Efficacy and Clinical Application of Physical Activity in Substance Use Disorder Rehabilitation: A Review on Mechanism and Benefits
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsEfficacy and Clinical Application of Physical Activity in Substance Use Disorder Rehabilitation: A Review on Mechanism and Benefits
This review aims to examine existing evidence on the effects of physical activity in individuals with substance use disorders (SUDs), with a particular focus on neurobiological mechanisms. A narrative review methodology was employed. The review discusses the psychological changes induced by PA during SUD rehabilitation, identifies barriers to participation in PA programs, and suggests clinical and organizational strategies to enhance adherence. The authors concluded that physical activity is a promising adjunctive therapy for managing SUDs. However, long-term longitudinal studies are needed to strengthen the scientific evidence of its efficacy. The success of PA programs also depends on overcoming barriers to adherence, including physical, psychological, and logistical challenges.
The methodology of the study is sound, and the topic is particularly interesting and highly worthy of publication. However, several aspects require improvement:
Introduction: The introduction section is overly concise and does not adequately guide the reader into the topic. I recommend expanding this section to provide a more comprehensive background.
Methodology
I believe that the methodology for selecting the studies for this review needs to be described in detail, especially the keywords used in each analysis. This is not clear. Based on my experience in this subject, I am concerned that not all relevant studies on the topic have been selected. See also one more comment of mine below.
Discussion: A more detailed analysis of the recommendations, along with the presentation of practical implications, should be included. These areas require enhancement for greater clarity and depth. Additionally, the study's limitations are not addressed and should be explicitly discussed.
Biomarkers and Technology: While the authors highlight the importance of developing specific biomarkers and employing innovative technologies to improve therapeutic programs' effectiveness and sustainability, it is unclear how these conclusions arise from the current review. As there are related studies on this topic, including research on virtual reality in Substance Use Disorders rehabilitation, better documentation and integration of this evidence into the review are necessary.
Main Point for the Authors:
During a search of relevant databases based on the authors' stated methodology, I identified several studies. I would like to know if these studies were included in the review and whether they met the inclusion criteria for analysis.
Can Gür, G.; Okanli, A. The Effects of Cognitive-Behavioral Model-Based Intervention on Depression, Anxiety, and Self-Efficacy in Alcohol Use Disorder. Clin. Nurs. Res. 2019, 28, 52–78.
Chen, Y.; Liu, T.; Zhou, C. Effects of 12-week aerobic exercise on drug craving in methamphetamine-dependent patients and the moderation effect of working memory. Ment. Health Phys. Act. 2021, 21, 100420.
Dowla, et al., (2022). The Effectiveness of Exercise as an Adjunct Intervention to Improve Quality of Life and Mood in Substance Use Disorder: A Systematic Review. Subst. Use Misuse 2022, 57, 911–928.
Fitzgerald, et al., (2021). A Mixed-Method Investigation into Therapeutic Yoga as an Adjunctive Treatment for People Recovering from Substance Use Disorders. Int. J. Ment. Health Addict. 2021, 19, 1330–1345.
Giménez-Meseguer, J. et al., (2015). Benefits of Exercise for the Quality of Life of Drug-Dependent Patients. J. Psychoact. Drugs 2015, 47, 409–416.
Klamert, et al., (2023). Physical activity interventions for young people with increased risk of problematic substance use: A systematic review including different intervention formats. Ment. Health Phys. Act. 2023, 25, 100551.
Panagiotounis, et al., (2022). Effects of an exercise theory-based intervention program on craving during the early stage of adults’ SUD treatment. Ment. Health Phys. Act. 2022, 23, 100463.
Panagiotounis, et al., (2022). Psychological effects of an adventure therapy program in the treatment of substance use disorders. A Greek pilot study. J. Subst. Use 2021, 26, 118–124.
Xu, J. et al., (2022). Effects of moderate-intensity exercise on social health and physical and mental health of methamphetamine-dependent individuals: A randomized controlled trial. Front. Psychiatry 2022, 13, 997960.
Zhu, D. et al., (2018). Long-term effects of Tai Chi intervention on sleep and mental health of female individuals with dependence on amphetamine-type stimulants. Front. Psychol. 2018, 9, 1476.
Author Response
Please see the attachment
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Comments and Suggestions for AuthorsThe paper is a narrative review of the existing literature on the potential role of physical activity as a complementary treatment for SUDs. It is well-written, clear, and provides a thorough summary of the relevant literature. While the authors might have considered adopting a systematic approach to the topic, they chose not to do so. Given the methodology used, there are no specific concerns about the paper. However, I have a few suggestions for the authors to consider:
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Could you address the potential for publication bias in this field? For instance, I am thinking about the possible risks of physical activity in bipolar disorders, which may share some similarities with SUDs.
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Would it be possible to include a paragraph discussing the limitations of the current literature on this topic?
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Although not required for a narrative review, could you provide information about the search strategy used? For example, which databases were consulted?
Author Response
Please see the attachment
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
Comments and Suggestions for Authorsno more comments
