Impact of physical exercise interventions on post-traumatic stress disorder symptoms: A systematic review and meta-analysis

BACKGROUND: Physical exercise has received increasing attention as a complementary approach for managing post-traumatic stress disorder (PTSD). Nevertheless, evidence regarding its effectiveness across different exercise modalities and populations remains mixed. This systematic review and meta-analysis synthesizes findings to assess the impact of structured exercise programs on PTSD symptom severity and to explore potential moderators. METHODS: Searches of PubMed, Embase, Web of Science, the Cochrane Library, and EBSCOhost-SportDiscus were conducted from inception to 27 September 2025. We included randomized controlled trials in which participants receiving an exercise intervention were compared with those receiving usual care or a control condition without structured physical activity. Subgroup analyses were conducted based on exercise type, participant characteristics, and outcome measures. In addition, a random-effects meta-regression was used to examine whether the total supervised training duration influenced treatment efficacy. RESULTS: Sixteen randomized controlled trials involving 663 participants met the inclusion criteria. Pooled findings indicated that exercise interventions were associated with a significant reduction in PTSD symptoms (Hedges' g = -0.49, 95% CI -0.76 to -0.22). Subgroup analyses suggested that yoga-based interventions and studies involving military populations showed larger effect sizes; however, differences between subgroups were not statistically significant. Training duration did not significantly moderate the treatment outcome. CONCLUSIONS: This review provides evidence that physical exercise can effectively reduce PTSD symptoms. Beneficial effects were observed across different exercise modalities and populations, although no statistically significant subgroup differences were identified. These findings support structured exercise as a promising and scalable component of PTSD treatment strategies.