Remarks y The 2020 WHO guidelines on physical activity and sedentary behaviour provide further detail on physical exercise and physical activity.

• Exercise is defined as “a subcategory of physical activity that is planned, structured, repetitive, and purposeful in the sense that the improvement or maintenance of one or more components of physical fitness is the objective.” “Exercise” and “exercise training” are frequently used interchangeably and generally refer to physical activity performed during leisure time with the primary purpose of improving or maintaining physical fitness, physical performance, or health.
• It is recommended that all adults ages 18–64 (not specific to those with GAD or panic disorder) “should do at least 150–300 minutes of moderateintensity aerobic physical activity; or at least 75–150 minutes of vigorous-intensity aerobic physical activity; or an equivalent combination of moderate- and vigorous-intensity activity throughout the week, for substantial health benefits” (45). y This current recommendation is specific to the additional benefits of physical exercise in the reduction of anxiety symptoms in adults with GAD or panic disorder. y In resource-constrained settings, physical exercise may be more feasible than more intensive psychological interventions. y The type of physical exercise may vary and depend on individual preferences and feasibility for the person. y In cases of moderate-to-severe anxiety disorders, this intervention may be most appropriate as an adjunct to pharmacological and/or psychological interventions.

Implementation considerations y There is cultural variability in the perceived value of physical exercise, which may lead to variability in uptake and successful implementation of this intervention in different settings. y This intervention for the reduction of anxiety symptoms in adults with GAD or panic disorder may be less appropriate for people engaged in physical labour or otherwise with an active lifestyle and instead may be more relevant for those with less active lifestyles.