title: Randomized Controlled Trial Comparing Exercise to Health Education for Stimulant Use Disorder: Results From the CTN-0037 STimulant Reduction Intervention Using Dosed Exercise (STRIDE) Study.
abstract: OBJECTIVE
  To evaluate exercise as a treatment for stimulant use disorders.
  
  
  METHODS
  The STimulant Reduction Intervention using Dosed Exercise (STRIDE) study was a randomized clinical trial conducted in 9 residential addiction treatment programs across the United States from July 2010 to February 2013. Of 497 adults referred to the study, 302 met all eligibility criteria, including DSM-IV criteria for stimulant abuse and/or dependence, and were randomized to either a dosed exercise intervention (Exercise) or a health education intervention (Health Education) control, both augmenting treatment as usual and conducted thrice weekly for 12 weeks. The primary outcome of percent stimulant abstinent days during study weeks 4 to 12 was estimated using a novel algorithm adjustment incorporating self-reported Timeline Followback (TLFB) stimulant use and urine drug screen (UDS) data.
  
  
  RESULTS
  Mean percent of abstinent days based on TLFB was 90.8% (SD = 16.4%) for Exercise and 91.6% (SD = 14.7%) for Health Education participants. Percent of abstinent days using the eliminate contradiction (ELCON) algorithm was 75.6% (SD = 27.4%) for Exercise and 77.3% (SD = 25.1%) for Health Education. The primary intent-to-treat analysis, using a mixed model controlling for site and the ELCON algorithm, produced no treatment effect (P = .60). In post hoc analyses controlling for treatment adherence and baseline stimulant use, Exercise participants had a 4.8% higher abstinence rate (78.7%) compared to Health Education participants (73.9%) (P = .03, number needed to treat = 7.2).
  
  
  CONCLUSIONS
  The primary analysis indicated no significant difference between exercise and health education. Adjustment for intervention adherence showed modestly but significantly higher percent of abstinent days in the exercise group, suggesting that exercise may improve outcomes for stimulant users who have better adherence to an exercise dose.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier: NCT01141608.
authors.affiliation: Center for Depression Research and Clinical Care, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9119. Madhukar.Trivedi@utsouthwestern.edu.|Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Madhukar H
authors.initials: MH
authors.lastname: Trivedi
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Greer
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Chad D
authors.initials: CD
authors.lastname: Rethorst
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Carmody
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Grannemann
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Robrina
authors.initials: R
authors.lastname: Walker
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Warden
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Kathy
authors.initials: K
authors.lastname: Shores-Wilson
authors.affiliation: Department of Public Health Services, University of Miami, Miami, Florida, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Stoutenberg
authors.affiliation: The EMMES Corporation, Rockville, Maryland, USA.
authors.forename: Neal
authors.initials: N
authors.lastname: Oden
authors.affiliation: Arapahoe House, Denver, Colorado, USA.
authors.forename: Meredith
authors.initials: M
authors.lastname: Silverstein
authors.affiliation: Gateway Community Services, Jacksonville, Florida, USA.
authors.forename: Candace
authors.initials: C
authors.lastname: Hodgkins
authors.affiliation: Gibson Recovery Center, Cape Girardeau, Missouri, USA.
authors.forename: Lee
authors.initials: L
authors.lastname: Love
authors.affiliation: Nexus Recovery Center, Dallas, Texas, USA.
authors.forename: Cindy
authors.initials: C
authors.lastname: Seamans
authors.affiliation: Department of Family and Community Medicine, University of Texas Health Science Center at Houston, Texas, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Stotts
authors.affiliation: Morris Village Alcohol and Drug Addiction Treatment Center, Columbia, South Carolina, USA.
authors.forename: Trey
authors.initials: T
authors.lastname: Causey
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Regina P
authors.initials: RP
authors.lastname: Szucs-Reed
authors.affiliation: St Luke's-Roosevelt Hospital, New York, New York, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Rinaldi
authors.affiliation: Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA.
authors.forename: Hugh
authors.initials: H
authors.lastname: Myrick
authors.affiliation: National Institutes of Health, National Institute on Drug Abuse, Bethesda, Maryland, USA.
authors.forename: Michele
authors.initials: M
authors.lastname: Straus
authors.affiliation: National Institutes of Health, National Institute on Drug Abuse, Bethesda, Maryland, USA.
authors.forename: David
authors.initials: D
authors.lastname: Liu
authors.affiliation: The EMMES Corporation, Rockville, Maryland, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Lindblad
authors.affiliation: Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Church
authors.affiliation: Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
authors.forename: Steven N
authors.initials: SN
authors.lastname: Blair
authors.affiliation: Department of Psychiatry, Columbia University Medical Center, New York, New York, USA.
authors.forename: Edward V
authors.initials: EV
authors.lastname: Nunes
mesh_terms: D000328:Adult; D000697:Central Nervous System Stimulants / Q000494:pharmacology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods / Q000523:psychology; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants