Effects of exercise interventions on mental health and social function reconstruction in individuals with substance use disorders: a systematic review and meta-analysis

This meta-analysis evaluated the effects of exercise interventions on mental health and social adaptation in individuals with substance use disorders (SUDs) to inform evidence-based physical/psychological rehabilitation and social reintegration. We retrieved randomized controlled trials (RCTs) from Web of Science, PubMed, Cochrane Library, EBSCOhost, and Embase (inception to July 2026). Quality was assessed using Cochrane ROB 2.0; RevMan 5.4 analyzed heterogeneity and effect sizes and generated plots, with Stata 18 for sensitivity analyses. 13 RCTs (953 participants; sample size 20–70; intervention 2–6 months; mostly moderate-intensity exercise; controls: health education/standard care) were included. Exercise significantly improved depression ( SMD = − 1.15, 95% CI − 1.87 to − 0.43, P = 0.002), anxiety ( SMD = − 0.68 , 95% CI − 1.19 to − 0.18 , P = 0.008), sleep quality ( MD = − 2.93 , 95% CI − 5.13 to − 0.73 , P = 0.009), degree of craving (SMD = − 0.43, 95% CI − 0.68 to − 0.19, p < 0.001 ), and relapse tendency ( SMD = − 1.73, 95% CI − 2.83 to − 0.63, P = 0.002). Significant enhancements were also observed in social function domains: physical function ( SMD = 0.70, 95% CI 0.11 to 1.29, P = 0.02), psychological function ( SMD = 0.71, 95% CI 0.47 to 0.95, p < 0.001), social adaptation ( SMD = 0.69, 95% CI 0.42 to 0.96, p < 0.001), and overall scores ( SMD = 0.68, 95% CI 0.30 to 1.05, p < 0.001), although the improvement in withdrawal symptoms did not reach statistical significance ( SMD = 0.59, 95% CI − 0.07 to 1.25, P = 0.08), likely reflecting the complex neurobiological nature of withdrawal and its limited short-term responsiveness to exercise alone. The available evidence suggests potential benefits of moderate-intensity mind–body and aerobic exercise on mental health and social functioning in individuals with SUDs, pending confirmation in larger, pre-registered RCTs with objective endpoints.