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

Vancampfort, Davy and Sánchez, Carlos P. R. and Hallgren, Mats and Schuch, Felipe B. and Firth, Joseph and Rosenbaum, Simon and Van Damme, Tine and Stubbs, Brendon (2021) Dropout from exercise randomized controlled trials among people with anxiety and stress-related disorders: A meta-analysis and meta-regression. Journal of Affective Disorders, 282. pp. 996-1004. ISSN 1573-2517

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Official URL: https://doi.org/10.1016/j.jad.2021.01.003

Abstract

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, I2 = 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.

Item Type: Journal Article
Keywords: Anxiety, Dropout, Exercise, Physical activity, PTSD, Stress
Faculty: Faculty of Health, Education, Medicine & Social Care
Depositing User: Lisa Blanshard
Date Deposited: 18 Mar 2021 11:39
Last Modified: 21 Apr 2021 15:26
URI: https://arro.anglia.ac.uk/id/eprint/706424

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