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 editorsNoetel, 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 seriesBMJ

ISSN0959-8138

eISSN1756-1833

Publication year2024

Publication date14/02/2024

Volume384

Article numbere075847

PublisherBMJ Publishing Group

Publication countryUnited Kingdom

Publication languageEnglish

DOIhttps://doi.org/10.1136/bmj-2023-075847

Research data linkhttps://osf.io/nzw6u/

Publication open accessOpenly available

Publication channel open accessOpen Access channel

Publication is parallel published (JYX)https://jyx.jyu.fi/handle/123456789/93572

Publication is parallel publishedhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10870815


Abstract

Objective
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.


Keywordsexercise (people)exercisesdepression (mental disorders)strength trainingyogawalking (motion)runningsystematic reviewsmeta-analysis


Contributing organizations


Ministry reportingYes

Reporting Year2024

Preliminary JUFO rating2


Last updated on 2024-13-05 at 18:06