Physical activity to address multimorbidity among survivors of sexual violence: A comprehensive narrative review

Background: Sexual Violence (SV) is highly prevalent and experienced by women and men throughout the United States and world. Survivors of SV often experience poor mental and physical health, and poor health-related quality of life. Studies have explored the associations between SV survivorship and maladaptive health behaviors, but few have examined SV and health promoting activities such as exercise. Purpose: The aim of this narrative review is to describe available peer-reviewed literature regarding SV and physical activity and provide recommendations for future research. Specifically, this review aimed to identify information relevant for promoting and designing exercise interventions that can integrate into clinical treatments for adult survivors of SV. Methods: A search of electronic databases identified 18 articles on SV and exercise behavior. Results: Four of these studies were exercise interventions, 10 were observational studies, and 4 were qualitative interviews. Results broadly indicate that levels of physical activity among survivors of SV is unclear. Findings from trials indicate exercise may have a positive impact on mental health in survivors of SV. Qualitative interviews found survivors often enjoyed exercising and identified several health benefits, suggesting exercise interventions may be feasible and acceptable in this population. Interviews also identified valuable information about survivors' experiences with exercise. Conclusions: Research in this area would benefit from: representative samples of adults among populations at high risk for victimization, more consistent and in-depth reporting of SV history and exercise levels, consistent and trauma-informed outcome measurements, and more diverse study designs and interventions. Increased exploration of exercise in this population is warranted given the well-established evidence base indicating the health promoting qualities of exercise for mental and physical health among trauma affected populations.