Exercise as adjunctive treatment for alcohol use disorder: A randomized controlled trial.

Kirsten K Roessler, Randi Bilberg, Anette Søgaard Nielsen, Kurt Jensen, Claus Thorn Ekstrøm, Sengül Sari

Journal: PloS one 2017;12(10):e0186076

PMID: 29049336

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Plain Language Summary

Treating alcohol-use disorder (AUD) is challenging and multi-faceted thus many analyses suggest the effectiveness of interventions be low. Recent evidence suggests exercise may be a promising addition to intervention in both reducing consumption as well as the co-morbidities linked with AUD. The aim of this study was to evaluate the efficacy of physical activity as an adjunct to outpatient alcohol treatment on alcohol consumption in 100 patients. Participants were allocated to one of three arms: treatment, treatment with group exercise or treatment with individual exercise, and alcohol intake was measured at six and 12 months after treatment initiation. This study demonstrated that there is no significant effect of physical activity on alcohol consumption, however moderate physical activity was seen to be protective against excessive drinking following treatment. Based on this study as well as the Health Lifestyle Study, the authors support the need for implementing physically active lifestyles for patients in treatment.

Abstract

AIMS

To examine whether physical activity as an adjunct to outpatient alcohol treatment has an effect on alcohol consumption following participation in an exercise intervention of six months' duration, and at 12 months after treatment initiation.

METHODS

The study is a randomized controlled study with three arms: Patients allocated to (A) treatment as usual, (B) treatment as usual and supervised group exercise, (C) treatment as usual and individual physical exercise. The primary outcome measure was excessive drinking six months after treatment start and completion of the intervention. A logistic regression model was used to evaluate the odds of excessive drinking among the three groups, based on intention-to-treat. Changes in level of physical activity in all three groups were tested by using a generalized linear mixed model. A multiple linear model was used to test if there was an association between amount of performed physical activity and alcohol consumption.

RESULTS

A total of 175 patients (68.6% male) participated. Response rates were 77.7% at six months and 57.1% at 12 months follow-up. OR 0.99 [95% CI: 0.46; 2.14], p = 0.976 for excessive drinking in the group exercise condition, and 1.02 [95% CI: 0.47; 2.18], p = 0.968 in the individual exercise condition, which, when compared to the control group as reference, did not differ statistically significantly. Participants with moderate level physical activity had lower odds for excessive drinking OR = 0.12 [0.05; 0.31], p<0.001 than participants with low level physical activity. Amount of alcohol consumption in the intervention groups decreased by 4% [95% CI: 0.03; 6.8], p = 0.015 for each increased exercising day.

CONCLUSIONS

No direct effect of physical exercise on drinking outcome was found. Moderate level physical activity was protective against excessive drinking following treatment. A dose-response effect of exercise on drinking outcome supports the need for implementing physically active lifestyles for patients in treatment for alcohol use disorder.

Address: Department of Psychology, University of Southern Denmark, Odense M, Denmark.; Unit of Clinical Alcohol Research, Clinical Institute, University of Southern Denmark, Odense C, Denmark.; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark.; Department of Biostatistics, University of Copenhagen, Copenhagen K, Denmark.

DOI: 10.1371/journal.pone.0186076