Juan Ángel Bellón1, Sonia Conejo-Cerón2, Almudena Sánchez-Calderón3, Beatriz Rodríguez-Martín4, Darío Bellón5, Emiliano Rodríguez-Sánchez6, Juan Manuel Mendive7, Ignacio Ara8, Patricia Moreno-Peral2. 1. 'El Palo' Health Centre, Health District of Primary Care Málaga-Guadalhorce, Andalusian Health Service (SAS); Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III (ISCIII); Biomedical Research Institute of Malaga (IBIMA); and Faculty of Medicine, Department of Public Health and Psychiatry, University of Málaga (UMA), Spain. 2. Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III (ISCIII); and Biomedical Research Institute of Malaga (IBIMA), Spain. 3. Faculty of Medicine, Department of Public Health and Psychiatry, University of Málaga (UMA), Spain. 4. Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III (ISCIII); and Faculty of Health Sciences, Talavera de la Reina, Toledo, University of Castilla-La Mancha (UCLM), Spain. 5. Faculty of Sport Sciences, University of Castilla-La Mancha (UCLM), Spain. 6. Prevention and Health Promotion Research Network (redIAPP); Institute of Biomedical Research of Salamanca (IBSAL); Primary Care Research Unit of Salamanca (APISAL); and Department of Medicine, University of Salamanca, Spain. 7. Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III (ISCIII); and 'La Mina' Health Centre, Institute of Health Català (ICS), Spain. 8. Faculty of Sport Sciences, University of Castilla-La Mancha (UCLM); GENUD Toledo Research Group, University of Castilla-La Mancha (UCLM), Spain; and CIBER of Frailty and Healthy Aging (CIBERFES), Spain.
Abstract
BACKGROUND: In most trials and systematic reviews that evaluate exercise-based interventions in reducing depressive symptoms, it is difficult to separate treatment from prevention. AIMS: To evaluate the effectiveness of exercise-based interventions in reducing depressive symptoms in people without clinical depression. METHOD: We searched PubMed, PsycINFO, Embase, WOS, SPORTDiscus, CENTRAL, OpenGrey and other sources up to 25 May 2020. We selected randomised controlled trials (RCTs) that compared exclusively exercise-based interventions with control groups, enrolling participants without clinical depression, as measured using validated instruments, and whose outcome was reduction of depressive symptoms and/or incidence of new cases of people with depression. Pooled standardised mean differences (SMDs) were calculated using random-effect models (registration at PROSPERO: CRD42017055726). RESULTS: A total of 14 RCTs (18 comparisons) evaluated 1737 adults without clinical depression from eight countries and four continents. The pooled SMD was -0.34 (95% CI -0.51 to -0.17; P < 0.001) and sensitivity analyses confirmed the robustness of this result. We found no statistical evidence of publication bias and heterogeneity was moderate (I2 = 54%; 95% CI 22-73%). Only two RCTs had an overall low risk of bias and three had long-term follow-up. Multivariate meta-regression found that a larger sample size, country (Asia) and selective prevention (i.e. people exposed to risk factors for depression) were associated with lower effectiveness, although only sample size remained significant when adjustment for multiple tests was considered. According to the Grading of Recommendations Assessment, Development and Evaluation tool, the quality of evidence was low. CONCLUSIONS: Exercise-based interventions have a small effect on the reduction of depressive symptoms in people without clinical depression. It could be an alternative to or complement psychological programmes, although further higher-quality trials with larger samples and long-term follow-up are needed.
BACKGROUND: In most trials and systematic reviews that evaluate exercise-based interventions in reducing depressive symptoms, it is difficult to separate treatment from prevention. AIMS: To evaluate the effectiveness of exercise-based interventions in reducing depressive symptoms in people without clinical depression. METHOD: We searched PubMed, PsycINFO, Embase, WOS, SPORTDiscus, CENTRAL, OpenGrey and other sources up to 25 May 2020. We selected randomised controlled trials (RCTs) that compared exclusively exercise-based interventions with control groups, enrolling participants without clinical depression, as measured using validated instruments, and whose outcome was reduction of depressive symptoms and/or incidence of new cases of people with depression. Pooled standardised mean differences (SMDs) were calculated using random-effect models (registration at PROSPERO: CRD42017055726). RESULTS: A total of 14 RCTs (18 comparisons) evaluated 1737 adults without clinical depression from eight countries and four continents. The pooled SMD was -0.34 (95% CI -0.51 to -0.17; P < 0.001) and sensitivity analyses confirmed the robustness of this result. We found no statistical evidence of publication bias and heterogeneity was moderate (I2 = 54%; 95% CI 22-73%). Only two RCTs had an overall low risk of bias and three had long-term follow-up. Multivariate meta-regression found that a larger sample size, country (Asia) and selective prevention (i.e. people exposed to risk factors for depression) were associated with lower effectiveness, although only sample size remained significant when adjustment for multiple tests was considered. According to the Grading of Recommendations Assessment, Development and Evaluation tool, the quality of evidence was low. CONCLUSIONS: Exercise-based interventions have a small effect on the reduction of depressive symptoms in people without clinical depression. It could be an alternative to or complement psychological programmes, although further higher-quality trials with larger samples and long-term follow-up are needed.
Authors: Roy Rillera Marzo; Vineet Vinay; Rafidah Bahari; Shekhar Chauhan; Deborah Anak Fo Ming; Stephanie Fernandez A/P Nelson Fernandez; Colin Cornelius Pereira Johnson; Agkesh Qumar A/L Thivakaran; Mohammad Meshbahur Rahman; Sonu Goel Journal: Clin Epidemiol Glob Health Date: 2021-09-16
Authors: Patricia Moreno-Peral; Alberto Pino-Postigo; Sonia Conejo-Cerón; Darío Bellón; Beatriz Rodríguez-Martín; Vicente Martínez-Vizcaíno; Juan Ángel Bellón Journal: Int J Environ Res Public Health Date: 2022-02-05 Impact factor: 3.390