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Quantifying the Placebo Effect in Psychological Outcomes of Exercise Training: A Meta-Analysis of Randomized Trials

Abstract

Background

The placebo effect could account for some or all of the psychological benefits attributed to exercise training. The magnitude of the placebo effect in psychological outcomes of randomized controlled exercise training trials has not been quantified. The aim of this investigation was to estimate the magnitude of the population placebo effect in psychological outcomes from placebo conditions used in exercise training studies and compare it to the observed effect of exercise training.

Methods

Articles published before 1 July 2013 were located using Google Scholar, MEDLINE, PsycINFO, and The Cochrane Library. To be included in the analysis, studies were required to have (1) a design that randomly assigned participants to exercise training, placebo, and control conditions and (2) an assessment of a subjective (i.e., anxiety, depression, energy, fatigue) or an objective (i.e., cognitive) psychological outcome. Meta-analytic and multi-level modeling techniques were used to analyze effects from nine studies involving 661 participants. Hedges’ d effect sizes were calculated, and random effects models were used to estimate the overall magnitude of the placebo and exercise training effects.

Results

After adjusting for nesting effects, the placebo mean effect size was 0.20 (95 % confidence interval [CI] −0.02, 0.41) and the observed effect of exercise training was 0.37 (95 % CI 0.11, 0.63).

Conclusion

A small body of research suggests both that (1) the placebo effect is approximately half of the observed psychological benefits of exercise training and (2) there is an urgent need for creative research specifically aimed at better understanding the role of the placebo effect in the mental health consequences of exercise training.

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Acknowledgments

The authors wish to thank Shaan Uppal for assistance with article retrieval and data management. We also thank the reviewers and editor for their insightful suggestions. No sources of funding were used to assist in the preparation of this review. The authors have no potential conflicts of interest that are directly relevant to the content of this review.

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Correspondence to Jacob B. Lindheimer.

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Lindheimer, J.B., O’Connor, P.J. & Dishman, R.K. Quantifying the Placebo Effect in Psychological Outcomes of Exercise Training: A Meta-Analysis of Randomized Trials. Sports Med 45, 693–711 (2015). https://doi.org/10.1007/s40279-015-0303-1

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  • DOI: https://doi.org/10.1007/s40279-015-0303-1

Keywords

  • Placebo
  • Exercise Training
  • Exercise Intervention
  • Placebo Effect
  • Placebo Intervention