Preliminary effects and feasibility of a school-based regular aerobic exercise intervention on PTSD-related symptoms among college students: a single-group pre-post study

Background: College students are considered a high-risk group for post-traumatic stress disorder (PTSD). Existing non-pharmacological interventions, although effective and accessible, still have notable limitations. Regular aerobic exercise, as a potential mental health promotion strategy, requires empirical validation in real campus environments to determine its specific effects on reducing anxiety, depression, and PTSD symptoms, as well as its role in enhancing psychological resilience. Method: This study employed a single-group pre-test/post-test design and was conducted in August 2025 at a comprehensive university in Sichuan, China. Using convenience sampling, 47 participants with elevated PTSD symptoms were recruited for the "School-Based Regular Aerobic Exercise" intervention trial (operationalized as a 21-Day Exercise Check-In Activity). All participants engaged in 30 min of aerobic exercise daily for 3 weeks. Before and after the intervention, participants completed the PTSD Checklist for DSM-5 (PCL-5), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Connor-Davidson Resilience Scale (CD-RISC). Result: All 47 participants completed the 21-day intervention. Significant pre- to post-intervention improvements were observed in PTSD symptoms, anxiety, depression, and psychological resilience. Clinical significance analysis showed that 57.45% of participants fell below the PTSD clinical cutoff after the intervention, and 87.23% demonstrated reliable change. Exploratory change-score analyses indicated that improvements in resilience were significantly associated with reductions in anxiety and PTSD symptoms, but not depression. Conclusion: In a real-world campus setting, this 21-day school-based regular aerobic exercise intervention appears feasible and is associated with improvements in PTSD-related symptoms and psychological resilience. However, because the study lacked randomization and a control group, causal inferences regarding effectiveness and underlying mechanisms cannot be made. Randomized controlled trials with longer follow-up periods and objective activity measures are warranted.