Effects of Exercise Interventions on Anxiety in Korean University Students: A Narrative Review

초록

Background: Anxiety is a common mental health concern among Korean university students, and exercise, a core physical therapy modality, has been proposed as a non-pharmacological approach to its management. Yet this evidence has not previously been reviewed from a physical therapy standpoint. Design: Narrative review. Methods: Primary studies examining exercise interventions or physical activity and anxiety in Korean university student samples were identified through two domestic databases (RISS, KISS) and three international databases (PubMed, ScienceDirect, Google Scholar), using population, intervention, and outcome search terms. Twenty studies met the eligibility screen. Eleven satisfied all pre-specified criteria (Korean university-student sample; exercise or physical activity as the independent variable; anxiety measured directly with a standardized instrument; anxiety analyzed as a primary outcome) and were treated as fully eligible study, while the remaining nine partially met these criteria and were treated as partially eligible study. Results: Reductions in state or trait anxiety were reported across aerobic, resistance, combined aerobic-resistance, mind-body, and other move- ment-based categories, although not all studies reached statistical significance. Heterogeneity in design and anxiety instruments precluded direct comparison between exercise categories. Only one randomized controlled trial was identified among the fully eligible studies, sample sizes were small, and the evidence skewed toward female participants. One fully eligible study, a 15-week Pilates course, reported a significant increase, rather than a decrease, in anxiety; this counter-directional finding is retained and discussed rather than omitted. None of the reviewed programs were delivered within a formal therapeutic exercise prescription framework, and only one involved a physical therapy-affiliated research team. Conclusion: Exercise may be associated with reduced anxiety in some studies of Korean university students, though the evidence base remains small, mostly non-randomized, and skewed toward women, with at least one counter-directional finding. This gap points to a concrete role for physical therapists in designing and testing dose-specified, individually progressed exercise programs for anxiety in this population.

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