Table 2.

Studies investigating EX in the therapy of alcohol abuse/dependence.

First author, year	Sample characteristics	Study design, standard therapy	Exercise intervention (EX)	Control condition(s)	Outcome variables and findings Exercise > control condition	Comments
Gary and Guthrie (1972) [28]	- N = 20 - alcohol-dependent patients (m) - Ethnicity not reported	- Inpatient alcohol rehab treatment - Group therapy, recreation programs - Duration and type of therapy not reported - Random assignment to EX or Control	- Duration: 4 weeks - 5 times/week - Incremental running program (1 mile/training day)	- Standard care - (Group therapy, recreation programs)	- No effects with regard to drinking episodes notices by staff	- Small N - Lack of equal contact time control - Duration and type of therapy not reported - No direct alcohol-related outcomes reported - No follow-up data reported
					(no other alcohol-related outcomes reported) - Significant gains in cardiovascular fitness and self-cathexis scale, Significantly reduced sleep disturbances
Frankel and Murphy (1974) [29]	- N = 214 - alcohol-dependent patients (m) - Ethnicity not reported	- Inpatient alcohol rehab treatment - Group psycho-therapy, physical fitness program, work assignment, education, family counseling, individual therapy - Duration: 12 weeks	- Duration: 12 weeks - 5 times/week, 1 h each - Warm-up, individual strengthening activities, 20 m in of cardiovascular training (group walk or run)	None	- No alcohol-related outcomes reported - significant gains in cardiovascular fitness, reductions in self-reported depression and paranoia	- One-sample pre-post comparison - Lack of control condition to control for general treatment/recovery effects - No alcohol-related outcomes reported - No follow-up data reported
Sinyor et al. (1982) [30]	- N = 58 - patients (m, f) (diagnoses not reported) - Ethnicity not reported	- Inpatient alcohol rehab treatment - Daily group therapy led by abstinent alcoholics - Type of therapy not reported Duration: 6 weeks	- Duration: 6 weeks - 5 times/week, 1 h each - Stretching, calisthenics, muscle-strengthening EX, running or cross-country skiing	- Control group with standard care in different therapy center	- At 3-month followup, significantly higher abstinence rates (self- report, validated by family members or colleagues) - Significant fitness gains	- Comparison of patients from different study centers (effects of patient or treatment characteristics interfering with effects of EX) - Lack of randomization
Weber  (1984) [31]	- N = 46 - alcohol-dependent patients (m) - Ethnicity not reported	- Inpatient alcohol rehab treatment - Type of therapy not reported - Duration: 4 months - Randomized assignment to treatment group	- Duration: 4 months - 3 times/week - Running with increasing intensity and duration (individually adjusted)	- Standard therapy (type not reported)	- No alcohol-related outcomes reported - Significant training effects: almost all patients were able to run ≥ 1 h at the end of treatment - Significantly stronger reductions of stress (self-developed scale), nonsignificant improvements regarding state anxiety (STAI), depression, psychosomatic symptoms, coping, well-being	- Small N - Lack of equal contact time control - No alcohol-related outcomes reported - Lack of intention-to-treat analysis to correct for high dropout rate (only 26/46 patients included in analyses) - No follow-up data reported
Murphy et al. (1986) [32]	- N = 48 - students (m) classified as “heavy social drinkers” - Ethnicity not reported	- Daily journals recording 15 different variables - Duration: 16 weeks: 2 weeks baseline, 8 weeks intervention, 6 weeks followup - Randomized assignment to condition	- Duration: 8 weeks - 3 times/week (+ instruction to train at least one time/week on their own) - 30 min of running at individual intensity	- Control 1: standard intervention (daily journals) - Control 2:3 times/week supervised meditation	- Significantly stronger reduction in alcohol consumption during treatment phase (also trendwise during followup) - Only alcohol consumption on weekdays affected, not on weekends - Significant fitness gains	- Small N - Subjects without clinical diagnosis of alcohol abuse/dependence - Only self-report of drinking behavior - Drinking behavior uncorrelated with fitness gains → general lifestyle modification? - Subjects with high treatment compliance from control 2 improved as much as subjects in EX group
Palmer et al. (1988) [33]	- N = 27 - “alcoholic patients” (m, f) (diagnoses not reported) - Predominantly white sample (92%)	- Inpatient alcohol rehab treatment (influenced by AA philosophy) - Duration: 4 weeks	- Duration: 4 weeks - 3 times/week - 20–30 min Walking/running at 60–80% maximum HR	- Standard care without EX (time-staggered)	- No alcohol-related outcomes reported - No fitness gains in EX group - Significantly lower anxiety and depression in EX group at the end of treatment	- Small N - Lack of equal contact time control - EX duration too short to improve fitness - No alcohol-related outcomes reported - No follow-up data reported
Donaghy (1997) [34]	- N = 165 “alcoholic patients” (m, f) - (diagnoses not reported) - Ethnicity not reported	- Multicenter study: inpatient and outpatient treatment programs of different kinds and durations	- Duration: 3 weeks supervised EX, followed by 12 weeks home-based EX - 3 times/week - 30 min of aerobic and muscle-strengthening training following ACSM guidelines	- Duration: 3 weeks of supervised gentle stretching and breathing exercises, followed by 12 weeks home-based training - 3 times/week, 30 min each	- No significant differences in abstinence rates - Significant higher improvement in power, fitness, body self-perception, and self-esteem after 15 weeks - Power and fitness gains maintained at 5-month followup - No differences in body weight and resting pulse - Anxiety and depression equally reduced in both groups	- Diagnoses and type of therapy not reported - Lack of intention-to-treat analysis to correct for high number of dropouts at followup
Ermalinski et al. (1997) [35]	- N = 90 - veterans (m) - Ethnicity not reported	- Inpatient alcohol rehab treatment - daily group psychotherapy, didactic sessions, incentive therapy - Duration: 6 weeks	- Duration: 6 weeks “Body-Mind-Component” - 5 times/week, 1.5 h each - Fitness component including Yoga, incremental jogging in place up to 20 min; other components: motivational aspects, responsibility for health elements	- Standard care without “Body-Mind-Component”	- Significantly reduced craving in “Body-Mind-Component” group - Only partial fitness gains - No impact of “Body-Mind-Component” on depression, body satisfaction - Significant increase of internal locus of control and responsibility for health	- No pure EX program: unclear which part of the “Body-Mind-Component” is related to reported changes - Nongeneralizable sample (veterans)
Brown et al. (2009) [36]	- N = 19 - alcohol-dependent patients (m, f) after detoxification (mean 19 days) - Ethnicity not reported	- Pilot study, outpatient alcohol treatment program (no details reported)	- Duration: 12 weeks - Once per week supervised, including CBT-based EX counseling, 2-3 times/week alone - 20–40 min (gradually increasing) of aerobic training (treadmill, ergometer) at 50–69% max HR	None	- Significantly higher rate of abstinent days at end of treatment and 3-month followup - Significantly increased fitness and decreased BMI at end of treatment (no difference at 3-month followup)	- Very small N - Lack of control group, therefore effects not explained by EX alone

AA: alcoholics anonymous, ACSM: American College of Sports Medicine, CBT: cognitive-behavioral therapy, EX: exercise, f: female, h: hour(s), HR: heart rate, HR-R: heart rate reserve, m: male, max HR: maximum heart rate, min: minutes, N: sample size, PA: physical activity.