Acute effect of moderate-intensity aerobic exercise on state anxiety and anger symptoms evoked by aversive stimuli in young women: a randomized clinical trial

Abstract

Background Aerobic exercise is widely recognized for its acute anxiolytic and mood-regulating effects, typically demonstrated in neutral emotional contexts. However, it remains unclear whether such effects are preserved when exercise is performed concurrently with emotionally aversive stimuli, a situation that more closely mirrors real-world stress conditions. Objective To examine whether a single session of moderate-intensity continuous aerobic exercise, performed simultaneously with exposure to aversive images, could mitigate acute symptoms of state anxiety and anger in young adult women. Methods In a randomized controlled design, 52 healthy women (18–40 years) attended two laboratory visits. The first visit included informed consent, health screening, anthropometric assessments, and a graded exercise test. In the second visit, participants were randomized to four groups: Neutral Control, Aversive Control, Neutral Exercise, and Aversive Exercise. During a 30-minute intervention (cycling at 64–76% maximal heart rate or quiet sitting), participants viewed neutral or aversive images from the International Affective Picture System. State anxiety and state anger were measured at baseline, immediately post-session, and at 10- and 20-minute follow-ups. Results A significant main effect of time was observed for both anxiety and anger (p < 0.05). For anxiety, symptoms increased immediately post-session but returned to baseline, with no main effect of group (p > 0.05) and no significant time × group interaction (p > 0.05). For anger, there was a main effect of time (p < 0.05) and a significant time × group interaction (p = 0.028), driven by an increase in anger in the Aversive Exercise group immediately post-session (p = 0.0001). No significant effects were detected under neutral conditions. Conclusions Concurrent exposure to emotionally aversive stimuli during moderate-intensity aerobic exercise does not reduce acute anxiety or anger in young women and may amplify anger responses. Emotional context may override the affective benefits typically associated with aerobic exercise.