Treatment for generalized anxiety disorder through physical exercise: a systematic review

Abstract

Introduction: Physical exercise improves various physical abilities, as well as it can promote improvement in the clinical condition of several diseases, including those related to the central nervous system. In this sense, the objective of this work was to produce a systematic review of the literature to investigate whether exercise is capable of promoting improvement in the clinical condition in human adults diagnosed with generalized anxiety disorder, whether there is a specific physical exercise, as well as whether the intensity of it is related to the improvement in the disease. Methods: Randomized clinical trials published up to May 2019 were searched in online databases (PubMed, Scopus, Web of Science, Cochrane Library, LILACS, OpenGrey and Google Scholar) after developing a PICO statement focused on comparison between adults who received an intervention with the practice of regular, planned and supervised physical exercises, compared with sedentary participants and after verifying their effects in the context of generalized anxiety disorder. The search and data extraction were performed following the guidelines of the PRISMA manuscript writing guide. Quality assessment and risk of bias were analyzed following the Cochrane – RoB 2.0 protocol. Results: A total of 4694 reference articles were retrieved/searched, while only six were considered eligible for the present review. Most articles showed a reduction in generalized anxiety disorder from an intervention with physical, aerobic and anaerobic exercises of moderate intensity. However, in the risk of bias analysis, all articles showed some concerns regarding the reported evidence. Conclusion: Physical exercise is a potential tool for reducing generalized anxiety disorder, and moderate exercise intensity is directly related to an improvement in the clinical condition of the disease, regardless of the type: aerobic or anaerobic. However, it is important that further research seek to investigate the physiological and neuroendocrine mechanisms related to such improvement. Keywords: Physical exercise, Anxiety, Systematic review.