Evidence map›Paper›PMID 40988014›Full record

SynthesisBMC psychiatry2025

Effectiveness of indoor rock climbing and bouldering as treatment for depression - a systematic review.

Robin Larsson, Anette Larsson, Lena Nordeman

Abstract readSystematic Review
In one paragraph

Synthesis in BMC psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

3 authors.

Robin LarssonDin Hälsocentral Kilafors, Primary Health Care, Region Gävleborg, Stationsgatan 2, Kilafors, 823 30, Sweden. ljrobin.larsson@gmail.com.ORCID 0009-0002-6469-0592
Anette LarssonResearch, Education, Development and Innovation, Primary Health Care, Region Västra Götaland, Borås, Sweden.ORCID 0000-0002-0405-3877
Lena NordemanResearch, Education, Development and Innovation, Primary Health Care, Region Västra Götaland, Borås, Sweden.ORCID 0000-0003-4691-9330

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDepression is one of the most prevalent disorders worldwide. In addition to psychotherapy, cognitive behavioural therapy and antidepressants, exercise therapy is frequently recommended, with emerging evidence highlighting the unique characteristics of rock climbing, including its potential to promote mindfulness, making it a promising therapy. This review aimed to assess whether rock climbing reduces symptoms of depression, the magnitude of effect, and whether effects are sustained long-term.

methodsSystematic review conducted according to PICO framework and reported according to PRISMA-statement. Eligible studies were controlled trials assessing indoor rock climbing versus any comparator, including adults with moderate depression, with symptoms reduction on validated depression scales as outcome. Systematic searches were conducted in PubMed, Scopus, and Web of Science (inception to January 2025), with no language or publication date restrictions. Screening (via Rayyan), data extraction, and methodological quality assessment (using PEDro scale) were performed independently and in duplicate. Clinical relevance was assessed using minimal clinically important difference (MCID). Due to heterogeneity of interventions and comparators, findings were narratively synthesized. Certainty of evidence was rated using GRADE.

resultsOut of 1,832 identified records, seven studies (reported in 10 articles) including 471 participants, met PICO-criteria. Included studies were conducted between 2015 and 2023, in Germany/Austria. Methodological quality was generally good (median PEDro score 6/10). Indoor bouldering (combined with mindfulness exercises) significantly reduced symptoms of depression from moderate to mild (e.g. -8.3 points on MADRS, exceeding MCID of 5 points), indicating a clinically meaningful improvement compared to no intervention (high certainty evidence). Longer duration interventions (8-10 weeks) were needed for effects to persist at 6-12 months (high certainty evidence). Four weeks of top-rope climbing also reduced symptoms of depression from moderate to mild, were sustained long-term, but did not exceed MCID (low certainty evidence). No adverse events were reported.

conclusionsIndoor rock climbing, particularly bouldering (combined with mindfulness exercises), appears to be an effective, clinically meaningful, safe, and sustainable adjunctive intervention for adults with moderate depression. However, further high-quality trials are needed to isolate the effects of rock climbing from co-interventions and to compare it with established treatments such as antidepressants and aerobic exercise.

trial registrationPROSPERO: CRD42024468119, date of registration: 24-01-2024.

Indexed as

DepressionDepressive DisorderExercise TherapyMindfulnessHumansBoulderingDepressionDepressive disorderExercise therapyIndoor climbingMindfulnessRock climbingTherapeutic climbing

Identifiers

PMID40988014
PMCPMC12459035

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.