Exercise as a treatment for clinical depression in adults and progressing the physiotherapists role: A systematic review and meta-analysis

2021 ◽  
pp. 1-14
Author(s):  
Mary E. Davis ◽  
Niall McGrane
Keyword(s):  
Depressive Symptoms ◽  
Meta Analysis ◽  
Effective Dosage ◽  
Moderate Intensity ◽  
Optimal Dosage ◽  
Extensive Literature ◽  
Post Intervention ◽  
Exercise Interventions ◽  
Evidence Database ◽  
Meta Analyses

BACKGROUND: There has been extensive literature examining the efficacy of exercise interventions in the treatment of depression over the past few decades. However, there is ongoing debate regarding the optimal dosage and the implications of utilising physiotherapists for the management of clinically depressed adults using exercise has not been examined. OBJECTIVES: This review aimed to examine the effectiveness of exercise as a treatment for depression (without comorbidities) and to determine the most effective dosage/mode to treat this population. This review strived to appraise the literature for a potential role for physiotherapists in depression management. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, a search for randomized controlled trials was conducted on the nine databases. All studies were appraised for quality using the Physiotherapy Evidence Database (PEDro) scale and Cochrane Risk of Bias Tool (RoB). Data was manually extracted, and pre- and post-intervention depression scores and program variables were analysed. RESULTS: Of the 5036 papers retrieved, 7 papers met this review’s inclusion criteria. The results of the meta-analysis reveal that exercise as a sole treatment and as an add-on is significantly effective in reducing depressive symptoms. The findings support the use of moderate intensity aerobic exercise for three sessions per week. CONCLUSIONS: Exercise was shown to significantly improve depressive symptoms in depressed adults. This review adds to the growing body of evidence regarding the important role of physiotherapists in the treatment of psychiatric disorders in the design and implementation of exercise interventions.

Mindfulness- and Acceptance-Based Interventions for Stroke Survivors: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 003435522110432
Author(s):  
Areum Han
Keyword(s):  
Systematic Review ◽  
Depressive Symptoms ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Mental Fatigue ◽  
Stroke Survivors ◽  
Positive Effects ◽  
Meta Analyses

Objective: Mindfulness- and acceptance-based intervention (MABI) is an emerging evidenced-based practice, but no systematic review incorporating meta-analyses for MABIs in stroke survivors has been conducted. The objective of this systematic review was to measure the effectiveness of MABIs on outcomes in people with stroke. Method: Three electronic databases, including PubMed, CINAHL, and PsycINFO, were searched to identify relevant studies published in peer-reviewed journals. The methodological quality of the included studies was assessed. Data were extracted and combined in a meta-analysis with a random-effect model to compute the size of the intervention effect. Results: A total of 11 studies met the eligibility criteria. Meta-analyses found a small-to-moderate effect of MABIs on depressive symptoms (standardized mean difference [SMD] = 0.39, 95% confidence interval [CI] = [0.12, 0.66]) and a large effect on mental fatigue (SMD = 1.22, 95% CI = [0.57, 1.87]). No statistically significant effect of MABIs on anxiety, quality of life, and mindfulness was found, but there was a trend in favor of MABIs overall. Conclusions: This meta-analysis found positive effects of MABIs on depressive symptoms and mental fatigue in stroke survivors, but future high-quality studies are needed to guarantee treatment effects of MABIs on varied outcomes in stroke survivors.

scholarly journals Pilot Studies to Evaluate Feasibility of a Physical Activity Intervention in Persons with Depression

2019 ◽  
Author(s):  
Kendall Sharp ◽  
Charles South ◽  
Cherise Chin Fatt ◽  
Madhukar Trivedi ◽  
Chad Rethorst
Keyword(s):  
Physical Activity ◽  
Depressive Symptoms ◽  
Depressive Disorders ◽  
Physical Activity Intervention ◽  
Post Intervention ◽  
Pilot Studies ◽  
Exercise Interventions ◽  
Physical Health Outcomes ◽  
Physical Activity Interventions ◽  
Efficacious Treatment

Depressive disorders are associated with high disease burden and high rates of medical comorbidities. Exercise interventions have been shown to reduce depressive symptoms and help improve physical health outcomes in persons with depression. However, the interventions used in studies demonstrating exercise as an efficacious treatment for depression are unlikely to be adopted into clinical practice due to the significant resources (personnel, facilities, equipment) required to deliver these interventions. This suggests the need for more efficient interventions for increasing physical activity in persons with depression. Two pilot studies were conducted to determine the feasibility of a multi-component physical activity intervention in persons with depression. Components of the intervention included group educational sessions about increasing physical activity, a Fitbit, and access to on-site exer-cise facility. The results from these pilot studies show significant decreases in depressive symptoms post intervention (PA: t(13)= 3.51, p = .004; BC: t(13) = 3.05, p = .009). 100% of participants in the PA pilot and 85.7% of participants in the BC pilot responded that they benefited overall from the study. These results indicate that implementing a multi-component physical activity intervention is feasible and can reduce depressive symptoms and other psychosocial outcomes. Limitations and future directions for physical activity interventions are discussed.

Comparative Efficacy of Seven Exercise interventions for Symptoms of depression in college students: a network of meta-analysis

2019 ◽  
Author(s):  
Shengyu Guo ◽  
Fuying Li ◽  
Yan Yang ◽  
Ling Chen
Keyword(s):  
College Students ◽  
Depressive Symptoms ◽  
Usual Care ◽  
Tai Chi ◽  
Exercise Intervention ◽  
Meta Analysis ◽  
Eligibility Criteria ◽  
Exercise Interventions ◽  
Symptoms Of Depression ◽  
Depressed College Students

Abstract Background Depression among college students is common, exercise interventions are valued as one of the most widely prescribed interventions for depressed college students, however, it is especially difficult for university administrators to determine which exercise intervention is most effective, and efficacy of exercise interventions among depressed college students have not been evaluated. Objectives To systematically review and compare the efficacy of Seven Exercise interventions for Symptoms of depression in college students. Method A network of meta-analysis was conducted to fill the objectives. PubMed, Embase databases, and two Chinese language electronic databases WANFANG and CNKI were searched for the related articles. Eligibility criteria Randomized controlled trials comparing the efficacy of Seven Exercise interventions with usual care of college students with depression were included in the review. Main outcomes The Primary outcome of the present study were standardized mean difference(SMD) and the mean change of depressive symptoms. Results 14 trials were identified, including 2010 depressed college students. The result of direct meta-analysis of this review indicated exercise interventions overall had a significantly lower mean depression scores (SMD=-1.13) when compared with usual care. The result of NMA indicated when comparing with badminton intervention, yoga(SMD=-7.7, 95%CI -14 to -0.93) and tai chi (SMD=-9.4, 95%CI -16 to -2.7) can significantly decrease depression scores of the depressed college students. The rank of seven exercise interventions with respect to efficiently decrease symptom of depressed undergraduates was Tai chi > Yoga > Volleyball > Dance > Run> Basketball> Badminton, respectively. Conclusions Tai chi exhibited the highest probability that became the most efficacy intervention among the comparions, and Yoga showed the second most effectiveness to alleviate depressive symptoms of depressed college students, and dance ranks the third, followed by run, volleyball, basketball, badminton respectively.

scholarly journals HIIT is not superior to MICT in altering blood lipids: a systematic review and meta-analysis

2019 ◽  
Vol 5 (1) ◽  
pp. e000647 ◽  
Author(s):  
Gina Wood ◽  
Anna Murrell ◽  
Tom van der Touw ◽  
Neil Smart
Keyword(s):  
Systematic Review ◽  
Athletic Training ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Moderate Intensity ◽  
Continuous Training ◽  
Intervention Component ◽  
Post Intervention ◽  
Eligibility Criteria

ObjectiveTo compare the effects of moderate intensity continuous training (MICT) and high intensity interval training (HIIT) on adult lipid profiles; to identify training or participant characteristics that may determine exercise-induced change in total cholesterol (TC), triglycerides (TRG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C).DesignSystematic review and meta-analysis.Data sourcesEnglish language searches of several databases were conducted from inception until September 2019.Eligibility criteria for excluding studiesInclusion: (1) published randomised controlled human trials with group population n≥5; (2) intervention duration ≥4 weeks; (3) comparing HIIT with MICT; and (4) reporting pre–post intervention lipid measurements. Exclusion: subjects with chronic disease, <18 years, pregnant/lactating, in elite athletic training; and studies with a dietary or pharmaceutical intervention component.ResultsTwenty-nine data sets (mmol/L) of 823 participants were pooled and analysed. Neither HIIT nor MICT was better in decreasing TC (0.10 (−0.06 to 0.19), p=0.12, I2=0%), TRG (−0.05 (−0.11 to 0.01), p=0.10, I2=0%), LDL-C (0.05 (−0.06 to 0.17), p=0.37, I2=0%), or TC/HDL-C (−0.03 (−0.36 to 0.29), p=0.85, I2=0%). HIIT significantly raised HDL-C (0.07 (0.04 to 0.11), p<0.0001, I2=0%) compared with MICT.ConclusionNeither HIIT nor MICT is superior for altering TC, TRG, or LDL-C, or TC-HDL-C ratio. Compared with MICT, HIIT appeared to significantly improve HDL-C. Clinicians may prescribe either protocol to encourage participation in exercise and reduce cardiovascular risk. To raise HDL-C, HIIT may result in a larger effect size compared with MICT.PROSPERO registration numberCRD42019136722.

scholarly journals A Systematic Review and Meta-Analysis of Nature-Based Mindfulness: Effects of Moving Mindfulness Training into an Outdoor Natural Setting

2019 ◽  
Vol 16 (17) ◽  
pp. 3202 ◽  
Author(s):  
Djernis ◽  
Lerstrup ◽  
Poulsen ◽  
Stigsdotter ◽  
Dahlgaard ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Mindfulness Training ◽  
Medium Size ◽  
Natural Environments ◽  
Natural Setting ◽  
Positive Health ◽  
Post Intervention ◽  
Registration Number ◽  
Mindfulness Interventions ◽  
Meta Analyses

Research has proven that both mindfulness training and exposure to nature have positive health effects. The purpose of this study was to systematically review quantitative studies of mindfulness interventions conducted in nature (nature-based mindfulness), and to analyze the effects through meta-analyses. Electronic searches revealed a total of 25 studies to be included, examining 2990 participants. Three analyses were conducted: Nature-based mindfulness interventions evaluated as open trials (k = 13), nature-based mindfulness compared with groups in non-active control conditions (k = 5), and nature-based mindfulness compared with similar interventions but without contact with nature (k = 7). The overall combined psychological, physiological, and interpersonal effects from pre- to post-intervention were statistically significant and of medium size (g = 0.54, p < 0.001). Moderation analyses showed that natural environments characterized as forests/wild nature obtained larger numerical effects than environments characterized as gardens/parks, as did informal mindfulness compared with formal mindfulness. The small number of studies included, as well as the heterogeneity and generally low quality of the studies, must be taken into consideration when the results are interpreted. PROSPERO registration number: CRD42017065639.

scholarly journals Effectiveness of Vestibular Training for Balance and Dizziness Rehabilitation in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (2) ◽  
pp. 590 ◽  
Author(s):  
Cristina García-Muñoz ◽  
María-Dolores Cortés-Vega ◽  
Alberto Marcos Heredia-Rizo ◽  
Rocío Martín-Valero ◽  
María-Isabel García-Bernal ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Vestibular Rehabilitation ◽  
Exercise Interventions ◽  
Cochrane Database ◽  
Balance Development ◽  
Evidence Database ◽  
Experimental Group

Postural instability and dizziness are commonly observed in people with multiple sclerosis (PwMS). The aim of this systematic review was to evaluate the evidence for the use of vestibular rehabilitation, in comparison with other exercise interventions or no intervention, to treat balance impairments and dizziness in PwMS. An electronic search was conducted by two independent reviewers in the following databases: MEDLINE (Pubmed), Scopus, the Physiotherapy Evidence Database (PEDro), Web of Science (WOS), Lilacs, CINHAL and the Cochrane Database of Systematic Reviews (CDSR). A quality assessment was performed using the PEDro scale and the Cochrane Risk of Bias Tool. When possible, the data were pooled in a meta-analysis (95%CI). This systematic review followed the PRISMA guideline statement and was registered in the PROSPERO database (CRD42019134230). Seven studies were included, with a total of 321 participants analysed. Compared with no intervention, vestibular rehabilitation was more effective for balance development (SMD = 2.12; 95% CI = 0.49, 3.75; p = 0.01; I2 = 89%) and dizziness symptoms improvement (SMD = −17.43; 95% CI = −29.99, −4.87; p= 0.007; I2= 66%). Compared with other exercise interventions, improvements in favour of the experimental group were observed, but statistical significance for the differences between groups was not reached.

scholarly journals The comparative effectiveness of physical exercise interventions in individuals with chronic non-specific neck pain: protocol for a network meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e034846 ◽  
Author(s):  
Rutger MJ de Zoete ◽  
James H McAuley ◽  
Nigel R Armfield ◽  
Michele Sterling
Keyword(s):  
Physical Exercise ◽  
Neck Pain ◽  
Meta Analysis ◽  
Network Effect ◽  
Effect Sizes ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Exercise Interventions ◽  
Meta Analyses

IntroductionNeck pain is a global burdensome problem, with a large proportion of neck pain cases becoming chronic. Although physical exercise is a commonly prescribed treatment, the evidence on the effectiveness of isolated exercise interventions remains limited. Traditional pairwise randomised controlled trials (RCTs) and meta-analyses are limited in only comparing two interventions. This protocol describes the design of a network meta-analysis, which enables a comparative investigation of all physical exercise interventions for which RCTs are available. We aim to systematically compare the effectiveness of different types of physical exercise in people with chronic non-specific neck pain.Methods and analysisNine electronic databases (AMED, CINAHL, Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Physiotherapy Evidence Database, PsycINFO, Scopus and SPORTDiscus) were searched for RCTs from inception to 12 March 2019. Titles and abstract firstly, and full-text papers secondly, will be screened by two reviewers. Data will be extracted by two reviewers. The primary outcome measure is effectiveness of the intervention. Methodological quality of included studies will be assessed by two reviewers using the PEDro scale. The overall quality of evidence will be assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework, which has been adapted for network meta-analyses. The available evidence will be summarised using a network diagram. A contribution matrix will be presented to allow assessment of direct and indirect evidence. Forest plots will be constructed to visualise effects of all included exercise interventions. Pairwise effect sizes will be calculated by including all evidence available in the network. Effect measures for treatments that have not been compared in a pairwise RCT can be compared indirectly by contrasting effect sizes of comparisons with a common comparator.Ethics and disseminationThis work synthesises evidence from previously published studies and does not require ethics review or approval. A manuscript describing the findings will be submitted for publication in a peer-reviewed scientific journal.PROSPERO registration numberCRD42019126523.

scholarly journals Do improved biomass cookstove interventions improve indoor air quality and blood pressure? A systematic review and meta-analysis

2021 ◽  
Author(s):  
Nitya Kumar ◽  
Eunice Phillip ◽  
Helen Cooper ◽  
Megan Davis ◽  
Jessica Langevin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Air Quality ◽  
Meta Analysis ◽  
Fine Particulate Matter ◽  
Grey Literature ◽  
Post Intervention ◽  
Middle Income ◽  
Low Middle Income Countries ◽  
Meta Analyses ◽  
The Impact

AbstractBackgroundHousehold air pollution (HAP) kills 4 million annually, with access to clean cooking being a challenge for 37% of the world’s population. Whilst there have been advancements in improved biomass cookstove (ICS) technologies, reviews on the impact of these ICS on HAP are now more than three years old.ObjectivesThis review and meta-analysis examines the most recent evidence on the impact of ICS on HAP and blood pressure (BP).MethodsA literature search was conducted using scientific literature databases and grey literature. Studies were included if they were published between January 2012 and June 2020, reported impact of ICS interventions in non-pregnant adults in low/middle-income countries, and reported post-intervention results along with baseline of traditional cookstoves. Outcomes included 24- or 48-hour averages of kitchen area fine particulate matter (PM2.5), carbon monoxide (CO), mean systolic BP (SBP) and mean diastolic BP (DBP). Meta-analyses estimated weighted mean differences between baseline and post-intervention values for all outcome measures.ResultsNine studies were included; eight contributed estimates for HAP and three for BP. Interventions lead to significant reductions in PM2.5 (−0.28 mg/m3, 95% CI: -0.46, -0.10), CO (−6.59ppm, 95%CI: - 10.73, -2.46) and SBP (−2.82mmHg, 95% CI: -5.53, -0.11); and a non-significant reduction in DBP (−0.80 mmHg, 95%CI: -2.33, 0.73), when compared to baseline of traditional cookstoves. Except for DBP, greatest reductions in all outcomes came from standard combustion ICS with a chimney, compared to ICS without a chimney and advanced combustion ICS. WHO air quality targets were met by post-intervention values for CO but not for PM2.5.ConclusionOur review suggests that ICS with a chimney results in the greatest reductions in HAP and BP. Further research on qualitative impact of such ICS on end-users is required to understand feasibility of adoption at scale.

scholarly journals TaiChi and Qigong for Depressive Symptoms in Patients with Chronic Heart Failure: A Systematic Review with Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Wei Jiang ◽  
Shaojun Liao ◽  
Xiankun Chen ◽  
Cecilia Stålsby Lundborg ◽  
Gaetano Marrone ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Depressive Symptoms ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Therapeutic Effects ◽  
Cochrane Central Register ◽  
China National Knowledge Infrastructure ◽  
Beneficial Effects ◽  
Meta Analyses

Background. Depression is a debilitating comorbidity of heart failure (HF) that needs assessment and management. Along with mind-body exercise to deal with HF with depression, the use of TaiChi and/or Qigong practices (TQPs) has increased. Therefore, this systematic review assesses the effects of TQPs on depression among patients with HF. Methods. Randomized controlled trials (RCTs) that examined the effect of TQPs on depression in patients with HF were searched by five databases (PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, CINAHL, and China National Knowledge Infrastructure (CNKI)). With standardized mean difference (SMD) and 95% confidence intervals (95% CI), random-effects meta-analyses of the effect of TQPs on depressive symptoms were performed. Results. Of eight included RCTs, seven (481 patients) provided data for the meta-analysis. The pooling revealed that TQPs contribute to depression remission in HF (SMD −0.66; 95% CI −0.98 to −0.33, P < 0.0001 ; I2 = 64%). Its antidepressive effect was not influenced by intervention duration or exercise setting, but rather by ejection fraction subtype, depressive severity, and depression instruments. The beneficial effects were preserved when the study with the largest effect was removed. Conclusion. This study suggests that TQPs might be a good strategy for alleviating depressive symptoms in patients with HF. And rigorous-design RCTs, which focus on the identified research gaps, are needed to further establish the therapeutic effects of TQPs for depression in HF.

scholarly journals High-intensity Exercise and Cognitive Function in Cognitively Normal Older Adults: A Randomised Clinical Trial

2020 ◽  
Author(s):  
Belinda Brown ◽  
Natalie Frost ◽  
Stephanie R. Rainey-Smith ◽  
James Doecke ◽  
Shaun Markovic ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cardiorespiratory Fitness ◽  
High Intensity ◽  
Randomised Clinical Trial ◽  
Cognitive Change ◽  
Moderate Intensity ◽  
Moderate Intensity Exercise ◽  
Post Intervention ◽  
Cognitively Normal ◽  
Exercise Interventions

Abstract BACKGROUND: Physical inactivity has been consistently linked to increased risk of cognitive decline; however, studies examining the impact of exercise interventions on cognition have produced inconsistent findings. Some observational studies suggest exercise intensity may be important for inducing cognitive improvements; however, this has yet to be thoroughly examined in older adult cohorts. The objective of the current study was to evaluate the effect of systematically manipulated high-intensity and moderate-intensity exercise interventions on cognition. In addition, we investigated individual variability in exercise response by examining effects of relevant genetic factors and changes in cardiorespiratory fitness on cognitive change.METHODS: This multi-arm randomised clinical trial investigated the effects of 6-months of high-intensity exercise and moderate-intensity exercise, compared with an inactive control, on cognition. Outcome measures were assessed at pre- (baseline), post- (6 months), and 12-months post-intervention. Ninety-nine cognitively normal men and women (aged 60 – 80 years) were enrolled from October 2016 to November 2017. Participants that were allocated to an exercise group (i.e., high-intensity or moderate-intensity) engaged in cycle-based exercise two times per week for 6 months. Cognition was assessed using a comprehensive neuropsychological test battery. Cardiorespiratory fitness was evaluated by a graded exercise test. Apolipoprotein e4 genotype and brain-derived neurotrophic factor Val66Met carriage were identified.RESULTS: There was a dose-dependent effect of exercise intensity on cardiorespiratory fitness; whereby the high-intensity group experienced greater increases in fitness than the moderate-intensity and control groups. However, there was no direct effect of exercise on cognition. We observed an association between changes in global cognition and executive function and changes in cardiorespiratory fitness from pre- to post-intervention: this relationship was strongest in brain-derived neurotrophic factor non-Met carriers.CONCLUSIONS We did not observe a direct effect of exercise on cognition. Nevertheless, our data suggests genetics may moderate the relationship between fitness and cognitive change following exercise, and this should be examined further in larger trials.TRIAL REGISTRATION: This study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12617000643370). Registered 3rd May 2017 - retrospectively registered. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372780

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