Intervenções de exercício físico no meio natural em pessoas com trauma por uso de substâncias: revisão sistemática
DOI:
https://doi.org/10.47197/retos.v71.117219Palavras-chave:
Exercício físico, meio natural, trastorno uso consumo de substâncias, terapia coadjuvanteResumo
Introdução: o exercício físico e a exposição nos espaços naturais são ferramentas evidenciadas com carácter benéfico nos processos de tratamento pessoal com traumas pelo uso de substâncias (TUS) (Shirazi et al., 2025; Wicks et al., 2022).
Objectivo: recuperar resultados, tendências e conclusões dos estudos realizados no âmbito do exercício físico no meio natural em pessoas com TUS.
Metodologia: Foi realizada uma revisão sistemática nas bases de dados Web of Science, Pubmed e Scopus. Foram incluídos 5 estúdios e analisados tendo em conta as características gerais, específicas e de qualidade metodológica.
Resultados: os estudos selecionados indicam que o exercício físico no meio natural é uma ferramenta eficaz para a melhoria dos aspetos psicológicos das pessoas com TUS. Observa-se também que o abandono das atividades é escasso e a qualidade metodológica é baixa ou aceitável em termos gerais.
Discussão: os escassos estudos encontrados demonstram-nos que as intervenções de exercício físico no meio natural são uma ferramenta coadjuvante em pessoas com TUS. Por outro lado, foram encontradas limitações metodológicas nos estúdios e no futuro será necessário abordar estudos que tenham em conta uma maior qualidade metodológica, baseada em princípios FITT e em variáveis biológicas e de condição física.
Conclusões: a revisão sistemática mostrou que o exercício físico natural melhorou a ansiedade, a depressão, o stress e o desejo em pessoas com TUS. Observam-se também tendências positivas de bem-estar e abstinência. Foi identificada a necessidade de estudos futuros com melhor desenho metodológico, aplicando princípios de exercício e medindo variáveis biológicas para otimizar as intervenções.
Referências
Abdullah, M., Huang, L.-C., Lin, S.-H., y Yang, Y. K. (2022). Dopaminergic and glutamatergic biomarkers disruption in addiction and regulation by exercise: A mini review. Biomarkers, 27(4), 306-318. https://doi.org/10.1080/1354750X.2022.2049367
American College of Sports Medicine, A. C. (2019). Manual ACSM para la Valoración y Prescripción del Ejercicio. Paidotribo.
Anderson, M., Devlin, A. M., Pickering, L., McCann, M., y Wight, D. (2021). ‘It’s not 9 to 5 recovery’: The role of a recovery community in producing social bonds that support recovery. Drugs: Educa-tion, Prevention and Policy, 28(5), 475-485. https://doi.org/10.1080/09687637.2021.1933911
Ashdown-Franks, G., Firth, J., Carney, R., Carvalho, A. F., Hallgren, M., Koyanagi, A., Rosenbaum, S., Schuch, F. B., Smith, L., Solmi, M., Vancampfort, D., y Stubbs, B. (2020). Exercise as Medicine for Mental and Substance Use Disorders: A Meta-review of the Benefits for Neuropsychiatric and Cognitive Outcomes. Sports Medicine, 50(1), 151-170. https://doi.org/10.1007/s40279-019-01187-6
Barisic, A., Leatherdale, S. T., y Kreiger, N. (2011). Importance of Frequency, Intensity, Time and Type (FITT) in Physical Activity Assessment for Epidemiological Research. Canadian Journal of Pu-blic Health, 102(3), 174-175. https://doi.org/10.1007/BF03404889
Bennett, L. W., Cardone, S., y Jarczyk, J. (1998). Effects of a Therapeutic Camping Program on Addic-tion Recovery. Journal of Substance Abuse Treatment, 15(5), 469-474. https://doi.org/10.1016/S0740-5472(97)00222-5
Benvegnù, G., Semenzato, M., Urbani, A., Zanlorenzi, I., Cibin, M., y Chiamulera, C. (2024). Nature-based experience in Venetian lagoon: Effects on craving and wellbeing in addict residential inpa-tients. Frontiers in Psychology, 15, 1356446. https://doi.org/10.3389/fpsyg.2024.1356446
Berry, M. S., Repke, M. A., Metcalf, A. L., y Jordan, K. E. (2020). Promoting Healthy Decision-Making via Natural Environment Exposure: Initial Evidence and Future Directions. Frontiers in Psychology, 11, 1682. https://doi.org/10.3389/fpsyg.2020.01682
Bettmann, J. E., Anderson, I., Makouske, J., y Hanley, A. (2022). Mental Health Outcomes of Peer-led Therapeutic Adventure for Military Veterans. Journal of Experiential Education, 45(3), 295-315. https://doi.org/10.1177/10538259211049535
Bettmann, J. E., Kouris, G. M., Anderson, I. M., y Casselman, B. (2021). Wilderness as Healing Environ-ment: Treating Adolescent Substance Misuse in Wilderness Therapy. The Psychoanalytic Study of the Child, 74(1), 249-264. https://doi.org/10.1080/00797308.2020.1859270
Biddle, S. J. H. (2021). Physical activity research in Australia: A view from exercise psychology and behavioural medicine. Asian Journal of Sport and Exercise Psychology, 1(1), 12-20. https://doi.org/10.1016/j.ajsep.2021.03.006
Cabral, D. A. R., Dongshi, W., Schuch, F. B., y Tavares, V. D. D. O. (2024). The role of physical exercise on the brain and cognitive functions of patients in recovery from substance use disorder: A narrative review and recommendations for researchers and practitioners. Mental Health and Physical Activity, 26, 100594. https://doi.org/10.1016/j.mhpa.2024.100594
Carden, L., y Wood, W. (2018). Habit formation and change. Current Opinion in Behavioral Sciences, 20, 117-122. https://doi.org/10.1016/j.cobeha.2017.12.009
Carroll, K. M., y Schottenfeld, R. (1997). Nonpharmacologic approaches to substance abuse treatment. Medical Clinics of North America, 81(4), 927-944. https://doi.org/10.1016/S0025-7125(05)70556-3
Coventry, P. A., Brown, JenniferV. E., Pervin, J., Brabyn, S., Pateman, R., Breedvelt, J., Gilbody, S., Stan-cliffe, R., McEachan, R., y White, PiranC. L. (2021). Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysis. SSM - Population Health, 16, 100934. https://doi.org/10.1016/j.ssmph.2021.100934
Dacosta‐Sánchez, D., González‐Ponce, B. M., Fernández‐Calderón, F., Sánchez‐García, M., y Lozano, O. M. (2022). Retention in treatment and therapeutic adherence: How are these associated with therapeutic success? An analysis using real‐world data. International Journal of Methods in Psy-chiatric Research, 31(4), e1929. https://doi.org/10.1002/mpr.1929
Dai, C.-L., Chen, C.-C., Richardson, G. B., y Gordon, H. R. D. (2020). Managing Substance Use Disorder through a Walking/Running Training Program. Substance Abuse: Research and Treatment, 14, 1178221820936681. https://doi.org/10.1177/1178221820936681
Engemann, K., Svenning, J.-C., Arge, L., Brandt, J., Erikstrup, C., Geels, C., Hertel, O., Mortensen, P. B., Plana-Ripoll, O., Tsirogiannis, C., Sabel, C. E., Sigsgaard, T., y Pedersen, C. B. (2020). Associa-tions between growing up in natural environments and subsequent psychiatric disorders in Denmark. Environmental Research, 188, 109788. https://doi.org/10.1016/j.envres.2020.109788
Furzer, B., Rebar, A., Dimmock, J. A., More, A., Thornton, A. L., Wright, K., Colthart, A., y Jackson, B. (2021). Exercise is medicine… when you enjoy it: Exercise enjoyment, relapse prevention effi-cacy, and health outcomes for youth within a drug and alcohol treatment service. Psychology of Sport and Exercise, 52, 101800. https://doi.org/10.1016/j.psychsport.2020.101800
Giménez-Meseguer, J., Tortosa-Martínez, J., y Cortell-Tormo, J. (2020). The Benefits of Physical Exer-cise on Mental Disorders and Quality of Life in Substance Use Disorders Patients. Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 17(10), 3680. https://doi.org/10.3390/ijerph17103680
Gómez-Conesa, A., Serrano, C. S., Matamoros, D. C., y López-López, J. A. (2015). The Spanish translation and adaptation of the Pedro scale. Physiotherapy, 101, e463-e464. https://doi.org/10.1016/j.physio.2015.03.3250
Gómez-Redondo, P., Valenzuela, P. L., Morales, J. S., Ara, I., y Mañas, A. (2024). Supervised Versus Unsupervised Exercise for the Improvement of Physical Function and Well-Being Outcomes in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Sports Medicine, 54(7), 1877-1906. https://doi.org/10.1007/s40279-024-02024-1
Gürel, Ş. C. (2024). Empowering Change: Psychosocial Interventions in Alcohol and Substance Use Di-sorders. 103-114. https://doi.org/10.70020/ehass.2024.7.10
Harper, N. J. (with Dobud, W. W.). (2020). Outdoor Therapies: An Introduction to Practices, Possibilities, and Critical Perspectives. Taylor & Francis Group.
Howlett, N., Trivedi, D., Troop, N. A., y Chater, A. M. (2019). Are physical activity interventions for healthy inactive adults effective in promoting behavior change and maintenance, and which behavior change techniques are effective? A systematic review and meta-analysis. Translatio-nal Behavioral Medicine, 9(1), 147-157. https://doi.org/10.1093/tbm/iby010
Jhanjee, S. (2014). Evidence Based Psychosocial Interventions in Substance Use. Indian Journal of Psychological Medicine, 36(2), 112-118. https://doi.org/10.4103/0253-7176.130960
Kelley, C., Mack, D. E., y Wilson, P. M. (2022). Does Physical Activity in Natural Outdoor Environments Improve Wellbeing? A Meta-Analysis. Sports, 10(7), 103. https://doi.org/10.3390/sports10070103
Lee, W.-C., Chen, J.-J., Hunt, D. D., Hou, C.-W., Lai, Y.-C., Lin, F.-C., Chen, C.-Y., Lin, C.-H., Liao, Y.-H., y Kuo, C.-H. (2004). Effects of hiking at altitude on body composition and insulin sensitivity in re-covering drug addicts. Preventive Medicine, 39(4), 681-688. https://doi.org/10.1016/j.ypmed.2004.02.035
Linke, S. E., y Ussher, M. (2015). Exercise-based treatments for substance use disorders: Evidence, theory, and practicality. The American Journal of Drug and Alcohol Abuse, 41(1), 7-15. https://doi.org/10.3109/00952990.2014.976708
Liu, C., Liang, X., & Sit, C. H. P. (2024). Physical Activity and Mental Health in Children and Adolescents With Neurodevelopmental Disorders: A Systematic Review and Meta-Analysis. JAMA Pediatrics, 178(3), 247. https://doi.org/10.1001/jamapediatrics.2023.6251
López-Goñi, J. J., Fernández-Montalvo, J., Illescas, C., Landa, N., y Lorea, I. (2008). Razones para el abandono del tratamiento en una comunidad terapéutica. Trastornos Adictivos, 10(2), 104-111. https://doi.org/10.1016/S1575-0973(08)74552-5
Lubans, D., Richards, J., Hillman, C., Faulkner, G., Beauchamp, M., Nilsson, M., Kelly, P., Smith, J., Raine, L., & Biddle, S. (2016). Physical Activity for Cognitive and Mental Health in Youth: A Systematic Review of Mechanisms. Pediatrics, 138(3), e20161642. https://doi.org/10.1542/peds.2016-1642
Mantler, A., y Logan, A. C. (2015). Natural environments and mental health. Advances in Integrative Medicine, 2(1), 5-12. https://doi.org/10.1016/j.aimed.2015.03.002
Marchand, W. R., Klinger, W., Block, K., VerMerris, S., Herrmann, T. S., Johnson, C., Shubin, E., y Sheppard, S. (2018). Safety and psychological impact of sailing adventure therapy among Vete-rans with substance use disorders. Complementary Therapies in Medicine, 40, 42-47. https://doi.org/10.1016/j.ctim.2018.07.013
Marcus, B. H., Bock, B. C., Pinto, B. M., Forsyth, L. A. H., Roberts, M. B., y Traficante, R. M. (1998). Effi-cacy of an individualized, motivationally-tailored physical activity intervention. Annals of Beha-vioral Medicine, 20(3), 174-180. https://doi.org/10.1007/BF02884958
Mitchell, R. (2013). Is physical activity in natural environments better for mental health than physical activity in other environments? Social Science & Medicine, 91, 130-134. https://doi.org/10.1016/j.socscimed.2012.04.012
Mitten, D., Overholt, J. R., Haynes, F. I., D’Amore, C. C., y Ady, J. C. (2018). Hiking: A Low-Cost, Accessi-ble Intervention to Promote Health Benefits. American Journal of Lifestyle Medicine, 12(4), 302-310. https://doi.org/10.1177/1559827616658229
Montón-Martínez, R., Castellano-Galvañ, I., Roldán, A., Javaloyes, A., Peña-González, I., Sarabia, J. M., Pastor, D., y Moya-Ramón, M. (2025). Effects of Physical Exercise on Substance Use Disorder: A Comprehensive Review. Applied Sciences, 15(3), 1481. https://doi.org/10.3390/app15031481
Mutz, M., y Müller, J. (2016). Mental health benefits of outdoor adventures: Results from two pilot stu-dies. Journal of Adolescence, 49(1), 105-114. https://doi.org/10.1016/j.adolescence.2016.03.009
Panno, A., Carrus, G., Lafortezza, R., Mariani, L., y Sanesi, G. (2017). Nature-based solutions to promote human resilience and wellbeing in cities during increasingly hot summers. Environmental Re-search, 159, 249-256. https://doi.org/10.1016/j.envres.2017.08.016
Roberts, H., Van Lissa, C., Hagedoorn, P., Kellar, I., y Helbich, M. (2019). The effect of short-term expo-sure to the natural environment on depressive mood: A systematic review and meta-analysis. Environmental Research, 177, 108606. https://doi.org/10.1016/j.envres.2019.108606
Ryan, D. A., y Boland, P. (2021). A scoping review of occupational therapy interventions in the treat-ment of people with substance use disorders. Irish Journal of Occupational Therapy, 49(2), 104-114. https://doi.org/10.1108/IJOT-11-2020-0017
Shirazi, A., Brody, A. L., Soltani, M., y Lang, A. J. (2025). Recovery Horizons: Nature-Based Activities as Adjunctive Treatments for Co-Occurring Post-Traumatic Stress Disorder and Substance Use Di-sorders. American Journal of Lifestyle Medicine, 19(4), 626-638. https://doi.org/10.1177/15598276241300475
Šprah, L., Dernovšek, M. Z., Wahlbeck, K., y Haaramo, P. (2017). Psychiatric readmissions and their association with physical comorbidity: A systematic literature review. BMC Psychiatry, 17(1), 2. https://doi.org/10.1186/s12888-016-1172-3
United Nations Office on Drugs and Crime. (2023). World Drug Report 2023. United Nations.
Upham, K., Auer, B. J., Sciamanna, C. N., Mowen, A. J., Smyth, J. M., Conroy, D. E., Silvis, M., Krasch-newski, J. L., Rovniak, L. S., Lehman, E., Kearcher, K., Vizzini, M., y Cesarone, L. (2020). Adults Want to Play Too: Feasibility of an Adult Physical Activity Program Designed to Maximize En-joyment. Journal of Physical Activity and Health, 17(2), 230-235. https://doi.org/10.1123/jpah.2018-0306
Ussher, M. H., Faulkner, G. E. J., Angus, K., Hartmann-Boyce, J., y Taylor, A. H. (2019). Exercise inter-ventions for smoking cessation. Cochrane Database of Systematic Reviews, 2019(10). https://doi.org/10.1002/14651858.CD002295.pub6
Van Den Bosch, M., y Ode Sang, Å. (2017). Urban natural environments as nature-based solutions for improved public health – A systematic review of reviews. Environmental Research, 158, 373-384. https://doi.org/10.1016/j.envres.2017.05.040
Volkow, N. D., y Blanco, C. (2023). Substance use disorders: A comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention. World Psychiatry, 22(2), 203-229. https://doi.org/10.1002/wps.21073
Wang, D., Wang, Y., Wang, Y., Li, R., y Zhou, C. (2014). Impact of Physical Exercise on Substance Use Disorders: A Meta-Analysis. PLoS ONE, 9(10), e110728. https://doi.org/10.1371/journal.pone.0110728
Wicks, C., Barton, J., Orbell, S., y Andrews, L. (2022). Psychological benefits of outdoor physical activity in natural versus urban environments: A systematic review and meta‐analysis of experimental studies. Applied Psychology: Health and Well-Being, 14(3), 1037-1061. https://doi.org/10.1111/aphw.12353
Wu, Y.-T., Prina, A. M., Jones, A., Matthews, F. E., Brayne, C., y MRC CFAS. (2015). Older people, the natural environment and common mental disorders: Cross-sectional results from the Cognitive Function and Ageing Study. BMJ Open, 5(9), e007936. https://doi.org/10.1136/bmjopen-2015-007936
Zhang, S., Qi, X., Wang, Y., y Fang, K. (2024). Global burden of drug use disorders by region and coun-try, 1990–2021. Frontiers in Public Health, Volume 12-2024. https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1470809
Zheng, Y., Zhao, Y., Chen, X., y Li, S. (2024). Effect of physical exercise on the emotional and cognitive levels of patients with substance use disorder: A meta-analysis. Frontiers in Psychology, 15, 1348224. https://doi.org/10.3389/fpsyg.2024.1348224
Zhu, D., Jiang, M., Xu, D., y Schöllhorn, W. I. (2020). Long-Term Effects of Mind-Body Exercises on the Physical Fitness and Quality of Life of Individuals With Substance Use Disorder—A Randomi-zed Trial. Frontiers in Psychiatry, 11, 528373. https://doi.org/10.3389/fpsyt.2020.528373
Zschucke, E., Heinz, A., y Ströhle, A. (2012). Exercise and Physical Activity in the Therapy of Substance Use Disorders. The Scientific World Journal, 2012, 1-19. https://doi.org/10.1100/2012/901741
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