Evidence map›Paper›PMID 28928174›Full record

SynthesisBMJ open2017

Exercise for patients with major depression: a systematic review with meta-analysis and trial sequential analysis.

Jesper Krogh, Carsten Hjorthøj, Helene Speyer, Christian Gluud, Merete Nordentoft

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 14 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 14 syntheses or guidelines pooled it.

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  13. Depression and Objectively Measured Physical Activity: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jesper KroghFaculty of Health Sciences, Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark.ORCID 0000-0003-4834-6724
Carsten HjorthøjFaculty of Health Sciences, Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark.ORCID 0000-0002-6943-4785
Helene SpeyerFaculty of Health Sciences, Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark.
Christian GluudCopenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Merete NordentoftFaculty of Health Sciences, Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo assess the benefits and harms of exercise in patients with depression.

designSystematic review DATA SOURCES: Bibliographical databases were searched until 20 June 2017. ELIGIBILITY CRITERIA AND OUTCOMES: Eligible trials were randomised clinical trials assessing the effect of exercise in participants diagnosed with depression. Primary outcomes were depression severity, lack of remission and serious adverse events (eg, suicide) assessed at the end of the intervention. Secondary outcomes were quality of life and adverse events such as injuries, as well as assessment of depression severity and lack of remission during follow-up after the intervention.

resultsThirty-five trials enrolling 2498 participants were included. The effect of exercise versus control on depression severity was -0.66 standardised mean difference (SMD) (95% CI -0.86 to -0.46; p<0.001; grading of recommendations assessment, development and evaluation (GRADE): very low quality). Restricting this analysis to the four trials that seemed less affected of bias, the effect vanished into -0.11 SMD (-0.41 to 0.18; p=0.45; GRADE: low quality). Exercise decreased the relative risk of no remission to 0.78 (0.68 to 0.90; p<0.001; GRADE: very low quality). Restricting this analysis to the two trials that seemed less affected of bias, the effect vanished into 0.95 (0.74 to 1.23; p=0.78). Trial sequential analysis excluded random error when all trials were analysed, but not if focusing on trials less affected of bias. Subgroup analyses found that trial size and intervention duration were inversely associated with effect size for both depression severity and lack of remission. There was no significant effect of exercise on secondary outcomes.

conclusionsTrials with less risk of bias suggested no antidepressant effects of exercise and there were no significant effects of exercise on quality of life, depression severity or lack of remission during follow-up. Data for serious adverse events and adverse events were scarce not allowing conclusions for these outcomes. SYSTEMATIC REVIEW REGISTRATION: The protocol was published in the journal

Indexed as

BiasExerciseHumansMajor Depressive DisorderRandomized Controlled Trials as TopicEvidence Based MedicineExerciseMeta-analysisRandomised Clinical TrialsSystematic Review

Identifiers

PMID28928174
PMCPMC5623558

What Socratic holds

Textmetadata
LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.