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

Madhukar H. Trivedi, Tracy L. Greer, Chad D. Rethorst, Thomas Carmody, Bruce D. Grannemann, Robrina Walker, Diane Warden, Kathy Shores-Wilson, Mark Stoutenberg, Neal Oden, Meredith Silverstein, Candace Hodgkins, Lee Love, Cindy Seamans, Angela Stotts, Trey Causey, Regina P. Szucs-Reed, Paul Rinaldi, Hugh Myrick, Michele StrausDavid Liu, Robert Lindblad, Timothy Church, Steven N. Blair, Edward V. Nunes

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1075-1082
Number of pages8
JournalJournal of Clinical Psychiatry
Volume78
Issue number8
DOIs
StatePublished - Sep 1 2017

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Health Education
Randomized Controlled Trials
Residential Treatment
Social Adjustment
Numbers Needed To Treat
Diagnostic and Statistical Manual of Mental Disorders
trans-crotonin
Urine
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Psychiatry and Mental health

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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. / Trivedi, Madhukar H.; Greer, Tracy L.; Rethorst, Chad D.; Carmody, Thomas; Grannemann, Bruce D.; Walker, Robrina; Warden, Diane; Shores-Wilson, Kathy; Stoutenberg, Mark; Oden, Neal; Silverstein, Meredith; Hodgkins, Candace; Love, Lee; Seamans, Cindy; Stotts, Angela; Causey, Trey; Szucs-Reed, Regina P.; Rinaldi, Paul; Myrick, Hugh; Straus, Michele; Liu, David; Lindblad, Robert; Church, Timothy; Blair, Steven N.; Nunes, Edward V.

In: Journal of Clinical Psychiatry, Vol. 78, No. 8, 01.09.2017, p. 1075-1082.

Research output: Contribution to journalArticle

Trivedi, MH, Greer, TL, Rethorst, CD, Carmody, T, Grannemann, BD, Walker, R, Warden, D, Shores-Wilson, K, Stoutenberg, M, Oden, N, Silverstein, M, Hodgkins, C, Love, L, Seamans, C, Stotts, A, Causey, T, Szucs-Reed, RP, Rinaldi, P, Myrick, H, Straus, M, Liu, D, Lindblad, R, Church, T, Blair, SN & Nunes, EV 2017, '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, vol. 78, no. 8, pp. 1075-1082. https://doi.org/10.4088/JCP.15m10591
Trivedi, Madhukar H. ; Greer, Tracy L. ; Rethorst, Chad D. ; Carmody, Thomas ; Grannemann, Bruce D. ; Walker, Robrina ; Warden, Diane ; Shores-Wilson, Kathy ; Stoutenberg, Mark ; Oden, Neal ; Silverstein, Meredith ; Hodgkins, Candace ; Love, Lee ; Seamans, Cindy ; Stotts, Angela ; Causey, Trey ; Szucs-Reed, Regina P. ; Rinaldi, Paul ; Myrick, Hugh ; Straus, Michele ; Liu, David ; Lindblad, Robert ; Church, Timothy ; Blair, Steven N. ; Nunes, Edward V. / 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. In: Journal of Clinical Psychiatry. 2017 ; Vol. 78, No. 8. pp. 1075-1082.
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abstract = "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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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

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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.

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