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Randomized Controlled Trial Comparing Exercise to Health Education for Stimulant Use Disorder: Results from the CTN-0037 STimulant Reduction Intervention Using Dosed Exercise (STRIDE) Study.

Journal of Clinical Psychiatry 2017;78(8):1075-1082. [doi: 10.4088/JCP.15m10591]

Madhukar H. Trivedi, MD (University of Texas Southwestern Medical Center, TX Node), Tracy L. Greer, PhD (UT Southwestern Medical Center, TX Node), Chad D. Rethorst, PhD (UT Southwestern Medical Center, TX Node), Thomas Carmody, PhD (UT Southwestern Medical Center, TX Node), Bruce D. Grannemann, MA (UT Southwestern Medical Center, TX Node), N. Robrina Walker, PhD (UT Southwestern Medical Center, TX Node), Diane Warden, PhD (UT Southwestern Medical Center, TX Node), Kathy Shores-Wilson, PhD (UT Southwestern Medical Center, TX Node), Mark Stoutenberg, PhD (University of Miami Miller School of Medicine, FNA Node), Neal L. Oden, PhD (Data & Statistics Center, Emmes), Meredith Silverstein, PhD (Arapahoe House, FNA Node), Candace Hodgkins, PhD (Gateway Community Services, FNA Node), Lee D. Love, MA (Gibson Recovery Center, OV Node), Cindy Seamans, PhD (Nexus Recovery Center, Inc., TX Node), Angela L. Stotts, PhD (UT Southwestern Medical Center, TX Node), Trey Causey, MD (Morris Village Alcohol and Drug Treatment Center, SC Node), Regina P. Szucs-Reed, MD (University of Pennsylvania, OV Node), Paul Rinaldi, MD (St. Luke's-Roosevelt Hospital Center, GNY Node), Hugh Myrick, MD (Morris Village Alcohol and Drug Treatment Center, SC Node), Michele Straus, RPh (NIDA Center for the Clinical Trials Network), David S. Liu, MD (NIDA Center for the Clinical Trials Network), Robert Lindblad, MD (Clinical Coordinating Center, Emmes), Timothy Church, MD (Louisiana State University), Steven N. Blair PEd (University of South Carolina, FNA Node), Edward V. Nunes, MD (New York State Psychiatric Institute, GNY Node).

This is the Primary Outcomes Article for CTN-0037. 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 screens (UDS) data.

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=0.60). 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=0.03, number needed to treat=7.2).

Conclusions: The primary analysis indicted 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. (Article (Peer-Reviewed), PDF, English, 2017)

Keywords: Behavior therapy | Cocaine | CTN primary outcomes | Exercise | Stimulant abuse | Timeline Follow-Back (TLFB) | Journal of Clinical Psychiatry (journal)

Document No: 1249, PMID: 28199070, PMCID: PMC5683711 (available 9/1/2018).

Submitted by the CTN Dissemination Librarians (2/16/2017).

Blair, Stephen N. mail
Carmody, Thomas mail
Causey, Trey
Church, Timothy
Grannemann, Bruce D.
Greer, Tracy L. mail
Hodgkins, Candace mail
Lindblad, Robert mail
Liu, David S. mail
Love, Lee D.
Myrick, Hugh
Nunes, Edward V. mail
Oden, Neal L. mail
Rethorst, Chad D. mail
Rinaldi, Paul mail
Seamans, Cindy mail
Shores-Wilson, Kathy mail
Silverstein, Meredith mail
Stotts, Angela L. mail
Stoutenberg, Mark mail
Straus, Michele
Szucs-Reed, Regina P.
Trivedi, Madhukar mail
Walker, N. Robrina mail
Warden, Diane mail
NIDA-CTN-0037 www
Texas (Lead) www
Delaware Valley www
Florida Node Alliance www
Greater New York www
Ohio Valley www
Southern Consortium www

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