TY - JOUR
T1 - Randomized controlled trial comparing exercise to health education for stimulant use disorder
T2 - Results from the CTN-0037 STimulant reduction intervention using dosed exercise (STRIDE) study
AU - Trivedi, Madhukar H.
AU - Greer, Tracy L.
AU - Rethorst, Chad D.
AU - Carmody, Thomas
AU - Grannemann, Bruce D.
AU - Walker, Robrina
AU - Warden, Diane
AU - Shores-Wilson, Kathy
AU - Stoutenberg, Mark
AU - Oden, Neal
AU - Silverstein, Meredith
AU - Hodgkins, Candace
AU - Love, Lee
AU - Seamans, Cindy
AU - Stotts, Angela
AU - Causey, Trey
AU - Szucs-Reed, Regina P.
AU - Rinaldi, Paul
AU - Myrick, Hugh
AU - Straus, Michele
AU - Liu, David
AU - Lindblad, Robert
AU - Church, Timothy
AU - Blair, Steven N.
AU - Nunes, Edward V.
N1 - Funding Information:
Funding/support: This work was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Numbers U10 DA020024 and UG1DA020024 (PI: Trivedi), U10 DA013727 (PI: Brady), U10 DA013035 (PIs: Nunes and Rotrosen), U10 DA013720 (PIs: Szapocznik and Metsch), U10 DA013732 (PI: Winhusen), and HHSN271200900034C and HHSN271200900034C (Emmes Corporation). Additional grant support was provided by NIDA K24 DA022412 (PI: Nunes) and NIMH K01 MH097847 (PI: Rethorst).
Publisher Copyright:
© Copyright 2017 Physicians Postgraduate Press, Inc.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Objective: To evaluate exercise as a treatment for stimulant use disorders. Methods: The STimulant Reduction Intervention using Dosed Exercise (STRIDE) study was a randomized clinical trial conducted in 9 residential addiction treatment programs across the United States from July 2010 to February 2013. Of 497 adults referred to the study, 302 met all eligibility criteria, including DSM-IV criteria for stimulant abuse and/or dependence, and were randomized to either a dosed exercise intervention (Exercise) or a health education intervention (Health Education) control, both augmenting treatment as usual and conducted thrice weekly for 12 weeks. The primary outcome of percent stimulant abstinent days during study weeks 4 to 12 was estimated using a novel algorithm adjustment incorporating self-reported Timeline Followback (TLFB) stimulant use and urine drug screen (UDS) data. Results: Mean percent of abstinent days based on TLFB was 90.8% (SD = 16.4%) for Exercise and 91.6% (SD = 14.7%) for Health Education participants. Percent of abstinent days using the eliminate contradiction (ELCON) algorithm was 75.6% (SD = 27.4%) for Exercise and 77.3% (SD = 25.1%) for Health Education. The primary intent-to-treat analysis, using a mixed model controlling for site and the ELCON algorithm, produced no treatment effect (P =.60). In post hoc analyses controlling for treatment adherence and baseline stimulant use, Exercise participants had a 4.8% higher abstinence rate (78.7%) compared to Health Education participants (73.9%) (P =.03, number needed to treat = 7.2). Conclusions: The primary analysis indicated no significant difference between exercise and health education. Adjustment for intervention adherence showed modestly but significantly higher percent of abstinent days in the exercise group, suggesting that exercise may improve outcomes for stimulant users who have better adherence to an exercise dose.
AB - Objective: To evaluate exercise as a treatment for stimulant use disorders. Methods: The STimulant Reduction Intervention using Dosed Exercise (STRIDE) study was a randomized clinical trial conducted in 9 residential addiction treatment programs across the United States from July 2010 to February 2013. Of 497 adults referred to the study, 302 met all eligibility criteria, including DSM-IV criteria for stimulant abuse and/or dependence, and were randomized to either a dosed exercise intervention (Exercise) or a health education intervention (Health Education) control, both augmenting treatment as usual and conducted thrice weekly for 12 weeks. The primary outcome of percent stimulant abstinent days during study weeks 4 to 12 was estimated using a novel algorithm adjustment incorporating self-reported Timeline Followback (TLFB) stimulant use and urine drug screen (UDS) data. Results: Mean percent of abstinent days based on TLFB was 90.8% (SD = 16.4%) for Exercise and 91.6% (SD = 14.7%) for Health Education participants. Percent of abstinent days using the eliminate contradiction (ELCON) algorithm was 75.6% (SD = 27.4%) for Exercise and 77.3% (SD = 25.1%) for Health Education. The primary intent-to-treat analysis, using a mixed model controlling for site and the ELCON algorithm, produced no treatment effect (P =.60). In post hoc analyses controlling for treatment adherence and baseline stimulant use, Exercise participants had a 4.8% higher abstinence rate (78.7%) compared to Health Education participants (73.9%) (P =.03, number needed to treat = 7.2). Conclusions: The primary analysis indicated no significant difference between exercise and health education. Adjustment for intervention adherence showed modestly but significantly higher percent of abstinent days in the exercise group, suggesting that exercise may improve outcomes for stimulant users who have better adherence to an exercise dose.
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U2 - 10.4088/JCP.15m10591
DO - 10.4088/JCP.15m10591
M3 - Article
C2 - 28199070
AN - SCOPUS:85020726942
SN - 0160-6689
VL - 78
SP - 1075
EP - 1082
JO - Journal of Clinical Psychiatry
JF - Journal of Clinical Psychiatry
IS - 8
ER -