What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Depression (n=2170). Intervention: Exercise vs. Non-exercise control group. Primary outcome: Depression (SMD -0.71, 95% CI -0.94 to -0.48, p=<0.001).

July 8, 2024Open Access

Effects of exercise on depression and anxiety in postmenopausal women: a pairwise and network meta-analysis of randomized controlled trials

Q: What are the key findings of this study?

Exercise interventions significantly reduced depression in postmenopausal women compared to control interventions (SMD -0.71), with mind-body exercise being the most effective modality.

Resultado clave

Exercise interventions significantly reduced depression in postmenopausal women compared to control interventions (SMD -0.71), with mind-body exercise being the most effective modality.

Diseño del estudio

Tipo

Meta-Analysis (n=2,170)

PICO estructurado

Does exercise (specifically mind-body, aerobic, or multicomponent) reduce depression and anxiety in postmenopausal women compared to non-exercise controls?

Población

2,170 postmenopausal women without hormone therapy or regular exercise habits, included in 26 randomized controlled trials assessing the effect of exercise on depression.

Intervención

Exercise interventions implemented for at least four weeks, categorized into stretching exercise (SE), aerobic exercise (AE), resistance training (RT), mind-body exercise (MBE), and multicomponent exercise (ME).

Comparador

Non-exercise control group (e.g., usual care, wait-list control conditions, or health education) or other exercise interventions.

Resultado

Depression, measured by validated scales (e.g., Geriatric Depression Scale, Beck Depression Inventory, Hospital Anxiety and Depression Scale) as pre-to-post intervention changes.patient reported

Exercise, particularly mind-body exercise, is an effective non-pharmacological intervention for reducing depression and anxiety in postmenopausal women.

Resultado numérico

Standardized Mean Difference: -0.71 (95% CI -0.94–-0.48)

valor p: p=<0.001

Limitaciones

Heterogeneity due to different exercise intervention modalities across included studies
Diverse scales used to measure depression may have contributed to heterogeneity
Predominant pre-post intervention design limited analysis to intervention endpoints without long-term follow-up data
Potential deficiencies in the inclusion of grey literature
Fewer original studies examined stretching exercise, resistance training, and multicomponent exercise, leading to broader confidence intervals

Resumen

BACKGROUND: Exercise has been identified as a promising non-pharmacological therapy for the management of depression, but there is still controversy over which type is most effective. We aimed to compare and rank the types of exercise that improve depression in postmenopausal women by quantifying information from randomized controlled trials (RCTs). METHODS: The PubMed, Web of Science, SPORTDiscus, CNKI, The Cochrane Library, PsycINFO, EMBASE, and CINAHL Plus databases were searched to identify articles published from inception to 1 March 2024 reporting RCTs that examined the effectiveness of exercise on depression in postmenopausal women. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for RCTs. The quality of the evidence for each comparison was graded using the online confidence in network meta-analysis tool (CINeMA). Standardized mean differences (SMDs) were calculated using the mean and standard deviation of pre-to-post intervention changes and then pooled using a random effects model in a pairwise meta-analysis using Review Manager 5.4. Then, a frequentist network meta-analysis was conducted using a random effects model was conducted to evaluate the efficacy of different exercise types using the network package of Stata 15. RESULTS: = 78%). The network meta-analysis revealed that mind-body exercise (SMD = -0.97, 95% CI = -1.28 to -0.67), aerobic exercise (SMD = -0.58, 95% CI = -0.88 to -0.27) and multicomponent exercise (SMD = -0.57, 95% CI = -1.15 to -0.002) significantly reduced depression compared to the control intervention. Mind-body exercise had the highest probability of being the most effective intervention. Exercise interventions also showed positive effects on anxiety. Most studies were judged to have some concerns regarding their risk of bias, and the confidence in evidence was often very low according to CINeMA. CONCLUSION: For postmenopausal women, there is very low to moderate quality evidence that exercise interventions are an effective antidepressant therapy, with mind-body exercise most likely being the optimal type. TRIAL REGISTRATION: This meta-analysis was prospectively registered with PROSPERO (registration number: CRD42024505425).

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Cite This Study

Han et al. (Mon,) conducted a meta-analysis in Depression (n=2,170). Exercise vs. Non-exercise control group was evaluated on Depression (SMD -0.71, 95% CI -0.94 to -0.48, p=<0.001). Exercise interventions significantly reduced depression in postmenopausal women compared to control interventions (SMD -0.71), with mind-body exercise being the most effective modality.

synapsesocial.com/papers/6a2186b796850e9b858b8967 https://doi.org/https://doi.org/10.1186/s12889-024-19348-2

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