***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Exercise training may be especially helpful for patients with generalized anxiety disorder ( GAD ) . We conducted a r and omized controlled trial to quantify the effects of 6 weeks of resistance ( RET ) or aerobic exercise training ( AET ) on remission and worry symptoms among sedentary patients with GAD . Methods : Thirty sedentary women aged 18–37 years , diagnosed by clinicians blinded to treatment allocation with a primary DSM-IV diagnosis of GAD and not engaged in any treatment other than pharmacotherapy , were r and omly allocated to RET , AET , or a wait list ( WL ) . RET involved 2 weekly sessions of lower-body weightlifting . AET involved 2 weekly sessions of leg cycling matched with RET for body region , positive work , time actively engaged in exercise , and load progression . Remission was measured by the number needed to treat ( NNT ) . Worry symptoms were measured by the Penn State Worry Question naire . Results : There were no adverse events . Remission rates were 60 % , 40 % , and 30 % for RET , AET , and WL , respectively . The NNT was 3 ( 95 % CI 2 to 56 ) for RET and 10 ( 95 % CI –7 to 3 ) for AET . A significant condition-by-time interaction was found for worry symptoms . A follow-up contrast showed significant reductions in worry symptoms for combined exercise conditions versus the WL . Conclusions : Exercise training , including RET , is a feasible , low-risk treatment that can potentially reduce worry symptoms among GAD patients and may be an effective adjuvant , short-term treatment or augmentation for GAD . Preliminary findings warrant further investigation The prevalence of mental health disorders among college students is rising and the increasing rates of anxiety and depression have important societal implication s. Physical activity has been proposed as an adjuvant to traditional treatment approaches ( i.e. psychotherapy or pharmacotherapy ) , and the internet is a potentially useful means of delivering physical activity information to the college-aged population . This r and omized pilot trial examined the effects of an internet-based physical activity intervention on physical activity , self-efficacy , depression , and anxiety in college students ( n = 47 ) receiving mental health counseling .  Physical activity , depression , anxiety , exercise self-efficacy , and barriers self-efficacy were assessed at baseline and post-intervention . There was a significant time effect for physical activity , with both groups increasing their physical activity levels across the 10-week intervention but with a larger increase in the intervention condition ( d = 0.68 ) than the control condition ( d = 0.05 ) . Exercise and barriers self-efficacy declined across the intervention , but more so in the control than intervention condition . Effects on depression and anxiety were nonsignificant . Finally , correlation analyses showed increases in physical activity were associated with increases in exercise self-efficacy ( r = 0.62 ) and barriers self-efficacy ( r = 0.63 ) and decreases in depression ( r = −0.44 ) in the intervention condition , but not in the control condition . These results suggest that an internet-delivered physical activity intervention may be a promising approach to promoting physical activity among college students undergoing mental health counseling Background : Previous studies have suggested that physical exercise can reduce symptoms for subjects suffering from panic disorder ( PD ) . The efficacy of this intervention has so far not been compared to an established psychotherapy , such as cognitive behaviour therapy ( CBT ) . Assessment of controlled long-term effects and the clinical significance of the treatment are also lacking . Aim : To compare physical exercise to CBT as treatment for PD , and assess controlled long-term and clinical ly significant effects . Method : PD- patients were r and omized to either three weekly sessions of physical exercise ( n = 17 ) , or one weekly session of CBT ( n = 19 ) . Both treatments ran for 12 weeks , were manualized and administered in groups . Patients were assessed twice before the start of treatment , at post-treatment and at 6 and 12 months thereafter . Primary outcome - measures consisted of the Mobility Inventory ( MI ) , the Agoraphobia Cognitions Question naire ( ACQ ) and the Body Sensations Question naire ( BSQ ) . Results : A two-way repeated measures MANOVA of these measures demonstrated a significant effect of time , F(16 , 544 ) = 7.28 , p < .01 , as well as a significant interaction effect , F(16 , 544 ) = 1.71 , p < .05 , in favour of CBT . This finding was supported by the assessment of clinical ly significant changes of avoidant behaviour and of treatment-seeking one year later . Conclusion : Group CBT is more effective than group physical exercise as treatment of panic disorder , both immediately following treatment and at follow-up assessment A moderate to vigorous intensity exercise program is emerging as a promising strategy for reducing  anxiety sensitivity ( AS ) .  Initial evidence suggests that the effects of exercise on mental health outcomes may vary as a function of gender , with men benefitting more than women . Building upon this evidence , the present study tested the hypothesis that the effect of exercise on AS would vary as a function of gender , such that the effect would be stronger for men than for women . We tested this hypothesis using the data from a published study ( Smits , Berry , Rosenfield , et al. , 2008 ) . In this study , participants ( N = 60 ) with elevated levels of AS were r and omly assigned to a two-week exercise intervention [ EX ] or a waitlist control condition [ WL ] . Results revealed that males showed significantly greater initial AS reductions relative to females ( following 1 week of exercise ) . However , these gender differences were no longer evident at the end of the intervention . Possible mechanisms for the observed findings and directions for future research are discussed Background It is generally believed that exhaustive search es of bibliographic data bases are needed for systematic review s of health care interventions . The CENTRAL data base of controlled trials ( RCTs ) has been built up by exhaustive search ing . The CONSORT statement aims to encourage better reporting , and hence indexing , of RCTs . Our aim was to assess whether developments in the CENTRAL data base , and the CONSORT statement , mean that a simplified RCT search strategy for identifying RCTs now suffices for systematic review s of health care interventions . Methods RCTs used in the Cochrane review s were identified . A brief RCT search strategy ( BRSS ) , consisting of a search of CENTRAL , and then for variants of the word r and om across all fields ( r and om$.af . ) in MEDLINE and EMBASE , was devised and run . Any trials included in the meta-analyses , but missed by the BRSS , were identified . The meta-analyses were then re-run , with and without the missed RCTs , and the differences quantified . The proportion of trials with variants of the word r and om in the title or abstract was calculated for each year . The number of RCTs retrieved by search ing with " r and om$.af . " was compared to the highly sensitive search strategy ( HSSS ) . Results The BRSS had a sensitivity of 94 % . It found all journal RCTs in 47 of the 57 review s. The missing RCTs made some significant differences to a small proportion of the total outcomes in only five review s , but no important differences in conclusions result ed . In the post-CONSORT years , 1997–2003 , the percentage of RCTs with r and om in the title or abstract was 85 % , a mean increase of 17 % compared to the seven years pre-CONSORT ( 95 % CI , 8.3 % to 25.9 % ) . The search using r and om$.af . reduced the MEDLINE retrieval by 84 % , compared to the HSSS , thereby reducing the workload of checking retrievals . Conclusion A brief RCT search strategy is now sufficient to locate RCTs for systematic review s in most cases . Exhaustive search ing is no longer cost-effective , because in effect it has already been done for CENTRAL Abstract Anxiety sensitivity , or the belief that anxiety-related sensations can have negative consequences , has been shown to play an important role in the etiology and maintenance of panic disorder and other anxiety-related pathology . Aerobic exercise involves exposure to physiological cues similar to those experienced during anxiety reactions . The present study sought to investigate the efficacy of a brief aerobic exercise intervention for high anxiety sensitivity . Accordingly , 24 participants with high anxiety sensitivity scores ( Anxiety Sensitivity Index-Revised scores > 28 ) were r and omly assigned to complete either six 20-minute sessions of aerobic exercise or a no-exercise control condition . The results indicated that individuals assigned to the aerobic exercise condition reported significantly less anxiety sensitivity subsequent to exercise , whereas anxiety sensitivity scores among non-exercisers did not significantly change . The clinical research and public health implication s of these findings are discussed , and several potential directions for additional research are recommended Anxiety disorders are the most common mental illness , but are not uniform , many clinical diagnoses include the symptoms of anxiety . That is the reason why there are relatively small numbers of population surveys and r and omized-controlled trials which have examined the relationship between exercise and the various anxiety symptoms/ disorders . In our review we summarize meta-analytic studies , epidemiological surveys and r and omized controlled studies which examine the role of regular physical activity in the prevention and treatment of sub clinical anxiety/anxiety symptoms and anxiety disorders .  The meta-analytic studies and r and omized-controlled trials examining the relationship between sub clinical anxiety disorders and anxiety symptoms demonstrated small to moderate effect of exercise in the decrease of anxiety symptoms , especially for moderate-intensity exercise . This relationship was confirmed for both acute and chronic exercise , for state and trait anxiety in different sex , age and state of health groups . In the case of the anxiety disorders based on review ed studies , we can conclude that there is a potential association between decreased symptoms of anxiety and exercise .  The regular , moderate-intensity exercise can reduce and alleviate the symptoms of anxiety - at least in panic , agoraphobia and generalized anxiety disorders . The review ed studies have been highlighted the fact , that exercise can be effective in psychiatric practice as an alternative or adjuvant therapy . Physically healthy people with anxiety symptoms , or patients with anxiety disorders can perform exercise , there are no contraindications . Although based on previous studies , we can not assume that the relationship is causal , but we can not ignore the evidence s that are already available OBJECTIVE Effective treatments for social anxiety disorder ( SAD ) exist , but additional treatment options are needed for nonresponders as well as those who are either unable or unwilling to engage in traditional treatments . Mindfulness-based stress reduction ( MBSR ) is one nontraditional treatment that has demonstrated efficacy in treating other mood and anxiety disorders , and preliminary data suggest its efficacy in SAD as well . METHOD Fifty-six adults ( 52 % female ; 41 % Caucasian ; age mean [ M ] ± st and ard deviation [ SD ] : 32.8 ± 8.4 ) with SAD were r and omized to MBSR  or an active comparison condition , aerobic exercise ( AE ) . At baseline and post-intervention , participants completed measures of clinical symptoms ( Liebowitz Social Anxiety Scale , Social Interaction Anxiety Scale , Beck Depression Inventory-II , and Perceived Stress Scale ) and subjective well-being ( Rosenberg Self-Esteem Scale , Satisfaction with Life Scale , Self-Compassion Scale , and UCLA-8 Loneliness Scale ) . At 3 months post-intervention , a subset of these measures was readministered . For clinical significance analyses , 48 healthy adults ( 52.1 % female ; 56.3 % Caucasian ; age [ M ± SD ] : 33.9 ± 9.8 ) were recruited .  MBSR and AE participants were also compared with a separate untreated group of 29 adults ( 44.8 % female ; 48.3 % Caucasian ; age [ M ± SD ] : 32.3 ± 9.4 ) with generalized SAD who completed assessment s over a comparable time period with no intervening treatment . RESULTS A 2 ( Group ) x 2 ( Time ) repeated measures analyses of variance ( ANOVAs ) on measures of clinical symptoms and well-being were conducted to examine pre-intervention to post-intervention and pre-intervention to 3-month follow-up . Both MBSR and AE were associated with reductions in social anxiety and depression and increases in subjective well-being , both immediately post-intervention and at 3 months post-intervention . When participants in the r and omized controlled trial were compared with the untreated SAD group , participants in both interventions exhibited improvements on measures of clinical symptoms and well-being . CONCLUSION Nontraditional interventions such as MBSR and AE merit further exploration as alternative or complementary treatments for SAD A group r and omized trial of adding a home-based walking program to a st and ard group cognitive behavioral therapy ( GCBT+EX ) was compared with groups receiving GCBT and educational sessions ( GCBT+ED ) . The study was implemented in an outpatient clinic providing GCBT for clients diagnosed with panic disorder , generalized anxiety disorder or social phobia . Pre- and post-treatment measures included the self-report depression , anxiety , and stress scale ( DASS-21 ) and measures of physical activity .  From January 2004 to May 2005 , six groups were allocated to GCBT+EX ( n=38 ) and five to GCBT+ED ( n=36 ) . Analysis of covariance for completed cases ( GCBT+EX , n=21 ; GCBT+ED , n=20 ) , adjusting for the group design , baseline DASS-21 scores , and anxiety diagnosis showed significant effect for GCBT+EX on depression , anxiety , and stress ( regression coefficients=-6.21 , -3.41 , and -5.14 , respectively , p 
    Output:
    
There was no significant difference in outcomes between groups of patients with diagnosed anxiety disorders and patients who had raised anxiety on a rating scale .
Conclusions were limited by the small number of studies and wide variation in the delivery of exercise interventions .
Conclusion Exercise programmes are a viable treatment option for the treatment of anxiety .
High intensity exercise regimens were found to be more effective than low intensity regimens .