Cognitive behavior therapy combined with physical exercise significantly reduced depression (SMC -0.34), anxiety (SMC -0.18), and fatigue (SMC -0.96) compared to controls in adults with chronic diseases, but did not show greater efficacy than either intervention alone.
Meta-Analysis
Does cognitive behavior therapy combined with physical exercise improve depression, anxiety, fatigue, and pain in adults with chronic illness compared to each condition alone?
Cognitive behavior therapy combined with exercise improves depression, anxiety, and fatigue in adults with chronic diseases, but does not provide an additive benefit over either intervention alone.
Estimación del efecto: SMC -0.34 (95% CI -0.53; -0.14)
OBJECTIVE: The present meta-analysis aimed to determine the overall effect of cognitive behavior therapy combined with physical exercise (CBTEx) interventions on depression, anxiety, fatigue, and pain in adults with chronic illness; to identify the potential moderators of efficacy; and to compare the efficacy of CBTEx versus each condition alone (CBT and physical exercise). METHOD: Relevant randomized clinical trials, published before July 2017, were identified through database searches in PubMed, PsycARTICLES, CINAHL, SportDiscus, and the Cochrane Central Register for Controlled Trials. RESULTS: A total of 30 studies were identified. CBTEx interventions yielded small to large effect sizes for depression (standardized mean change SMC = -0.34, 95% CI -0.53, -0.14), anxiety (SMC = -0.18, 95% CI -0.34, -0.03), and fatigue (SMC = -0.96, 95% CI -1.43, -0.49). Moderation analyses revealed that longer intervention was associated with greater effect sizes for depression and anxiety outcomes. Low methodological quality was also associated with increased CBTEx efficacy for depression. When compared directly, CBTEx interventions did not show greater efficacy than CBT alone or physical exercise alone for any of the outcomes. CONCLUSION: The current literature suggests that CBTEx interventions are effective for decreasing depression, anxiety, and fatigue symptoms but not pain. However, the findings do not support an additive effect of CBT and exercise on any of the 4 outcomes compared to each condition alone. (PsycINFO Database Record
Bernard et al. (Fri,) conducted a meta-analysis in Chronic diseases. Cognitive behavior therapy combined with physical exercise (CBTEx) vs. Usual care, wait-list, active control, CBT alone, or physical exercise alone was evaluated on Depression (SMC -0.34, 95% CI -0.53; -0.14). Cognitive behavior therapy combined with physical exercise significantly reduced depression (SMC -0.34), anxiety (SMC -0.18), and fatigue (SMC -0.96) compared to controls in adults with chronic diseases, but did not show greater efficacy than either intervention alone.
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