A controlled clinical trial on the effects of resistance training and recreational physical activity on health parameters in individuals with substance use disorders

Background Substance use disorders (SUD) are public health challenges that require multidisciplinary care. As part of rehabilitation, exercise interventions have shown benefits in individuals with SUD. However, it remains unclear whether different exercise modalities produce distinct benefits in this population. This study investigated the effects of two exercise modalities (resistance training versus recreational physical activity) compared with no-exercise on health parameters in individuals with SUD.Methods In this single-blind, randomized clinical trial, 107 participants were allocated to three groups: resistance training, recreational physical activity, and no-exercise. The interventions were conducted over 12 weeks. Outcome measures included anthropometric, body composition, and cardiovascular parameters. Within- and between-group comparisons were performed using Wilcoxon signed-rank and Kruskal–Wallis tests. Effect sizes (ES) were calculated.Results No significant differences were observed between the groups at baseline. Following the intervention, resistance training reduced adiposity (0.241 ≤ ES ≤ 0.453), lowered blood pressure (0.165 ≤ ES ≤ 0.170), and improved body composition (0.074 ≤ ES ≤ 0.541) of the participants. Recreational physical activity maintained the stability of participants’ anthropometric, cardiovascular, and body composition parameters. In contrast, no-exercise was associated with the deterioration of anthropometric and body composition measurements.Conclusion Compared with the other groups, resistance training demonstrated superior improvements in anthropometric, cardiovascular, and body composition parameters. Recreational physical activity contributed to the maintenance of outcomes, suggesting that even leisure-based exercise may help prevent physical decline during rehabilitation. These findings reinforce the benefits of different exercise modalities in individuals with SUD and support their incorporation into rehabilitation programs.