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Exercise as Treatment for Anxiety: Systematic Review and Analysis
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BACKGROUND: Exercise has been shown to reduce symptoms of anxiety, but few studies have studied exercise in individuals preselected because of their high anxiety. PURPOSE: The objective of this study is to review and critically evaluate studies of exercise training in adults with either high levels of anxiety or an anxiety disorder. METHODS: We conducted a systematic review of randomized clinical trials (RCTs) in which anxious adults were randomized to an exercise or nonexercise control condition. Data were extracted concerning anxiety outcomes and study design. Existing meta-analyses were also reviewed. RESULTS: Evidence from 12 RCTs suggested benefits of exercise, for select groups, similar to established treatments and greater than placebo. However, most studies had significant methodological limitations, including small sample sizes, concurrent therapies, and inadequate assessment of adherence and fitness levels. CONCLUSIONS: Exercise may be a useful treatment for anxiety, but lack of data from rigorous, methodologically sound RCTs precludes any definitive conclusions about its effectiveness.
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“Rodriguez-Ayllon et al. (2019) and Stonerock et al. (2015) reported beneficial but heterogeneous effects of physical activity on psychological well-being”
From Anxiety, Academic Performance, and Physical Activity in University Students: A Scoping Review (2025) · cites this paper as Stonerock et al. (2015)
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Consistent with previous reviews (Rodriguez-Ayllon et al., 2019; Stonerock et al., 2015), methodological shortcomings such as non-random sampling, lack of control groups, and unvalidated measurement tools remain barriers to drawing definitive conclusions.”
From Anxiety, Academic Performance, and Physical Activity in University Students: A Scoping Review (2025) · cites this paper as Stonerock et al., 2015
Experimental — accuracy not yet measuredIn the citing paper
“Exercise may therefore incorporate gradual exposure with response prevention in the context of training, similar to conventional psychotherapy paradigms using desensitization techniques through gradual exposure (80–82).”
From The Role of Exercise in Management of Mental Health Disorders: An Integrative Review (2021) · cites this paper as [82]
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The cerebellum tells the amygdala, “Nothing diminishes anxiety faster than action”
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Metadata
- Authors
- Stonerock, G. L., Hoffman, B. M., Smith, P. J., & Blumenthal, J. A.
- Affiliations
- Duke University (US)
- Corresponding author
- Stonerock, Gregory L.
- Venue
- Annals of Behavioral Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-02-20
- Volume
- 49
- Issue
- 4
- Pages
- 542-556
- ISSN
- 0742-5554 (ISSN-L)
- 0883-6612
- 1532-4796
- PMC
- PMC4498975
- OpenAlex
- W2028247430
- Cited by
- 363
- References
- 127
- Citations by year
- 2026: 19 · 2025: 38 · 2024: 38 · 2023: 48 · 2022: 38 · 2021: 45 · 2020: 46 · 2019: 26 · 2018: 25 · 2017: 19 · 2016: 12 · 2015: 8
- FWCI
- 2.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Heart, Lung, and Blood Institute (R01HL093374, HL080664-01, R01HL080664)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- exercise training, anxiety disorders, anxiety symptoms, exercise therapy, methodological limitations, exercise adherence, physical fitness
- MeSH terms
- Anxiety, Anxiety Disorders, Combined Modality Therapy, Exercise Therapy, Humans
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