Objective
To investigate whether participation in a multicomponent physical exercise program is associated with longitudinal changes in craving, cognition, and self-esteem among inpatients with crack cocaine use disorder.

Methods
This prospective, naturalistic, non-randomized longitudinal study included 37 inpatients with crack cocaine use disorder classified into an exercise group (EG, n = 21) or non-exercise group (NEG, n = 16) based on participation in the institutional exercise program. Assessments were conducted at baseline, week 5, and week 10. Outcomes included global cognition (MMSE), executive function (TMT-A/B), self-esteem (RSE), and craving (CCQ-Brief). Longitudinal data were analyzed using repeated-measures models.

Results
No significant group-by-time interactions were observed for cognition or self-esteem, although both groups improved over time. In the primary analysis, a significant group-by-time interaction was observed for craving (p = 0.034), with greater reductions in the exercise group, particularly during the first five weeks. However, this interaction was attenuated after adjustment for age and duration of crack cocaine use.

Conclusion
Participation in multicomponent exercise was associated with greater reductions in craving in the primary analysis, although this finding was attenuated after adjustment for baseline group differences. Improvements in cognition and self-esteem were observed in both groups, suggesting shared effects of structured care and abstinence. These findings support further investigation of exercise as a complementary strategy in substance use disorder treatment.