Physical activities for alleviating depression -
For each study, sample size, depressive symptoms mean scores, and SDs were extracted to calculate the effect size. When relevant data were not clearly reported, we contacted the authors.
When authors were unresponsive or unreachable, we used previously validated methods to extract means and SD; namely, data were computed from the P values or CIs provided in the study or from the included graphs.
Additional information regarding participant and trial characteristics was collected to determine their association with physical activity interventions and depressive symptoms. Data on race and ethnicity were not collected as they were not within the objectives of this study.
Risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials. independently assessed each study as having low risk of bias, some concerns, or high risk of bias. Any discrepancies between the 2 evaluations were resolved by consensus after consulting a third investigator P.
The criteria used for the risk-of-bias assessment are available in eAppendix 2 in the Supplement. The meta-analysis was performed using R, version 4. Hedges g was calculated from the postintervention or follow-up means, SDs, and sample sizes for each comparison of interest.
A negative effect size indicates a beneficial effect of the physical activity intervention compared with the control condition. Cochran Q test was used to assess between-study heterogeneity. Higgins I 2 statistic was used to define the percentage of variability that was due to between-study heterogeneity rather than sampling error.
The overall effect of the physical activity interventions on reducing depressive symptoms was used to calculate the number needed to treat.
Meta-regressions were performed to assess the influence of potential moderators on the overall effect size to explain any possible heterogeneity. We chose these moderators based on their possible associations with physical activity, depressive symptoms, or both and because previous meta-analyses on exercise for depressive symptoms in adults showed significant associations with similar moderators.
Definitions of all moderators and the codes used for each level are included in eTable 1 in the Supplement. The database search identified unique records.
After assessment of titles and abstracts, full texts were screened, and 21 studies involving participants were included in the meta-analysis.
A summary of the characteristics of the included studies is presented in Table 1. Of the 21 studies included, 17 were RCTs, 36 - 41 , 43 - 49 , 51 , 52 , 54 , 55 and 4 were NRCTs, 35 , 42 , 50 , 53 and included participants [ The mean SD age of participants at baseline was 14 3 years.
Eighteen studies 35 - 40 , 42 - 46 , 48 , 49 , 51 - 55 included both boys and girls, and 3 studies 41 , 47 , 50 included female participants only. Twelve studies included participants with a somatic or psychiatric disorder, such as depression, obesity, attention deficit hyperactivity disorder, and diabetes.
The frequency of the physical activity sessions ranged from 2 to 5 days per week, with 3 days per week being the most commonly used frequency 8 studies 35 , 36 , 38 , 40 , 47 , 48 , 50 , The mean duration of the physical activity sessions was 50 minutes range, minutes.
Most interventions were fully supervised 16 studies 35 - 37 , 39 , 41 - 43 , 45 , 47 - 49 , 51 - 55 , and 2 did not report any supervision.
A visual representation of the distribution of the study effect sizes is provided in the Figure. Overall, the reduction in depressive symptoms after a physical activity intervention resulted in a number needed to treat of 6.
Only 4 studies 36 , 48 , 52 , 53 assessed the effects of physical activity interventions on depressive symptoms at follow-up. The mean follow-up period postintervention was 21 weeks range, weeks. Three outliers were detected. The differences in effect sizes may be attributed to different research designs 40 , 50 or a different study intervention.
Risk of bias was determined to be low in 6 studies, 36 , 38 , 51 - 54 moderate in 13 studies, 35 , 37 , 39 - 41 , 43 - 48 , 50 , 55 and high in 2 studies 42 , 49 eFigure 4 in the Supplement. Results of the secondary analyses are summarized in Table 3. Participant sex, supervision, and frequency and duration of the intervention also moderated the overall effect.
In this meta-analysis, we investigated the association of physical activity interventions with depressive symptoms in children and adolescents.
The results showed that physical activity interventions produced greater reductions in depressive symptoms compared with the control conditions. However, these differences were not detected after a mean follow-up of 21 weeks, possibly due to the limited number of studies with follow-up outcomes.
Increased levels of physical activity can reduce the risk of cardiovascular disease, 57 which is the leading cause of death in individuals with depression, 58 and improve executive function, 59 which is greatly impaired in youth with depression.
The findings of this systematic review and meta-analysis strengthen the role of physical activity for depressive symptom management and highlight the potential of structured physical education programs in primary and secondary schools for improving the mental health of children and adolescents.
While the association between physical activity and depression is strong, 61 , 62 the mechanisms underlying the antidepressant properties of physical activity remain unclear.
Potential pathways include the activation of the endocannabinoid system to stimulate the release of endorphins, 63 an increase in the bioavailability of brain neurotransmitters eg, serotonin, dopamine, noradrenaline that are reduced with depression, 64 and long-term changes in brain plasticity.
Evidence on the benefits of physical activity in conjunction with traditional depression treatments is even more sparse, though it seems that physical activity can enhance the treatment of cognitive and affective symptoms in depression. More research is warranted to explain whether and how these mechanisms moderate the effect of physical activity and whether these changes are also present in younger populations.
Similar results were observed in a meta-analysis on exercise for adult depression. Our findings suggest that physical activity interventions may be particularly helpful in children and adolescents with elevated depressive symptoms.
Physical activity had greater benefits in participants aged 13 years or older than in younger participants. A recent cohort study reported that between the ages of 12 and 16 years, the physical activity levels of children start to decrease while sedentary time increases, and this was associated with more depressive symptoms.
Three physical activity sessions per week and interventions that were shorter than 12 weeks induced greater benefits on depressive symptoms compared with other frequencies and durations.
These findings are reflected in the results of previous meta-analyses on the association between physical activity and depression, 61 , 70 suggesting that increasing amounts of physical activity may not translate into greater reductions in depressive symptoms.
A recent cross-sectional study found a U-shaped association between physical activity frequency and mental health, such that 10 to 15 sessions per month induced the greatest mental health improvements.
More research is needed to explain these findings and to establish the optimal physical activity parameters for depressive symptom management. We found differences in the effect sizes of studies involving female-only participants and studies with unsupervised interventions compared with studies on both males and females and studies with supervised or partially supervised interventions.
These findings are surprising and may be attributed to a discrepancy among the number of studies used to assess each moderator. Eighteen studies included boys and girls 35 - 40 , 42 - 46 , 48 , 49 , 51 - 55 and 3 included female participants only, 41 , 47 , 50 and 16 studies 35 - 37 , 39 , 41 - 43 , 45 , 47 - 49 , 51 - 55 reported fully supervised interventions, whereas 2 did not report any supervision.
This study has some limitations. First, we did not screen for study quality in our inclusion criteria, and it is possible that poorly conducted studies may have influenced the overall results. Second, there was a notable lack of complete reporting regarding participant and trial characteristics.
Specifically, information regarding the blinding of participants and assessors, exercise intensity, exercise type, and degree of supervision was often absent and had to be extrapolated from the article, requested from authors, or otherwise excluded from the analyses. Future research should include more rigorous reporting of study design and characteristics to allow for the analysis of potential moderators on the treatment effects.
Third, because of the exploratory nature of our univariable meta-regression analyses, other confounding variables could not be controlled for, which limits the interpretation of our findings and warrants further validation. The results of this systematic review and meta-analysis suggest that physical activity interventions can alleviate symptoms of depression in children and adolescents.
Future studies should investigate the influence of physical activity parameters such as frequency, duration, and supervision of the sessions to determine the optimal dose and mode of delivery of the intervention for depressive symptom management.
Published Online: January 3, Corresponding Author: Parco M. Siu, PhD, Division of Kinesiology, School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong , China pmsiu hku. Author Contributions: Mr Recchia had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Recchia, Bernal, Fong, S. Wong, Chung, Chan, Capio, S. Wong, Chen, Siu. Acquisition, analysis, or interpretation of data: Recchia, Bernal, Yu, Sit, Chen, Thompson, Siu.
Critical revision of the manuscript for important intellectual content: Recchia, Bernal, Fong, Chung, Chan, Capio, Yu, S. Wong, Sit, Chen, Siu. Conflict of Interest Disclosures: None reported. Additional Contributions: The authors thank Edwin Chin, PhD, The Chinese University of Hong Kong, for the technical advice provided for the conduct of this study.
He did not receive compensation for his contribution. full text icon Full Text. Download PDF Comment. Top of Article Key Points Abstract Introduction Methods Results Discussion Conclusions Article Information References. Forest Plot of the Distribution of Effect Sizes After Physical Activity Intervention.
View Large Download. Table 1. Study Characteristics. Table 2. Primary Moderator Analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses Flow Chart eFigure 2.
Forest Plot of the Distribution of Effect Sizes at Follow-up eFigure 3. Funnel Plot of the Included Studies eFigure 4. Risk of Bias of the Included Studies eTable 1. Definitions and Codes for Primary and Secondary Moderators eTable 2.
Intervention Characteristics eAppendix 1. Search Strategy eAppendix 2. Risk-of-Bias Assessment eReference. Erskine HE, Baxter AJ, Patton G, et al.
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Improving physical fitness and emotional well-being in adolescents of low socioeconomic status in Chile: results of a school-based controlled trial. If being outdoors appeals to you, Green Gym projects, run by The Conservation Volunteers TCV , provide exercise for people who do not like the idea of the gym or indoor exercise classes.
To find out more, visit the TCV website. If you like walking, groups such as Ramblers Wellbeing Walks can support people who have health problems, including mental health conditions. If you have not exercised for a long time or are concerned about the effects of exercise on your body or health, ask a GP about exercise on prescription.
Lots of GP surgeries across the country prescribe exercise as a treatment for a range of conditions, including depression. The National Institute for Health and Care Excellence NICE recommends group exercise as an option for people with mild to moderate depression.
This is usually more than 1 session a week with a trained practitioner, for 10 weeks. The GP can help you decide what type of activity will suit you. Depending on your circumstances and what's available locally, the exercise programme may be offered free or at a reduced cost.
Many treatments are available for depression, including talking therapies , antidepressants and self-help of various kinds. Find out more about treatment for depression. If you have been feeling down for a while and do not feel like your usual self, see a GP to discuss your symptoms.
They can tell you about the choice of treatments available for depression and help you decide what's best for you. Find out how being active helps mental wellbeing. In this audio guide, a doctor explains what you can do to help yourself cope with low mood and depression.
Page last reviewed: 7 September Next review due: 7 September Home Mental health Self-help Guides, tools and activities Back to Guides, tools and activities.
Exercise for depression. How often do you need to exercise? Read more about: physical activity guidelines for adults aged 19 to 64 years old physical activity guidelines for older adults If you have not exercised for a while, start gradually and aim to build up towards achieving minutes a week.
How to get started with exercise Find an activity you can do regularly. Find out about different types of exercise and the benefits of being more active for fitness Read about prevention and management of long-term conditions on the GOV.
Mayo Clinic offers appointments in Thermogenic dietary ingredients, Florida and Minnesota fod at Mayo Clinic Health Garcinia cambogia diet locations. Exercise Aleviating almost activitie form can act Oral health a stress reliever. Slleviating active can boost depressoin feel-good fof and distract you from daily worries. You know that exercise does your body good, but you're too busy and stressed to fit it into your routine. Hold on a second — there's good news when it comes to exercise and stress. Virtually any form of exercise, from aerobics to yoga, can act as a stress reliever. If you're not an athlete or even if you're out of shape, you can still make a little exercise go a long way toward stress management.
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