The Treatment Effects Of Aerobic Exercise For Substance Dependent Individuals And Its Mechanism

Substance dependence is one of the largest public health issues in the word. Substance dependence causes a variety of physical illness(such as, diabetes and HIV infection), increases the risk of the crime, and is an overall detriment to society, family and individuals. In our country, substance dependence is also considered as a serious social issue. Figures from the drug control report in 2014 show that more than 2.47 million people have the substance dependence, among them, 0.85 million suffering from new-type drugs dependence, mainly methamphetamine, with very strong rising momentum. Due to the seriousness of the substance dependence, more research on the treatment of the substance dependence, is needed. Currently, one of the most commonly used treatment for substance dependence is drug medication therapy, using methadone as the golden standard. But the pharmacological therapy has limitations and side effects. Currently, aerobic exercise is recognized as the potential adjunt treatment, characterized as a green、economic and no side-effect one, and is widely discussed. The aim of this study is also to research on the impact of the aerobic exercise on the substance dependence on the base of China’s national conditions.In the previous studies, there is no unified rehabilitation effect of aerobic exercise for the substance dependent individuals, and no evidence showed that the aerobic exercise has the rehabilitation benefits in the key indicators. In research 1, we used meta analyses method to examine whether long-term aerobic exercise could be a potential effective treatment for substance dependence. We conducted a search for 22 relevant literature published from January 1990 to August 2013, which all used randomized controlled trial(RCT). The selected papers were studying long-term aerobic exercise rehabilitation effect on substance, including cigarette, alcohol, illicit drug dependent individuals. The primary outcome measures of the effects of the aerobic exercise on the substance dependent individuals in this studies included the rate of abstinence from drug addiction, withdrawal symptom, the level of depression, and anxiety. The results indicated that aerobic exercise can effectively increase the abstinence rate(OR = 1.69), ease withdrawal symptoms(SMD =-1.24), and reduce anxiety(SMD =-0.31)and depression(SMD =-0.47). The results showed that aerobic exercise have the effective impact on the rehabilitation of the substance dependent individuals. Similarly to the commonly aerobic exercise, mind-body exercises, such as Qigong, Tai Chi Quan, and Yoga, also can benefit the treatment of substance dependent individuals.On the base of Research 1, we focused on the treatment effect of the aerobic exercise impact on the methamphetamines(MA)-dependent individuals. In Research 2, we firstly discussed treatment effect of aerobic exercise for the MA-dependent individuals at moderate intensity, to explore the effectiveness of the most commonly used exercise intensity. Research 2, Exerperiment1 employed a within-subject counterbalanced design, and a total of 24 participants for MA dependence were randomly recruited to perform the experiment sessions of aerobic exercise at a moderate intensity(65%—75% HR Max)and reading activity. Craving level, reaction time, and response accuracy, as well as the event-related potential(ERP) components N2 and P3 were measured following the aerbioc exercise and control treatments in a counterbalanced order. The results reported that MA craving attenuated during, temporarily following, and 50 min after the aerobic exercise at a moderate intensity which can also facilitate the inhibitory performance of the MA-dependent individuals. These results suggested a potential role for aerobic exercise to treatment of the MA dependant individuals.Though we found the treatment benefits in the Research 2 of taking the aerobic exercise in a moderate intensity, there was still no clear answer what kind of exercise intensity can bring the biggest benefits. In Research 3( Experiment2), we discussed dose response between the aerobic exercises at the different intensity and craving level and inhibitory control of MA-dependent individuals. Experiment 2 employed a between-subject. 92 participants for MA dependence were randomly divided to the four groups, and took the different rate among low-(40%-50% HR Max)、moderate-(65%—75% HR Max)、high-(85%—95% HR Max)intensity aerobic exercise and control treatments. Craving level, reaction time, and response accuracy, as well as the ERP components N2 and P3 were measured following the exercise or control treatments. The results reported that MA craving attenuated significantly after the starting of the aerobic exercise, following and 50 min after the aerobic exercise at moderate and high intensity. However, only aerobic exercise at moderate intensity can facilitate the inhibitory performance of the MA-dependent individuals. In general, moderate intensity aerobic exercise was likely to fit the weak MA-dependent individuals, and bought the top treatment benefit.The previous study suggested there is a potential role for aerobic exercise to treatment of the substance dependant individuals. So in Research 4(Experiment 3), we explored the treatment benefit of the long-term moderate aerobic exercise on MAdependant individuals. Using RCT, 63 MA-dependent participants were grouped randomly to have aerobic exercise intervention(experimental group) or daily life in drug rehabilitation center(control group). Under the guide of the professional trainers, 32 MA-dependent participants in the experimental group should have moderate aerobic(65%—75% HR Max) exercise for 30-40 min, three times a week, lasting 12 weeks, running and jumping ropes as main movement. At last, 25 people each group finished all the intervention and test mission. Physical fitness、emotional states(anxiety and depression)、craving level and inhibitory were measured. The results showed that 12-week aerobic exercise at moderate-intensity had the effective impact on controlling the body mass index(BMI) and improving the status of the anxiety and depression of the MA-dependent individuals. The craving level for drug decreased significantly from the sixth week, and in the ninth week, the index fell to the bottom. In addition, the moderate-intensity aerobic exercise also improved the inhibition ability. In general, moderate-intensify aerobic exercise can promote the treatment effectively.To sum up, all the results provided strong evidence that aerobic exercise can be a effective treatment method for the substance dependent individuals. In MA-dependent group, moderate-intensity aerobic exercise was considered to have the best treatment effect on them, and 6-week physical exercise can attenuate the drug craving level. Furthermore, promoting inhibition may be the key link that aerobic exercise promote the treatment of the substance dependent individuals. Given the reference cues to the substance dependent treatment, we expected them to play guiding role on the treatment practice.