Table 1.

Summary of Randomized Clinical Trials

Author	N	Country	Anxiety inclusion criteria	% Female	Age (M)	Exercise condition(s)				Control condition(s)
						Modality	Co-intervention	Frequency	Duration / Intensity
Broman-Fulks et al., 2008	35	USA	Symptoms of high anxiety sensitivity	79	19	Aerobic: brisk walking or jogging	None	6 sessions over 2 weeks	20 min, 60-90% HRR	Waitlist
Broocks et al., 1998; Bandelow et al., 2000; Broocks et al., 2003	46	Germany	Diagnosis of PD with Agoraphobia	50	33	Aerobic: running	None	4+ weekly sessions over 10 weeks	4-mile route, gradual pace increase encouraged	1.Clomipramine 2.Placebo
Carmeli et al., 2009	24	Israel	“Diagnosed with anxiety”	62	51	Aerobic: bicycle or treadmill	None	3 sessions weekly for 26 weeks	35 min, 50-70% HRR	1.Leisure program focused on stability, flexibility, balance 2.Vocational activities
Goldin et al., 2012; Jazaieri et al., 2012; Goldin et al., 2013	56	USA	Diagnosis of SAD, moderate or more; fear in 5+ social situations	52	33	Aerobic: gym exercise	None	3 weekly sessions for 8 weeks	Not specified, unsupervised	Mindfulness-based stress reduction - 1-day retreat and 8 weekly sessions, 150 mina
Gutierrez et al., 2012	60	Spain	Symptoms of anxiety, moderate or more; comorbid depression	100	64	Aerobic: group exercise	None	6 months of increasing sessions, 1 to 3 weekly	50-60 min, 60-85% HRR at end of study	Waitlist
Herring et al., 2011; Herring et al., 2012	30	USA	Diagnosis of GAD	100	23	Resistance (RET) group: leg presses, curls, extensions; Aerobic (AET) group: cycling	None	12 sessions over 6 weeks	RET: 16 min, gradual increase from 50% of 1RM AET: equal work output to RET	Waitlist
Hovland et al., 2013	36	Norway	Diagnosis of PD	81	38	Combined aerobic and resistance: group exercise	None	3 weekly sessions for 12 weeks	90 min, 60-80% HRR	Group CBT for PD
Kim et al., 2013	28	USA	Symptoms of PTSD	97	46	Mindfulness-based stretching and deep breathing exercise (MBX)	None	2 weekly sessions for 8 weeks	60 min, gradually increasing intensity	No intervention or waitlist identified
Merom et al., 2008 Phongsavan et al., 2008	85	Australia	Diagnosis of GAD, PD, or SAD	78	39	Participant's choice	Group CBT	5 days a week for 8 weeks encouraged	30 min, “moderate” intensity encouraged, unsupervised	Group CBT plus healthy eating education (GCBT+ED)
Oldridge et al., 1991; Oldridge et al., 1995	201	USA	Symptoms of anxiety, moderate, with depressive symptoms	11	54	Aerobic: cardiac rehabilitation	Group CBT, relaxation training	2 weekly sessions for 8 weeks	50 min	Usual care by local physician
Smits et al., 2008	60	USA	Symptoms of high anxiety sensitivity	75	21	Aerobic: treadmill	Cognitive restructuring (sub-sample)	6 sessions over 2 weeks	26 min at 70% HRR	Waitlist
Wedekind et al, 2010	75	Germany	Diagnosis of PD	69	32	Aerobic: running	Randomized to paroxetine or placebo	3 weekly sessions for 10 weeks	45 min each, gradual intensity increase encouraged	Relaxation training, daily plus once weekly with a trainer

Author	ITT	% Attrition	Blinded outcome assessment	EX supervised	Fitness improved	PEDro scale score	Anxiety outcome	Findings
Broman-Fulks et al., 2008	N	31	N/A	Y	?c	4	ASI-R	ASI-R: Exercise better than waitlist. exercise 27.92 (15.36), waitlist 41.0 (25.68)
Broocks et al., 1998; Bandelow et al., 2000; Broocks et al., 2003	Yb	20	Y	Partial	N	7	BAI CGI PAS HAM-A	HAM-A, BAI: EX and clomipramine better than placebo; no difference between EX and CL. PAS (observer) and CGI: Clomipramine better than EX, both better than placebo.
Carmeli et al., 2009	N	33	Y	Y	?	4	HAM-A (modified)	HAM-A: Decreased at post-test in exercise group (50%) and leisure program group (37.5%), but not control group (0%).
Goldin et al., 2012; Jazaieri et al., 2012; Goldin et al., 2013	N	25	N/A	N	?	4	LSAS-SR SIAS-S	LSAS-SR, SIAS-S: both groups improved, no significant difference between groups. About 25% of participants had clinically significant improvement in SAD.
Gutierrez et al., 2012	N	5	N/A	Y	N	5	HAM-A (Spanish)	HAM-A: Exercise group significantly improved at post-test (p < 0.01 for participants with minor anxiety, p < 0.05 for major anxiety). No change in control group.
Herring et al., 2011; Herring et al., 2012	Y	0	Y	Y	RET group only	7	POMS PSWQ	POMS-Tension scores: RET better than waitlist. NS for AET. PSWQ: Exercise conditions better than waitlist when grouped, but pairwise NS.
Hovland et al., 2013	Y	3	Y	Y	Y	7	ACQ BAI BSQ MI STAI	STAI, BAI: No Group x Time effect. ACQ; BSQ; MI: CBT showed more anxiety reduction than exercise.
Kim et al., 2013	Y	5	N/A	Y	?	5	PCL-C	PCL-C: MBX better than aerobic exercise group (reduced by mean of - 13.6) at post-test; effect maintained 8 weeks after intervention
Merom et al., 2008 Phongsavan et al., 2008	N	52	N	N	N	5	DASS-21	DASS-21: All groups improved. No significant group differences in anxiety; change scores were -6.1 (exercise) vs -4.6 (control) at post-test.
Oldridge et al., 1991; Oldridge et al., 1995	N	7	N/A	Y	Y	5	POMS STAI	STAI-State: Exercise better than UC at 8 weeks but NS at 4, 8, and 12 months. POMS tension-anxiety: exercise better than UC at 8 weeks but NS at 12 months.
Smits et al., 2008	Y	20	N/A	Y	?	5	ASI BAI	BAI, ASI: Both exercise groups better than waitlist. No effect for restructuring.
Wedekind et al., 2010	Y	20	Y	Partial	Y	6	CGI HAM-A PAS	HAM-A: Exercise better than relaxation at week 4 only (p < 0.01). PAS: No group differences. CGI: Exercise + paroxetine better than relaxation + placebo (p < 0.05), but all groups improved.

ASI Anxiety Sensitivity Inventory, ASI-R Anxiety Sensitivity Inventory-Revised, BAI Beck Anxiety Inventory, BSQ Body Sensations Questionnaire, CBT cognitive-behavioral therapy, CGI Clinical Global Impression, DASS-21 Depression Anxiety Stress Scale, GAD generalized anxiety disorder, HAM-A Hamilton Anxiety Rating Scale, ITT intent-to-treat, LSAS-SR Liebowitz Social Anxiety Scale-Self-Report, MI Mobility Inventory, PAS Panic and Agoraphobia Scale, PCL-C PTSD Checklist-Civilian version, PD panic disorder, POMS Profile of Mood States, PSWQ Penn State Worry Questionnaire, PTSD posttraumatic stress disorder, SAD social anxiety disorder, SIAS-S Social Interaction Anxiety Scale-Straightforward Scale

^aAerobic exercise was considered the control group for the purposes of this RCT.

^bThe authors reported an ITT analysis; however, not all patients randomized were included in the primary analysis, and most of the results focused on a completers analysis.

^cImprovements in fitness were either not measured or not reported.