A number of uncontrolled pilot studies have found aerobic exercise to be associated with improvements in PTSD symptoms [1380–1384]. Promising findings were also provided by a small controlled trial which found greater reductions in PTSD symptoms among people randomised to receive exposure therapy with exercise augmentation compared to those randomised to receive exposure therapy alone [1385]. Another small controlled trial reported greater reductions among people with PTSD as a single disorder following 12 weeks of aerobic and resistance exercises, compared to people randomised to a wait-list control [1386]. A more rigorous evaluation of the impact of exercise on PTSD symptoms was completed in Australia. Rosenbaum and colleagues [1387] compared the efficacy of a 12-week exercise program (consisting of three 30-minute resistance-training sessions per week and a walking program) provided as an adjunct to inpatient care for PTSD, to inpatient care alone, in an RCT. People randomised to receive the exercise program demonstrated significantly greater reductions in PTSD symptom severity compared to those randomised to receive inpatient care alone.
In a more recent RCT, veterans with PTSD as a single disorder participated in 12 weeks of supervised exercise training, including aerobic, balance, strength, and flexibility exercises, three days a week [1388]. Relative to veterans randomised to a wait-list control, those who received the exercise intervention reduced their PTSD symptoms by an average of 16% (compared to 7% in the control group), and also reported greater decreases in negative cognitions, negative mood, depressive symptoms, and improvements in sleep quality. While further research is needed examining the optimal dose, frequency and intensity of exercise, these findings provide preliminary support for the use of exercise as an adjunct to evidence-based PTSD treatments. Research has yet to examine the impact of physical exercise in people with co-occurring PTSD and AOD use disorders.