Association between improvements in physical fitness and improvements in mental health: Effects of an exercise and sport intervention among refugees living in a Greek refugee camp on mental health and physical fitness: SALEEM – A pragmatic randomized controlled trial

Background:
Refugees are at an increased risk for mental disorders. While the positive effects of exercise on the mental health of refugees have been shown several times, the influence of physical fitness is less well researched. The objective of this study is to investigate whether improvements in physical fitness are associated with improvements in mental health among refugees living in a refugee camp.
Methods:
This study is designed as a pragmatic randomized controlled trial with an intervention group (n = 34) and a wait-list control group (n = 33) and was conducted in a Greek refugee camp. The intervention group participated in a 10-week exercise and sport intervention. Cardiorespiratory fitness was measured using the (submaximal) Åstrand-Rhyming Indirect Test of Maximal Oxygen Uptake. Self-report instruments were used to collect data on mental health. The intervention effects were tested using repeated measures ANCOVAs and for the associations multiple linear regression analyses were performed.
Results:
The results show that the intervention group improved significantly in terms of cardiorespiratory fitness compared to the wait-list control group (p = 0.017). However, apart from VO2max, only the intervention effect for pain was significant (p = 0.031). Furthermore, this study provides no evidence that improvements in physical fitness are associated with improvements in mental health.
Conclusions:
Although few positive effects of the exercise and sport intervention and the improved physical fitness were found, other potential benefits for the health and well-being of the refugees should not be ruled out. More studies are needed to investigate how exercise programs in refugee camps can most effectively contribute to the prevention and treatment of mental disorders.