Summary: A 12-week program of group exercise, performed at either moderate or higher intensity, produced substantial reductions in anxiety symptoms among primary care patients, according to a new randomized trial.
Source: University of Gothenburg
Regular aerobic and strength training, whether performed at moderate or strenuous intensity, significantly reduced anxiety symptoms — even in patients with long-standing anxiety — in a large primary care study led by researchers at the University of Gothenburg.
This randomized controlled trial, published in the Journal of Affective Disorders, analyzed outcomes for 286 adults diagnosed with anxiety syndromes and recruited from primary care centers in Gothenburg and northern Halland County. Participants averaged 39 years of age, 70 percent were women, and roughly half had experienced anxiety for ten years or more.
Participants were randomly assigned to one of three groups: supervised group exercise at moderate intensity, supervised group exercise at higher intensity, or a control group that received standard advice on physical activity in line with public health guidelines. Both exercise programs ran for 12 weeks with sessions three times per week. Compared with the control group, patients in either exercise arm experienced significantly larger reductions in anxiety symptoms.
Most people taking part in the supervised exercise moved from moderate-to-high levels of anxiety at baseline to low anxiety by the end of the 12-week program. After adjusting for relevant factors, the odds of clinically meaningful improvement in anxiety were 3.62 times higher for the moderate-intensity group and 4.88 times higher for the higher-intensity group, relative to the control group. Participants were unaware of the exact training or counseling received by members of other groups.
“There was a clear intensity trend: the greater the training intensity, the better the improvement in anxiety symptoms,” says Malin Henriksson, doctoral student at the Sahlgrenska Academy, specialist in general medicine in the Halland Region, and the study’s first author.
Design and training protocol
This study is among the larger trials to examine exercise specifically for anxiety disorders. Both exercise groups completed 60-minute supervised sessions three times weekly, guided by a physical therapist. Sessions combined aerobic and resistance elements: a warm-up, approximately 45 minutes of circuit-style training across about a dozen stations, and a cooldown with stretching.
Target intensity differed between groups. The moderate-intensity group aimed for roughly 60 percent of estimated maximum heart rate, perceived as light-to-moderate exertion. The higher-intensity group targeted about 75 percent of maximum heart rate, a level experienced as vigorous. Perceived exertion was regularly monitored using the Borg scale and confirmed with heart rate monitors to ensure fidelity to the training targets.
Why new treatment options matter
Current first-line treatments for anxiety typically include cognitive behavioral therapy (CBT) and psychotropic medication. However, psychotropic medicines often produce side effects, and some patients do not respond adequately to drug treatment. Long wait times for CBT in many health systems further limit access to effective care.
Maria Åberg, associate professor at the Sahlgrenska Academy and the study’s corresponding author, emphasizes the practical advantages of an exercise-based intervention: “Primary care clinicians need options that can be individualized, have minimal side effects, and are feasible to offer. A 12-week supervised exercise program — effective at both moderate and higher intensities — represents a treatment that could be more widely implemented in primary care for patients with anxiety.”
About this anxiety and exercise research news
Author: Margareta Gustafsson Kubista
Source: University of Gothenburg
Contact: Margareta Gustafsson Kubista – University of Gothenburg
Image: The image is in the public domain
Original Research: Open access. “Effects of exercise on symptoms of anxiety in primary care patients: A randomized controlled trial” by Maria Åberg et al., Journal of Affective Disorders
Abstract
Effects of exercise on symptoms of anxiety in primary care patients: A randomized controlled trial
Background
High-quality research on exercise interventions for anxiety disorders is limited. This study examined whether a 12-week group exercise program, at different intensities, could reduce anxiety symptoms among patients diagnosed with anxiety syndromes in primary care.
Methods
A total of 286 patients were recruited from Swedish primary care. Symptom severity was self-rated using the Beck Anxiety Inventory (BAI) and the self-rated Montgomery-Åsberg Depression Rating Scale (MADRS-S). Participants were randomized 1:1:1 to one of two supervised group exercise programs (combining cardiorespiratory and resistance training) or to a control group receiving standard non-exercise treatment advice.
Results
Both exercise groups showed greater improvements in anxiety and depressive symptoms compared with the control group. Effect sizes did not differ significantly between the two exercise intensities. Using the mean change in the control group as a reference, adjusted odds ratios for clinically meaningful improvement in anxiety were 3.62 (95% CI 1.34–9.76) after low-intensity training and 4.88 (95% CI 1.66–14.39) after moderate/high-intensity training. For depressive symptoms, the odds ratios were 4.96 (95% CI 1.81–13.6) and 4.36 (95% CI 1.57–12.08), respectively. An intensity trend for anxiety improvement was observed.
Limitations
Outcomes relied on self-report measures, which can lead to under- or overestimation of symptoms.
Conclusions
A 12-week supervised group exercise program was effective in reducing anxiety symptoms among primary care patients with anxiety syndromes. These findings support the inclusion of structured physical exercise as a practical, low-risk treatment option that could be more widely offered in clinical practice for people with anxiety.