Table 2: Studies investigating EX in the therapy of alcohol abuse/dependence.

First author, yearSample characteristicsStudy design, standard therapyExercise intervention (EX)Control condition(s)Outcome variables and findings
Exercise > control condition
Comments

Gary and Guthrie (1972) [28]- 𝑁 = 2 0
- 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 = 2 1 4
- 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 = 5 8
- 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 = 4 6
- 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 = 4 8
- 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 = 2 7
- “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 = 1 6 5 “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 = 9 0
- 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 = 1 9
- 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.