# Effects of Physical Exercise on Substance Use Disorder: A Comprehensive Review
## 3 Results
### Assessment and Impact of Physical Exercise on Crawings in Individuals with SUD
#### 3.3.2. Craving and Duration, Frequency, and Intensity of Intervention Programs  
The duration and frequency of exercise are key variables in reducing cravings, as evidence suggests that programs lasting 8 to 12 weeks, with three to five 60 min sessions per week, are the most effective programs for significantly reducing cravings in individuals with SUD [13; 15; 70; 92; 100]. In these studies, regular and consistent sessions allow participants to experience stable improvements in cravings, with significant reductions observed after a minimum of eight weeks. Conversely, interventions lasting less than eight weeks or with fewer than three weekly sessions tend to show limited or non-significant effects. This may be because changing craving behaviors requires continuous exposure to exercise to establish an effective habit. Programs lasting 12 weeks or more [55; 70; 92; 94; 100] offer more durable results, indicating that longer interventions with higher weekly frequencies are more likely to maintain stable reductions in cravings. Moderate-intensity exercise (e.g., running or cycling) is particularly beneficial and is the most commonly used method [13; 52; 55; 61; 92; 97; 100]. It is sufficiently demanding to engage participants effectively without causing excessive fatigue, thereby supporting program adherence. In the latest meta-analysis, moderate-intensity exercise showed greater reductions in cravings than standard therapy, though with a small overall effect size (SMD = \(-\)0.30; \(Z\) = 2.33; \(p=0.01\)) [45]. Only three studies focused on the effects of high-intensity programs, showing substantial heterogeneity, with durations ranging from 21 days [62] to 32 weeks [42]. Two of these studies used the VAS. [PERSON] et al. (2021) [92] compared moderate- and high-intensity exercise over a 12-week intervention, finding significant pre-post craving reductions only in the high-intensity group. Similarly, the latest meta-analysis reported that high-intensity exercise showed the greatest reductions in cravings, with a large effect size (SMD = \(-\)1.33; \(Z\) = 4.58; \(p<0.01\)) [45]. These findings suggest that high-intensity exercise may be the most effective for reducing cravings, though moderate-intensity exercise also shows potential. However, the physical demands of high-intensity exercise may not be suitable for individuals with low or no prior physical activity. From that perspective, it may be advisable to initiate moderate-intensity exercise programs and gradually increase intensity over the course of several weeks. This progressive approach allows individuals to adapt physically and psychologically to the demands of exercise, reducing the risk of dropout due to fatigue or injury while promoting long-term adherence. The evidence indicates that physical exercise is an effective and complementary tool for reducing cravings in individuals with SUD, outperforming traditional interventions. Aerobic programs stand out for their accessibility, effectiveness, and potential to foster social interaction, while mind-body therapies show inconsistent results due to their lower physical intensity. Nevertheless, the positive effects of intensive programs within these therapies warrant further exploration. High-intensity and concurrent (aerobic and strength) programs appear promising, though their applicability is limited for individuals with low initial physical fitness. This underscores the importance of designing interventions tailored to the participants' initial capabilities and contexts, optimizing their therapeutic impact. Assessment and Impact of Physical Exercise on Physical Fitness and Cognitive Function in Individuals with SUID  
A wide spectrum of variables related to fitness has been analyzed in this population, including anthropometric measurements, cardiovascular indicators, body mass index (BMI), neuromuscular factors, balance, and flexibility, among others [43; 57; 103].