Effects of physical activity on patients with posttraumatic stress disorder: A systematic review and meta-analysis of randomized controlled trials

Background: Although it is often known that physical activity can effectively reduce anxiety and despair, differing results have been found for patients with posttraumatic stress disorder (PTSD) symptoms. This study sought to comprehensively examine how physical activity affected the quality of sleep, anxiety, sadness, and PTSD in individuals suffering from PTSD.

Methods: The Cochrane Library, PubMed, Web of Science, EMBASE, and Scopus databases in English were examined. Included were all randomized controlled trials (RCTs) that examined physical activity as a psychosocial remedy for PTSD sufferers. By the time of the meta-analysis search (February 2024), we had 12 RCT studies that met the eligibility requirements.

Results: The study's findings demonstrated that physical activity improved sleep quality (standardized mean differences [SMD] = -0.38, 95% CI [-0.59, -0.18], Z = 3.65, P = .0003), anxiety (SMD = -0.26, 95% CI [-0.47, -0.06], Z = 2.5, P = .01), depression (SMD = -0.19, 95% CI [-0.37, -0.01], Z = 2.09, P = .04), and PTSD (SMD = -0.34, 95% CI [-0.50, -0.17], Z = 3.99, P < .0001). Each intervention ≤ 60 (SMD = -0.52, I2 = 0%, P < .00001), frequency of interventions ≤ 2 per week (SMD = -0.44, I2 = 7%, P = .0004), intervention cycles > 10 (SMD = -0.46, I2 = 8%, P < .0001), and the yoga group (SMD = -0.44, I2 = 7%, P = .0004) had the best impact, according to subgroup analyses. Veterans with PTSD responded most significantly to physical activity (SMD = -0.60, I2 = 0%, P = .002).

Conclusions: It was discovered that people with PTSD can benefit from physical activity as an adjuvant method to enhance their PTSD, anxiety, despair, and sleep quality. Yoga has been found through research to help the symptoms of people with PTSD more than other sports. Due to limitations such as small sample size and some heterogeneity in this meta-analysis, further confirmation through more scientific and objective RCTs is needed in order to obtain definitive conclusions on physical activity for patients with PTSD.