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The Effects Of Ecologically-Valid Resistance Exercise Training Among Young Adults With Analogue Generalized Anxiety Disorder

PURPOSE: This randomized controlled trial examined the effects of eight weeks of ecologically-valid resistance exercise training (RET) compared to wait-list control among 27 young adults (26.6±4.5y; 18 female) with analogue Generalized Anxiety Disorder (AGAD; Psychiatric Diagnostic Screening Questionnaire GAD subscale ≥6 and Penn State Worry Questionnaire ≥45). METHODS: Fully supervised, ecologically-valid, one-on-one RET sessions designed according to World Health Organization (WHO) and American College of Sports Medicine (ACSM) guidelines, consisting of 2 sets of 8-12 repetitions of eight exercises, were delivered twice weekly, after a 3 week familiarization. Rating of perceived exertion (RPE) and muscle soreness (110) were assessed after each exercise. The primary outcome, remission based on change in AGAD status, was assessed post-intervention, and quantified with number needed to treat (NNT). Worry and anxiety symptoms were assessed at baseline, week 1, week 4, and post-intervention. Independent samples t-tests examined baseline differences between conditions. Paired sample ttests examined changes in 5RM strength. RM-ANOVAs examined differences between RET and wait-list across time. Significant interactions were decomposed with simple effects analysis. Hedges‘ d effect sizes (95%CI) quantified the magnitude of the difference in change between groups across time. RESULTS: There were no baseline differences between conditions. Attendance was 81%, and compliance was 77% (average RPE=14.41±1.58, muscle soreness=4.40±1.70). Participants significantly increased strength (t=6.86, p<0.001, d=1.24). RET improved AGAD status (NNT=3, 95%CI: 2 17). A significant condition-time interaction was found for worry (F(3,66)=3.12, p≤0.043, d=0.93 [0.13 1.73]), and anxiety symptoms (F(3,66)=2.91, p≤0.046, d=0.71 [-0.08 1.49]) . RET significantly reduced worry (mean difference=-6.49, p≤0.045) and anxiety symptoms (mean difference=-10.50, p≤0.001). CONCLUSIONS: Ecologically-valid RET, designed according to WHO and ACSM guidelines, improved AGAD status, and elicited large magnitude reductions in worry and anxiety symptoms among young adults with AGAD. This is the first ecologically-valid RET intervention among young adults with clinically relevant anxiety pathology.