Exercise and health-related quality of life and work-related outcomes in primary care patients with anxiety disorders - A randomized controlled study

Background: Exercise interventions show promise in the treatment of anxiety disorders, but effects on healthrelated quality of life (HR-QoL), work ability, and sick leave are little studied. We investigated these outcomes in a 12-week randomized controlled trial with a 1-year follow-up. Methods: Patients aged 18-65 (n = 222) with anxiety disorders from primary care centers in Gothenburg were randomized to a control group or one of two 12-week exercise intervention groups (low-intensity, [LI] and moderate/high-intensity, [HI]); 148 were evaluated at 12-weeks and 113 completed the 1-year follow-up. The EuroQol 5D (EQ5D; index and the visual analogue scale [VAS]), work ability score (WAS), presenteeism, and selfreported sick leave were assessed at baseline, 12 weeks, and 1 year. Improvements were defined by binary cutoffs for each scale. Binary logistic regression with odds ratios (OR) and 95 % confidence intervals (CI) were reported. Results: There were improved scores for EQ5D and WAS in the HI group compared to controls after 12 weeks (EQ5D index: 4.74 [1.91-11.7], EQ5D-VAS 4.00, [1.65-9.72], WAS 3.41 [1.24-7.37]) and 1 year (EQ5D index: 3.05 [1.05-8.81], EQ5D-VAS 3.20 [1.16-8.84], WAS 5.50 [1.85-16.3]). Post-hoc analysis showed higher ORs in participants on antidepressants (n = 75) (12-week EQ5D index: OR 9.95 [2.85-34.8]) and significant improvements in EQ5D scores for both intervention groups after 1 year. There were no between-group differences for presenteeism or sick leave. Limitations: Discontinuation was high, mostly early after randomization (n = 74), as is common for anxiety interventions. Conclusions: HI Exercise improves HR-QoL and work ability in anxiety patients, especially when combined with antidepressants.