Physical exercise to improve mental health outcomes and quality of life

Physical exercise for substance use disorders patients (both aereobic programs and body–mind activities such as tai chi, yoga, or qigong) was found in a systematic review with meta-analysis (Giménez-Meseguer et al., 2020, 59 studies) to be effective in:

• improving stress (SMD = 1.11 (CI: 0.31, 1.91); z = 2.73; p = 0.006)
• anxiety (SMD = 0.50 (CI: 0.16, 0.84); z = 2.88;p = 0.004) 
• depression (SMD = 0.63 (CI: 0.34, 0.92); z = 4.31; p < 0.0001).

All the studies included resulted in improvements in physical conditions expressed in terms of VO2, heart rate or performance in indirect tests that measure aerobic capacity.

When comparing the effects of aerobic-strength exercise with oriental practices, no relevant differences were found about the overall value of quality of life and mental health.

The results also showed a trend towards a positive effect on craving (SMD = 0.89 (CI: -0.05, 1.82); z = 1.85, p = 0.06) but not statistically significant.

Another systematic review with meta-analysis (Liu et al., 2020, 7 studies, N = 772) investigated specifically the effects of tai chi and Qigong exercise and found the latter (Qigong) effective in:

• improving anxiety compared to that of medication (SMD = -1.12[− 1.47, − 0.78]), and no treatment control (SMD = -0.52[− 0.77, − 0.27]).

The effect of Tai Chi was comparable to treatment as usual (TAU) on depression (standardized mean difference (SMD) = − 0.17[− 0.52, 0.17]).

The role of physical activity in opioid substitution therapy was assessed in a narrative systematic review (Alpers et al., 2022) and results confirmed that:

• physical activity has beneficial effects on physical fitness and mental health for patients in opioid substitution therapy