Effects of exercise on obsessive-compulsive disorder symptoms: a systematic review and meta-analysis

Abstract

Objective: This systematic review and meta-analysis assessed the efficacy of exercise in reducing OCD symptoms. Methods: We searched PubMed, Cochrane Central Register of Controlled Trials, MEDLINE, Scopus and grey literature until March 2022. The study was preregistered at Prospero (CRD42021283931). We included randomised controlled and pre-post trials assessing physical activity as an intervention for OCD. Risk of bias was assessed using the Cochrane ROBINS-I tool and the RoB2 tool. Results: The analysis included 6 trials (N=92); 2 were RCTS and 4 were pre-post design studies. A random-effects meta-analysis of pre-post data identified a large reduction of OCD symptoms following exercise (g = 1.33 [95%CI 1.06 to 1.61]; k=6). Exercise was also associated with significant pre-post reductions in anxiety (g= 0.71 [95%CI 0.37 to 1.05; k=4) and depression (g= 0.57 [95%CI 0.26 to 0.89]; k=2). Risk of bias was moderate-high in uncontrolled trials on the ROBINS-I and RCTs showed ‘some concerns’ on the RoB2. Conclusion: Exercise was associated with a large pre-post reduction of OCD symptoms; however, few trials were of robust quality and all were at risk of bias. Further well-powered and better quality RCTs are required to assess the role of exercise as an intervention for OCD.