# Effects of physical exercise interventions on multidimensional health outcomes in patients with substance use disorders: a network meta-analysis

## TL;DR

This study finds that different types of exercise help people with substance use disorders in different ways, such as improving physical health or sleep quality.

## Contribution

The study introduces a network meta-analysis showing how aerobic and mind-body exercises have distinct benefits for multidimensional health outcomes in substance use disorder patients.

## Key findings

- Aerobic exercise most benefits physiological health and substance use outcomes.
- Mind-body exercise significantly improves sleep quality and cognitive function.
- Exercise types have unique molecular mechanisms affecting different health domains.

## Abstract

This study investigated the intervention effects of different physical exercise programs on multidimensional health outcomes in patients with substance use disorders. Through systematic categorization of intervention types, duration, frequency, and outcome indicators, this research aimed to provide evidence-based exercise prescriptions for rehabilitation treatment of patients with substance use disorders.

A systematic search was conducted across six databases: PubMed, Web of Science, Cochrane Library, EMBASE, SCOPUS, and ScienceDirect, retrieving 11,689 articles related to substance use disorders. The search period was limited from database inception to July 1, 2025. Data extraction and quality assessment were performed using Review Manager 5.4 software, ultimately including 33 articles meeting inclusion criteria, encompassing 2,922 participants. Subsequently, network meta-analysis was conducted using Stata 16.0, with results presented as standardized mean differences (SMD) and 95% confidence intervals (CI).

A total of 33 randomized controlled trial articles were included, comprising 57 randomized controlled trials with 2,922 subjects. Network meta-analysis results demonstrated that aerobic exercise and mind-body exercise exhibited significantly different advantages: aerobic exercise performed optimally in physiological health indicators (SUCRA = 0.874), followed by substance use outcomes (SUCRA = 0.468) and sleep quality (SUCRA = 0.446); mind-body exercise showed the greatest advantage in improving sleep quality (SUCRA = 0.884), with cognitive function (SUCRA = 0.608) and mental health (SUCRA = 0.588) ranking second and third, respectively. In pairwise comparisons, substance use outcomes in the mind-body exercise network showed significant advantages compared to sleep quality (effect size 44.58, 95% CI: 3.30-85.85), while all comparisons in the aerobic exercise network did not reach statistical significance.

Different types of exercise exert therapeutic effects in their respective advantage domains through unique molecular biological mechanisms. Aerobic exercise primarily improves physiological health indicators through AMPK signaling pathways and anti-inflammatory mechanisms, while mind-body exercise optimizes sleep quality and cognitive function through HPA axis regulation and GABA receptor upregulation. These findings provide important evidence-based medical evidence for developing personalized exercise prescriptions for substance use disorders, contributing to the establishment of evidence-based rehabilitation treatment guidelines.

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251144089.