Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000, South Africa.
Addict Sci Clin Pract. 2018 Jan 16;13(1):4. doi: 10.1186/s13722-018-0106-4.
Methamphetamine (MA) is a highly addictive psychostimulant used by approximately 52 million people worldwide. Chronic MA abuse leads to detrimental physiological and neurological changes, as well as increases in anxiety and depression, and decreases in overall fitness and quality of life. Exercise has been reported to possibly reverse physiological and neurological damage caused by previous MA use, and to reduce anxiety and depression in this population. The aim of this systematic review was to identify, clinically appraise and synthesise the available evidence for the effectiveness of exercise, compared to cognitive behavioural therapy (CBT), standard care or no intervention, on decreasing anxiety and depression and improving fitness and quality of life in previous MA users.
Seven computerised databases were searched from inception to May 2017, namely Scopus, Cochrane Library, PubMed/MEDLINE, PEDro, CINAHL, and ScienceDirect. Search terms included exercise, methamphetamine, fitness measures, depression, anxiety and quality of life. Randomised and non-randomised controlled- or clinical trials and pilot studies, published in English, were considered for inclusion. Methodological quality was critically appraised according to the PEDro scale. Heterogeneity across studies regarding control groups and assessment intervals rendered meta analyses inappropriate for this review and results were thus described narratively using text and tables.
Two hundred and fifty-one titles were identified following the initial search, and 14 potentially-relevant titles were selected and the abstracts reviewed. Three studies (two randomised controlled trials and one quasi-experimental pilot) were included, with an average PEDro score of 6.66. Exercise resulted in significantly lower depression and anxiety scores versus CBT (p = 0.001). Balance also significantly improved following exercise versus standard care (p < 0.001); as did vital capacity, hand-grip and one-leg stand with eyes closed. There were significant changes in all subdivisions of the Quality of Life Scale Questionnaire (p < 0.05), except psychology (p = 0.227).
Level II evidence suggests that exercise is effective in reducing anxiety and depression and improving fitness in previous MA users, and Level III-2 evidence suggests that exercise is beneficial for improving quality of life in this population. Overall recovery in previous MA dependents might be significantly enhanced by including exercise in the rehabilitation process. Further research is required to strengthen these conclusions and to inform policy and health systems effectively.
甲基苯丙胺（MA）是一种高度成瘾的兴奋剂，全世界约有 5200 万人使用。慢性 MA 滥用会导致身体和神经的有害变化，以及焦虑和抑郁的增加，以及整体健康和生活质量的下降。有报道称，运动可能会逆转以前 MA 使用引起的身体和神经损伤，并降低该人群的焦虑和抑郁。本系统评价的目的是确定、临床评估和综合现有证据，比较运动与认知行为疗法（CBT）、标准护理或无干预相比，在降低以前 MA 使用者的焦虑和抑郁、提高健康和生活质量方面的有效性。
从 2017 年 5 月开始，对七个计算机数据库（Scopus、Cochrane 图书馆、PubMed/MEDLINE、PEDro、CINAHL 和 ScienceDirect）进行了搜索。搜索词包括运动、甲基苯丙胺、健身措施、抑郁、焦虑和生活质量。纳入了发表在英语中的随机和非随机对照或临床试验和试点研究。根据 PEDro 量表对方法学质量进行了严格评估。由于研究之间的对照组和评估间隔存在异质性，因此不适合进行荟萃分析，结果使用文字和表格进行叙述性描述。
初步搜索后确定了 251 个标题，选择了 14 个潜在相关标题并审查了摘要。纳入了三项研究（两项随机对照试验和一项准实验性试点研究），PEDro 评分为 6.66。与 CBT 相比，运动可显著降低抑郁和焦虑评分（p=0.001）。与标准护理相比，平衡也显著改善（p<0.001）；握力和闭眼单腿站立也有显著改善。生活质量量表问卷的所有分项都有显著变化（p<0.05），除了心理学分项（p=0.227）。
二级证据表明，运动可有效降低以前 MA 使用者的焦虑和抑郁，提高健康水平，三级证据表明，运动可改善该人群的生活质量。通过在康复过程中纳入运动，以前的 MA 依赖者的整体康复可能会得到显著增强。需要进一步研究来加强这些结论，并为政策和卫生系统提供有效信息。
