Braining, structured physical activity in specialized psychiatry for patients with substance use disorders—a feasibility study

BACKGROUND: Individuals with substance use disorders (SUD) have poor metabolic and cardiovascular health and a high prevalence of depression and anxiety symptoms. Regular physical activity can improve both somatic and mental health. This study aimed to evaluate the feasibility of an aerobic physical activity intervention (Braining) in psychiatric care services specialized in SUD. METHODS: In this uncontrolled open trial with pre-, post-, and 12-month follow-up measures, 22 patients with SUD participated in a 12-week physical activity intervention. Recommended participation was three 30-45-min moderate-to-vigorous interval-based exercise sessions per week combining aerobic and body-weight strength exercises. No minimum session attendance was required for study participation. Feasibility was assessed through recruitment yield, number of exercise sessions attended, and adherence to study procedures. Satisfaction, acceptability, credibility, and negative effects were assessed using self-report questionnaires and adverse event reporting. Physical activity was measured using accelerometry (ActiGraph GT3X) and self-report. Patient-centered outcomes were summarized descriptively. RESULTS: The mean number of attended exercise sessions was 9 (SD = 7.7). Adherence to ActiGraph measurements was 73% at baseline, 46% mid-intervention, and 32% post-intervention. Completion of self-report assessments was 100% at baseline, 86% post-intervention, and 77% at 12-month follow-up. The mean Client Satisfaction Questionnaire (CSQ-8) score was 27 (SD = 3.9), and no serious adverse events were reported. Descriptive trends suggested reductions in psychiatric symptoms and substance use and improvements in functional status and quality of life, whereas changes in somatic measures were limited. CONCLUSIONS: Acceptability of the intervention was high in the target patient population; however, exercise attendance was low. Participants engaged adequately in study procedures, but adherence to accelerometer-based measurements was low. With further methodological refinements to enhance patient engagement and adaptations to how physical activity is measured in vulnerable patient populations, Braining remains a relevant intervention and warrants systematic evaluation in future large-scale controlled trials. STUDY REGISTRATION: The study was registered on 25/12/2021 at ClinicalTrials.gov under ID NCT05186688.