamukkale, Pamukkale, Turkey
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Colledge F, Gerber M, Pühse U, Ludyga S. Anaerobic Exercise Training in the Therapy of Substance Use Disorders: A Systematic Review. Front Psychiatry 2018; 9:644. [PMID: 30564150 PMCID: PMC6288373 DOI: 10.3389/fpsyt.2018.00644] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 11/15/2018] [Indexed: 12/15/2022] Open
Abstract
Background: In the past 3 decades, there has been an increase in the number of studies assessing exercise as a form of treatment for substance use disorders (SUDs). While a variety of substance types and outcomes have been assessed, exercise intensities have never been systematically examined. Consequently, it remains unclear whether particular forms of exercise are better suited to the treatment of these populations. Anaerobic exercise has been shown to have positive effects in populations with psychiatric disorders, but its effectiveness in the treatment of SUDs has to date not been reviewed. Methods: The aim of this systematic review is to identify and evaluate studies which have employed either an acute or chronic anaerobic exercise component as a therapy modality for SUDs. The primary outcomes are abstinence, craving, withdrawal, consumption, quality of life, and the following psychological symptoms and disorders: depression, anxiety, stress, and mood. A secondary objective is to assess whether the type of training described in the study protocol can be reliably categorized as anaerobic training. Results: Twenty-six studies are included in this review. Twelve studies addressed nicotine dependence, one addressed alcohol dependence, and 13 addressed dependence on various illicit drugs. Thirteen studies reported the intensity at which participants actually exercised, but only one employed a test to determine whether training was carried out above the anaerobic threshold (AT). The risk of bias in the included studies was generally high. Results of the studies were mixed, with the most positive effects being found for abstinence in nicotine dependence. Conclusion: The evidence for the effects of anaerobic exercise in SUDs is weak, although a tendency toward positive effects on abstinence in nicotine dependent individuals was observable. The majority of studies do not report data on exercise intensity, making a categorization of anaerobic exercise impossible in all but one case. This means that the effects of this form of exercise cannot be determined, and therefore not evaluated or compared with other forms. In order to improve the quality of evidence for exercise in SUD treatment, clearly defined and objectively assessed evaluations of anaerobic and anaerobic exercise are necessary.
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Affiliation(s)
- Flora Colledge
- Departement für Sport, Bewegung und Gesundheit, Universität Basel, Basel, Switzerland
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Exercise training reduces alcohol consumption but does not affect HPA-axis activity in heavy drinkers. Physiol Behav 2017; 179:276-283. [PMID: 28684134 DOI: 10.1016/j.physbeh.2017.07.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 06/17/2017] [Accepted: 07/03/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND It has been suggested that physical exercise could have potential beneficial effects in substance abusers, which are based on both physiological and psychological theories. Although a few studies have examined the effect of exercise on alcohol intake and fitness in individuals with alcohol use disorders (AUDs), there is a gap in the literature concerning the physiological and biochemical mechanisms that could be affected by physical exercise in this population. PURPOSE The purpose of the present study was to examine physiological and biochemical responses to exercise after an 8-week supervised exercise training (ET) intervention in heavy drinkers. The investigation was mainly focused on the relationship among exercise, opioids, the hypothalamic-pituitary-adrenal axis (HPA) activity and heavy alcohol drinking. METHODS Eleven (Age: 30.3±3.5yrs; Body Mass Index: 28.4±0.86kg/m2) male heavy drinkers volunteered to participated in an 8-week supervised intervention of moderate intensity exercise (50-60% of Heart Rate Reserve). All participants were exhibiting low physical activity and used to drink heavily. Before intervention, the participants were asked to record their daily alcohol intake without changing their physical activity levels for 4weeks (control condition). During the 8-week supervised ET intervention, participants were recording their daily alcohol intake and were motivated to increase gradually the duration and frequency of ET. Blood samples were collected prior to and after 4weeks of the control condition, the day before the beginning of the ET intervention, and at the end of the 4th and 8th week of ET intervention. Blood samples were analyzed for β-E, epinephrine, norepinephrine, adrenocorticotropin, cortisol, gamma-glutamyl transferase (γ-GT), aspartate transaminase and alanine transaminase. Physiological and alcohol-related indices were also examined. RESULTS The 8-week supervised ET intervention resulted in reduced alcohol consumption, reduced γ-GT levels, and fitness improvement in heavy drinker. ET intervention did not significantly change the hormonal responses. CONCLUSION The results indicate that physical exercise could act as a healthy habit that can help individuals with AUDs reduce alcohol intake and improve health status; however, this is not related with changes in hormones associated with the HPA-axis.
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Hallgren M, Vancampfort D, Giesen ES, Lundin A, Stubbs B. Exercise as treatment for alcohol use disorders: systematic review and meta-analysis. Br J Sports Med 2017; 51:1058-1064. [PMID: 28087569 DOI: 10.1136/bjsports-2016-096814] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 12/13/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To conduct a systematic review and meta-analysis investigating effects of exercise for people with alcohol use disorders (AUDs) across multiple health outcomes. We also investigated the prevalence and predictors of dropout from exercise studies in AUDs. DESIGN Systematic review and random effects meta-analysis with meta-regression analyses. DATA SOURCES 3 major electronic databases were searched from inception until April 2016 for exercise intervention studies in adults with AUDs. ELIGIBILITY CRITERIA Studies of acute exercise in people with AUDs; and randomised and non-randomised trials examining effects of long-term (≥2 weeks) exercise. RESULTS 21 studies and 1204 unique persons with AUDs (mean age 37.8 years, mean illness duration 4.4 years) were included. Exercise did not reduce daily alcohol consumption (standardised mean difference (SMD) =-0.886, p=0.24), or the Alcohol Use Disorders Identification Test (AUDIT) total scores (SMD=-0.378, p=0.18). For weekly consumption (n=3 studies), a statistically significant difference was observed favouring exercise (SMD=-0.656, p=0.04), but not after adjustment for publication bias (SMD=-0.16, 95% CI -0.88 to 0.55). Exercise significantly reduced depressive symptoms versus control (randomised controlled trials (RCTs) =4; SMD=-0.867, p=0.006, I2=63%) and improved physical fitness (VO2) (RCTs=3; SMD=0.564, p=0.01, I2=46%). The pooled dropout rate was 40.3% (95% CI 23.3% to 60.1%) which was no different to control conditions (OR=0.73, p=0.52). Dropouts were higher among men (β=0.0622, p<0.0001, R2=0.82). LIMITATIONS It was not possible to investigate moderating effects of smoking. CONCLUSIONS Available evidence indicates exercise appears not to reduce alcohol consumption, but has significant improvements in other health outcomes, including depression and physical fitness. Additional long-term controlled studies of exercise for AUDs are required.
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Affiliation(s)
- Mats Hallgren
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.,KU Leuven-University of Leuven, University Psychiatric Centre KU Leuven, Leuven, Belgium
| | - Esther S Giesen
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany
| | - Andreas Lundin
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.,Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Giesen ES, Deimel H, Bloch W. Clinical exercise interventions in alcohol use disorders: a systematic review. J Subst Abuse Treat 2014; 52:1-9. [PMID: 25641736 DOI: 10.1016/j.jsat.2014.12.001] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 11/26/2014] [Accepted: 12/07/2014] [Indexed: 12/20/2022]
Abstract
The therapeutic impact of exercise interventions in psychiatric diseases such as depression, anxiety and schizophrenia has already been proven through several reviews whereas substance use disorders such as alcohol use disorders (AUD) have so far less frequently been a matter of investigation. Although several publications have summarized studies focusing on physical activities in substance use disorders, no systematic review exists summarizing the evidence of exercise interventions in AUD. A total of 14 studies using the Medline Database, CCMed, Cochrane Library and PsychINFO were identified and met the inclusion criteria. In order to evaluate the evidence, we used the evaluation system of the Oxford Centre for Evidence-Based Medicine (2011). Due to methodological flaws the overall evidence of the studies is rated level "3" but primarily findings confirm that exercise interventions as a complementary treatment component in AUD are feasible and safe. No adverse events were reported. This systematic review indicates that exercise may have beneficial effects on certain domains of physical functioning including VO2max, basal heart rate, physical activity level and strength. Inconsistent effects with a slight trend towards a positive effect on anxiety, mood management, craving, and drinking behavior have been shown and need to be verified. Results must be interpreted cautiously due to the numerous methodological flaws and the heterogeneity of the interventions and measures. However, according to preclinical studies several mechanisms of action are conceivable, especially as to alcohol-related outcomes and additionally seem to be promising. RCTs with high methodological quality are urgently needed in future research to establish evidence-based exercise recommendations for the treatment of AUD.
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Affiliation(s)
- Esther S Giesen
- Institute of Cardiovascular Research and Sport Medicine, Department of Molecular and Cellular Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Köln, Germany.
| | - Hubertus Deimel
- Institute of Movement Therapy and Movement-Related Prevention and Rehabilitation, Department of Neurology, Psychosomatic Medicine and Psychiatry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Köln, Germany.
| | - Wilhelm Bloch
- Institute of Cardiovascular Research and Sport Medicine, Department of Molecular and Cellular Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Köln, Germany.
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