data relating to the latter two elements yieldedno ﬁrm conclusions, but the meta-analysis didsuggest that the greatest improvements indepression were found after 17 weeks of exercise (albeit that e
ects were found fromfour weeks onwards). Likewise, it was sug-gested that the greater the number of exercisesessions the greater the decrease in depression.A recent narrative review
has criticised themeta-analysis of North
on methodologicaland interpretative grounds, urging that theirconclusions and recommendations should beviewed with caution. In contrast, Morgan
issympathetic towards a monograph reviewingthe psychological e
ects of aerobic ﬁtnesstraining.
Paradoxically, many of the conclu-sions of both studies are identical, in thatdepression was reduced after aerobic exercisefor men and women, all adult age groups,across survey and experimental studies, andthe e
ects were greatest among clinical sam-ples.Finally, a recent paper by Nicolo
attempts to integrate current re-search with a view to providing physicians withpractical guidelines for exercise prescription asan adjunct to other forms of psychotherapy.Despite acknowledging that no research basedguidelines exist for recommending exercisetype, frequency, intensity, and duration, theauthors invoke prescriptions suggested byHill
which basically concur with thoseproposed by the ACSM.
Such programmesadvocate aerobic exercise conducted at 60– 70% of maximal heart rate,for 30–40 minutes,twice to ﬁve times a week.In conclusion, on the basis of existing litera-ture, it seems safe to accept that physical exer-cise regimens will have a positive inﬂuence ondepression, with the most powerful e
ectsnoted among clinical populations. Limited evi-dence would also suggest that aerobic exerciseis most e
ective, including activities such aswalking, jogging, cycling, light circuit training,and weight training,and that regimens extend-ing over several months appear to yield themost positive e
To date, there have been over 30 publishedreviews dealing with the anxiolytic e
ects of exercise and physical activity. One review
concludes that regardless of anxiety measurestaken (trait or state, behavioural, self report,physiological), or exercise regimen invoked(acute
chronic),the results point to a consist-ent link between exercise and anxiety reduc-tion. Furthermore, a meta-analysis
speciﬁ-cally examining studies that distinguishbetween those who are coping with stress andthose who are not concluded that aerobic exer-cise training programmes were e
ective inreducing anxiety, particularly among thoseexperiencing chronic work stress. Their overalle
ect sizes were comparable with those foundby other meta-analyses of the exercise-stressliterature, as well as other forms of psycho-therapy used to reduce anxiety.
hasrefutedcriticismsof earlier studies that imply that anxiety reductionafter exercise represents no more than amethodological artefact
; instead, the e
ectdoes appear to be real and substantial.At the same time, explicating the variablesthat mediate the relation between exercise andanxiety reduction has proved problematic, atask made doubly di
cult because so few stud-ies specify levels of intensity, duration, and/orlength of exercise programme. To date, it canbe inferred that most research studies haveinvolved aerobic exercise, with the few studiesexamining non-aerobic activities—for exam-ple, strength/ﬂexibility training—actuallyshowing slight increases in anxiety. Althoughfurther research is obviously needed, it doesappear that aerobic activity is more beneﬁcialfor anxiety reduction.No consensus of opinion emerges fromexisting reviews and meta-analyses on the levelof exercise intensity and its duration. Forexample, Landers and Petruzzello
reportconﬂicting results from a large number of stud-ies. Some suggest low intensity exercise (walk-ing, jogging at 40–50% of maximal heart rate),while others argue that moderately intensiveexercise (50–60% of maximum heart rate) isbetter, and yet others argue that high intensityactivity (70–75% of maximum heart rate) ismost beneﬁcial.
Given this lack of consensus,a sensible compromise position in relation toprescription appears to be that originallyproposed by Franks and Jette.
That is, for theindividual to work with an adjustable level of intensity,chosen by him/herself in consultationwith a physician. This solution is especiallyattractive in the light of the goal settingliterature which argues that self selected goalsreceive greater commitment from the partici-pant.The duration of individual training sessionshas been considered across individual studies,with somewhat surprising results.According torecent research,even a single,ﬁve minute exer-cise bout may be su
cient to induce ananxiolytic e
31 35 37
In terms of the length of training programmes, both clinical and non-clinical studies have shown that the largestanxiolytic e
ects are noted when programmeshave run from 10 to 15 weeks or even longer,with smaller e
ects observed for programmeslasting less than nine weeks.In conclusion, the literature unequivocallysupports the positive e
ects of exercise onanxiety, with short bursts of exercise appearingto be su
cient, and, in addition, the nature of the exercise does not appear to be crucial. Aswith depression, the most positive e
ects arenoted among those who adhere to programmesfor several months.
A related literature has considered how exer-cise may protect against stress, althoughwhether this should be regarded as psychologi-cal or physiological research is questionable.This aside, the available research suggests thatincreases in physical condition or improved ﬁt-ness are likely to facilitate the individual’scapacity for dealing with stress. In reviewingthis work,
a distinction has been made
Exercise and psychological well being