CRF was moderately associated with trait anxiety, but not GAD symptoms, in a sample with MS prescreened for subclinical GAD.
Key Findings
Results
Cardiorespiratory fitness (CRF) was moderately associated with trait anxiety but not with GAD symptoms in people with MS who have subclinical GAD.
The association between CRF and trait anxiety was described as moderate in magnitude.
No significant association was found between CRF and GAD symptoms specifically.
The sample was prescreened for subclinical generalized anxiety disorder.
This distinction between trait anxiety and GAD symptom measures suggests these constructs may relate differently to fitness.
Background
Generalized anxiety disorder is described as prevalent, understudied, and poorly managed among persons with multiple sclerosis.
GAD is identified as a common comorbidity in the MS population.
The authors characterize GAD management in MS as inadequate in the current literature.
The study was motivated by a gap in research specifically targeting GAD in MS.
Aerobic exercise improving CRF was proposed as a potential mechanism for managing GAD symptoms in MS.
Methods
Physical activity was examined alongside CRF, trait anxiety, and GAD symptoms as part of the study's associations.
Physical activity was included as one of the key variables of interest in the study design.
The study examined associations among CRF, trait anxiety, GAD symptoms, and physical activity together.
The sample had MS and was prescreened for subclinical GAD, suggesting participants did not meet full diagnostic criteria for GAD.
The authors noted that research should further interrogate these associations in larger samples with MS and GAD.
Conclusions
The authors concluded that future research should examine these associations in larger samples of people with MS and GAD.
The current sample size was implicitly acknowledged as a limitation by the call for larger samples.
The authors specifically recommended samples with both MS and GAD (rather than subclinical GAD) for future study.
The findings were presented as preliminary, warranting further interrogation.
The study focused on subclinical GAD, which may limit generalizability to clinical GAD populations.
What This Means
This research suggests that among people with multiple sclerosis (MS) who have subclinical symptoms of generalized anxiety disorder (GAD — a condition involving excessive, hard-to-control worry), better cardiorespiratory fitness (a measure of how efficiently the heart and lungs deliver oxygen during exercise) was moderately linked to lower levels of trait anxiety (a person's general tendency to feel anxious). However, this fitness measure was not significantly linked to GAD symptom severity specifically, suggesting that the relationship between physical fitness and anxiety in MS may depend on how anxiety is measured.
The study also examined physical activity levels alongside these variables, building on the idea that aerobic exercise — by improving cardiovascular fitness — might help manage anxiety in people with MS. GAD is noted to be common in the MS population but is currently understudied and not well managed, making this an important area of investigation.
This research suggests that improving cardiorespiratory fitness through exercise could have some relevance to anxiety in MS, but the picture is complex and the findings are preliminary. The authors call for larger studies in people with both MS and a full clinical diagnosis of GAD to better understand these relationships and ultimately inform exercise-based approaches to anxiety management in this population.
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Šilić P, Motl R. (2026). Cardiorespiratory fitness, trait anxiety, and physical activity in people with multiple sclerosis who have subclinical generalized anxiety disorder.. Multiple sclerosis and related disorders. https://doi.org/10.1016/j.msard.2026.107273