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Morris L.1, Ebrahim W.1, Eksteen S.1, Meaden O.1, Ras A.1, Wessels A.1, Stander J.1
1Stellenbosch University, Physiotherapy, Cape Town, South Africa
Background: Methamphetamine (MA) is a highly addictive psychostimulant substance used by approximately 52 million people worldwide. Short-term use improves productivity, attention-spans and energy levels. In contrast, chronic MA abuse leads to various detrimental physiological and neurological changes, as well as decreased overall fitness and a lower quality of life. Previously the damage caused to the brain and body of individuals who were MA dependent was thought to be permanent. Recent evidence however shows that the damage caused by long-term MA use may be reversible using exercise. To date, no systematic review has been conducted to establish the effect of an exercise program on reducing depression and anxiety, and improving fitness and quality of life among previously MA dependent individuals.
Purpose: To identify, clinically appraise and evaluate available evidence for the effectiveness of exercise on decreasing depression and anxiety symptoms as well as improving fitness and quality of life in previous MA users compared to CBT, education, standard care and/or no intervention.
Methods: Seven computerized bibliographic databases accessed through the Stellenbosch University library services were searched, namely Scopus, Cochrane Library, Pubmed, PEDro, CINAHL, MEDLINE and ScienceDirect. The following search terms were used: exercise, methamphetamine, fitness measures, depression, anxiety and quality of life. The PEDro scale was used to critically appraise the methodological quality of each included study. Data was extracted from the relevant articles using the adapted JBI data extraction form and included the following categories: reference, type of study, description of participants, outcome measures, interventions, results, as well as post-intervention clinical status and the implications thereof. RevMan© was used to meta-analyze homogenous data. Where meta-analyses were not applicable, the data were presented in a narrative form.
Results: Three studies were found eligible for inclusion in this review: two RCTs and one pilot study. Two studies were conducted in the USA and one in China. The included studies scored an average of 6,66/11 on the PEDro scale. The study results showed that exercise resulted in statistically significantly lower depression and anxiety scores among previous MA users compared to CBT (p=0.001). Balance showed a statistically significant improvement in the intervention group compared to the standard care group (p 0.001) as well as vital capacity, right and left hand grip, and one-leg stand with eyes closed. There were statistically significant changes in all subdivisions of the Quality of Life Scale Questionnaire, except psychology (p=0.227).
Conclusion(s): There is level II evidence for the effect of exercise on the reduction of anxiety and depression and the improvement of fitness in previous MA users. There is level III-2 evidence for the effect of exercise on improving fitness and quality of life in previous MA users. Further research is however required.
Implications: Since MA is a widely abused drug, more emphasis should be placed on finding ways to reintegrate these individuals back into society following rehabilitation.Physiotherapists are often in the ideal position to administer such exercise programs and should confirm their role in the rehabilitation of previous MA users.
Funding acknowledgements: Not applicable.
Topic: Mental health
Ethics approval: Ethics for this study design was not required.
All authors, affiliations and abstracts have been published as submitted.
