title: Exercise as treatment for alcohol use disorders: systematic review and meta-analysis.
abstract: OBJECTIVE
  To conduct a systematic review and meta-analysis investigating effects of exercise for people with alcohol use disorders (AUDs) across multiple health outcomes. We also investigated the prevalence and predictors of dropout from exercise studies in AUDs.
  
  
  METHODS
  Systematic review and random effects meta-analysis with meta-regression analyses.
  
  
  METHODS
  3 major electronic databases were searched from inception until April 2016 for exercise intervention studies in adults with AUDs.
  
  
  METHODS
  Studies of acute exercise in people with AUDs; and randomised and non-randomised trials examining effects of long-term (≥2 weeks) exercise.
  
  
  RESULTS
  21 studies and 1204 unique persons with AUDs (mean age 37.8 years, mean illness duration 4.4 years) were included. Exercise did not reduce daily alcohol consumption (standardised mean difference (SMD) =-0.886, p=0.24), or the Alcohol Use Disorders Identification Test (AUDIT) total scores (SMD=-0.378, p=0.18). For weekly consumption (n=3 studies), a statistically significant difference was observed favouring exercise (SMD=-0.656, p=0.04), but not after adjustment for publication bias (SMD=-0.16, 95% CI -0.88 to 0.55). Exercise significantly reduced depressive symptoms versus control (randomised controlled trials (RCTs) =4; SMD=-0.867, p=0.006, I2=63%) and improved physical fitness (VO2) (RCTs=3; SMD=0.564, p=0.01, I2=46%). The pooled dropout rate was 40.3% (95% CI 23.3% to 60.1%) which was no different to control conditions (OR=0.73, p=0.52). Dropouts were higher among men (β=0.0622, p<0.0001, R2=0.82).
  
  
  CONCLUSIONS
  It was not possible to investigate moderating effects of smoking.
  
  
  CONCLUSIONS
  Available evidence indicates exercise appears not to reduce alcohol consumption, but has significant improvements in other health outcomes, including depression and physical fitness. Additional long-term controlled studies of exercise for AUDs are required.
authors.affiliation: Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Hallgren
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.|KU Leuven-University of Leuven, University Psychiatric Centre KU Leuven, Leuven, Belgium.
authors.forename: Davy
authors.initials: D
authors.lastname: Vancampfort
authors.affiliation: Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany.
authors.forename: Esther S
authors.initials: ES
authors.lastname: Giesen
authors.affiliation: Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Lundin
authors.affiliation: Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.|Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
mesh_terms: D000428:Alcohol Drinking; D019973:Alcohol-Related Disorders / Q000628:therapy*; D003863:Depression / Q000628:therapy; D005081:Exercise Therapy; D006801:Humans; D010352:Patient Dropouts; D010809:Physical Fitness; D016032:Randomized Controlled Trials as Topic
keywords: Anxiety; Depression; Exercise; Fitness; Physical activity