KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; University Psychiatric Center KU Leuven, Leuven, Kortenberg, Belgium.
KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.
J Affect Disord. 2021 Mar 1;282:996-1004. doi: 10.1016/j.jad.2021.01.003. Epub 2021 Jan 6.
. 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.
. 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.
. 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, I = 0%; N=16).
. Potentially important moderators of dropout, such as the severity of mental health symptoms and illness duration were insufficiently available.
. 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.
运动已被证实对焦虑和应激相关障碍患者有效。随机对照试验（RCT）的脱落率对证据的有效性构成威胁，不同研究的脱落率差异很大。我们进行了一项荟萃分析，以调查参加运动 RCT 的焦虑和应激相关障碍成年人的脱落率的发生率和预测因素。
两位作者搜索了截至 2020 年 7 月的主要电子数据库。我们纳入了报告脱落率的针对焦虑和应激相关障碍患者的运动干预 RCT。进行了随机效应荟萃分析和荟萃回归。
共纳入 14 项 RCT，涉及 16 项运动干预（n=369，平均年龄 20.7 至 67.7 岁；38.4%为男性）。所有研究的脱落率经修剪和填充调整后为 22.4%（95%CI=15.0%至 32.0%）。应用控制动机策略（P<0.001）可预测更高的脱落率。在所有治疗期间由运动处方专家进行监督和应用自主动机策略可预测较低的脱落率（均 P<0.001）。运动组与对照组的脱落率相似（OR=0.84，95%CI=0.54 至 1.29，p=0.42，I=0%；N=16）。
脱落的潜在重要调节因素，如心理健康症状的严重程度和疾病持续时间，尚不够充分。
运动对焦虑和应激相关障碍患者耐受良好，RCT 中的脱落率与对照组相似。因此，运动是一种可行的治疗方法，特别是当应用自主动机策略和由具有运动处方专业知识的医疗保健专业人员提供干预措施时。
