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Abstract
This dissertation investigated the effects of exercise training on anxiety symptoms among patients with a chronic illness and symptoms among generalized anxiety disorder (GAD) patients. A systematic review of randomized controlled trials (RCT) of exercise training effects on anxiety symptoms among medical patients showed that, compared with no treatment conditions, exercise training significantly reduced anxiety symptoms by a mean effect of 0.29 (95% confidence interval, 0.23-0.36). Exercise training programs of no more than 12 weeks, using session durations greater than 30 minutes and an anxiety report time frame greater than the past week resulted in the largest anxiety reductions. The findings of the systematic review highlighted the need for well-designed RCTs that use understudied types of exercise, such as resistance exercise training (RET), to investigate exercise training effects on understudied patient groups, particularly anxiety disorder patients.A RCT quantified the effects of six weeks of RET and aerobic exercise training (AET) on remission and worry symptoms among sedentary women with GAD and compared the effects of RET and AET, matched on the body area exercised (legs), total positive work, total time actively engaged in exercise, and weekly progression in load, on other symptoms and signs characteristic of GAD patients. Remission rates were higher among exercise conditions and significantly better in the RET condition compared with a wait list control. Six weeks of exercise training for the RET and AET groups combined significantly reduced worry symptoms, and RET and AET resulted in moderate-to-large improvements in symptoms associated with GAD. Well-designed investigations are needed that: (1) use large sample sizes to compare the effects of exercise training alone to empirically-supported treatments for GAD; (2) compare exercise modes that use different training intensities and durations matched on perceptual responses during exercise to better understand the minimal and optimal dose necessary to improve symptoms; and (3) block randomize patients based upon potential confounding variables including comorbid psychiatric diagnoses. The findings of this dissertation support the efficacy of exercise training as a potential treatment both for (1) GAD and its related symptoms and (2) for anxiety symptoms among patients with a chronic illness.