A2 Review article, Literature review, Systematic review
Effect of exercise for depression : systematic review and network meta-analysis of randomised controlled trials (2024)
Noetel, M., Sanders, T., Gallardo-Gómez, D., Taylor, P., del Pozo Cruz, B., van den Hoek, D., Smith, J. J., Mahoney, J., Spathis, J., Moresi, M., Pagano, R., Pagano, L., Vasconcellos, R., Arnott, H., Varley, B., Parker, P., Biddle, S., & Lonsdale, C. (2024). Effect of exercise for depression : systematic review and network meta-analysis of randomised controlled trials. BMJ, 384, Article e075847. https://doi.org/10.1136/bmj-2023-075847
JYU authors or editors
Publication details
All authors or editors: Noetel, Michael; Sanders, Taren; Gallardo-Gómez, Daniel; Taylor, Paul; del Pozo Cruz, Borja; van den Hoek, Daniel; Smith, Jordan J; Mahoney, John; Spathis, Jemima; Moresi, Mark; et al.
Journal or series: BMJ
ISSN: 0959-8138
eISSN: 1756-1833
Publication year: 2024
Publication date: 14/02/2024
Volume: 384
Article number: e075847
Publisher: BMJ Publishing Group
Publication country: United Kingdom
Publication language: English
DOI: https://doi.org/10.1136/bmj-2023-075847
Research data link: https://osf.io/nzw6u/
Publication open access: Openly available
Publication channel open access: Open Access channel
Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/93572
Publication is parallel published: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10870815
Abstract
To identify the optimal dose and modality of exercise for treating major depressive disorder, compared with psychotherapy, antidepressants, and control conditions.
Design
Systematic review and network meta-analysis.
Methods
Screening, data extraction, coding, and risk of bias assessment were performed independently and in duplicate. Bayesian arm based, multilevel network meta-analyses were performed for the primary analyses. Quality of the evidence for each arm was graded using the confidence in network meta-analysis (CINeMA) online tool.
Data sources
Cochrane Library, Medline, Embase, SPORTDiscus, and PsycINFO databases.
Eligibility criteria for selecting studies
Any randomised trial with exercise arms for participants meeting clinical cut-offs for major depression.
Results
218 unique studies with a total of 495 arms and 14 170 participants were included. Compared with active controls (eg, usual care, placebo tablet), moderate reductions in depression were found for walking or jogging (n=1210, κ=51, Hedges’ g −0.62, 95% credible interval −0.80 to −0.45), yoga (n=1047, κ=33, g −0.55, −0.73 to −0.36), strength training (n=643, κ=22, g −0.49, −0.69 to −0.29), mixed aerobic exercises (n=1286, κ=51, g −0.43, −0.61 to −0.24), and tai chi or qigong (n=343, κ=12, g −0.42, −0.65 to −0.21). The effects of exercise were proportional to the intensity prescribed. Strength training and yoga appeared to be the most acceptable modalities. Results appeared robust to publication bias, but only one study met the Cochrane criteria for low risk of bias. As a result, confidence in accordance with CINeMA was low for walking or jogging and very low for other treatments.
Conclusions
Exercise is an effective treatment for depression, with walking or jogging, yoga, and strength training more effective than other exercises, particularly when intense. Yoga and strength training were well tolerated compared with other treatments. Exercise appeared equally effective for people with and without comorbidities and with different baseline levels of depression. To mitigate expectancy effects, future studies could aim to blind participants and staff. These forms of exercise could be considered alongside psychotherapy and antidepressants as core treatments for depression.
Keywords: exercise (people); exercises; depression (mental disorders); strength training; yoga; walking (motion); running; systematic reviews; meta-analysis
Contributing organizations
Ministry reporting: Yes
VIRTA submission year: 2024
Preliminary JUFO rating: 2
