How much exercise, how often, and for how long
FUNDING: Humanities and Social Science Fund of Ministry of Education of China
Background
Exercise relieves anxiety — this study clarifies the dose.
The Study
Twenty-seven randomized trials with 1,447 participants were included — roughly half with comorbid chronic illness (heart disease, diabetes, cancer, renal failure) and half without. All studies compared an exercise intervention to a non-exercise control. Exercise types varied widely: aerobic, resistance, yoga, tai chi, qigong.
The overall effect was moderate (effect size, Cohen’s d = 0.42). Patients without chronic illness responded better (d = 0.48) than those with chronic illness (d = 0.29).
Across both groups, programs under 12 weeks outperformed longer ones. For patients without chronic illness, three sessions per week of more than 60 minutes each was optimal. For those with chronic illness, shorter sessions of 45–60 minutes but more frequent — more than three times per week — worked best.
In both groups, at least 180 minutes of weekly exercise was the target (similar to the 130-180 minutes/week target for depression).
Practice Implications
- For your patient without chronic illness: three sessions per week, each over an hour, totaling more than 180 minutes weekly.
- For your patient with chronic medical illness: shorter sessions of 45–60 minutes but more than three times per week — the higher frequency compensates for what they can’t sustain in duration.
- Find creative ways to exercise, like brisk walking, dance, e-sports, and washing the car.
- Check these medical risks before starting exercise, and warm up before the routine
- Write it like a prescription.
— Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
What’s Your Take? Share in Comments
- How do you help patients get started with exercise?
