Evidence map›Paper›PMID 38355154›Full record

SynthesisBMJ (Clinical research ed.)2024

Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials.

Michael Noetel, Taren Sanders, Daniel Gallardo-Gómez, Paul Taylor, Borja Del Pozo Cruz, Daniel van den Hoek, Jordan J Smith, John Mahoney, Jemima Spathis, Mark Moresi and 8 more

Erratum issued 2 registry-linked trialsOpen access · hybridAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 357 papers, 39 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
357citing papers in PubMed, 39 pooled it
145.0field-weighted citation impact, top 1% of its field
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.

NCT07236424 nacompletednot on this mapstarted 2025, after this paper: background citation

Effectiveness of Short-term Supervised Group Exercise Therapy, Walking and Education on Mental Health, Quality of Life and Mobility in Elderly Residents of Nursing Homes

TypeinterventionalSponsorUniversity of MostarRan2025 to 2026Enrolled44ConditionsMental Health Care, Depression Anxiety Disorder, Quality of LifeArmsPhysiotherapy
NCT07407829 narecruitingnot on this mapstarted 2025, after this paper: background citation

Step by Step Back - A Feasibility Study of a CBT-Based Physical Activity Intervention for Stress-Related Exhaustion

TypeinterventionalSponsorThe Swedish School of Sport and Health SciencesRan2025 to 2026Enrolled20ConditionsExhaustion Disorder, Stress-Related DisordersArmsCBT/ACT-based psychologist-delivered physical activity program
3 · Its place in the literature

Who cites it

357 citing papers in PubMed, 39 syntheses or guidelines pooled it, 444 citations in OpenAlex.

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297 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 9 institutions in 4 countries.

Michael NoetelSchool of Psychology, University of Queensland, St Lucia, QLD 4072, Australia m.noetel@uq.edu.au.ORCID 0000-0002-6563-8203
Taren SandersInstitute for Positive Psychology and Education, Australian Catholic University, North Sydney, NSW, Australia.ORCID 0000-0002-4504-6008
Daniel Gallardo-GómezDepartment of Physical Education and Sport, University of Seville, Seville, Spain.ORCID 0000-0002-3029-026X
Paul TaylorSchool of Health and Behavioural Sciences, Australian Catholic University, Strathfield, NSW, Australia.ORCID 0000-0003-0407-2821
Borja Del Pozo CruzDepartment of Clinical Biomechanics and Sports Science, University of Southern Denmark, Odense, Denmark.ORCID 0000-0003-3944-2212
Daniel van den HoekSchool of Health and Behavioural Sciences, University of the Sunshine Coast, Petrie, QLD, Australia.ORCID 0000-0001-8335-1620
Jordan J SmithSchool of Education, University of Newcastle, Callaghan, NSW, Australia.ORCID 0000-0003-4640-8645
John MahoneySchool of Health and Behavioural Sciences, Australian Catholic University, Banyo, QLD, Australia.ORCID 0000-0002-1056-7348
Jemima SpathisSchool of Health and Behavioural Sciences, Australian Catholic University, Banyo, QLD, Australia.ORCID 0000-0002-1980-3212
Mark MoresiSchool of Health and Behavioural Sciences, Australian Catholic University, Strathfield, NSW, Australia.ORCID 0000-0003-4102-3885
Rebecca PaganoSchool of Education, Australian Catholic University, Strathfield, NSW, Australia.ORCID 0000-0001-9305-3184
Lisa PaganoAustralian Institute of Health Innovation, Macquarie University, Macquarie Park, NSW, Australia.ORCID 0000-0002-2869-5671
Roberta VasconcellosInstitute for Positive Psychology and Education, Australian Catholic University, North Sydney, NSW, Australia.ORCID 0009-0003-0285-6750
Hugh ArnottInstitute for Positive Psychology and Education, Australian Catholic University, North Sydney, NSW, Australia.ORCID 0000-0002-9582-5122
Benjamin VarleyChildren's Hospital Westmead Clinical School, University of Sydney, Westmead, NSW, Australia.ORCID 0000-0002-1191-6108
Philip ParkerAustralian Catholic University, North Sydney, NSW, Australia.ORCID 0000-0002-4604-8566
Stuart BiddleCentre for Health Research, University of Southern Queensland, Springfield, QLD, Australia.ORCID 0000-0002-7663-6895
Chris LonsdaleAustralian Catholic University, North Sydney, NSW, Australia.ORCID 0000-0002-2523-5565
Australian Catholic University · AUMacquarie University · AUThe University of Queensland · AUThe University of Sydney · AUUniversidad de Sevilla · ESUniversity of Newcastle Australia · AUUniversity of Southern Denmark · DKUniversity of Southern Queensland · AUUniversity of the Sunshine Coast · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo identify the optimal dose and modality of exercise for treating major depressive disorder, compared with psychotherapy, antidepressants, and control conditions.

designSystematic review and network meta-analysis.

methodsScreening, 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.

results218 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.

conclusionsExercise 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. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018118040.

Indexed as

Exercise TherapyMajor Depressive DisorderRandomized Controlled Trials as TopicAntidepressive AgentsExerciseHumansPsychotherapyTreatment OutcomeYogaAntidepressive Agents

Identifiers

PMID38355154
PMCPMC10870815
OpenAlexW4391847428

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

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.