Abstract Background Patients with depression often suffer from significant social dysfunction, manifested as social withdrawal, difficulties in interpersonal interaction, and impaired role functioning, which severely affects their quality of life and rehabilitation process. Non-pharmacological interventions play an important role in promoting social function recovery. As an intervention combining regular, rhythmic physical activity with the unique aquatic environment, swimming is believed to facilitate social function reconstruction through multiple pathways, such as improving physical symptoms, enhancing emotional states, boosting self-efficacy, and providing low-threat social contexts. Therefore, this study systematically analyzes the effects of structured swimming training on improving social function in patients with depression through standardized scale assessments and explores its potential intervention mechanisms, aiming to provide empirical evidence for the application of exercise rehabilitation in the field of mental health. Methods A total of 120 children aged 3-6 years clinically diagnosed with ASD were enrolled and randomly divided into an intervention group (n = 60) and a control group (n = 60). The intervention group received 12-week special preschool education intervention (5 sessions/week, 60 min/session), including social skills training, emotional regulation training, and sensory integration activities. The control group only received routine daily care and regular game activities. The Child Behavior Checklist (CBCL) and Emotion Regulation Checklist (ERC) were used for psychological assessment at pre-intervention (T0), mid-intervention (Week 6, T1), and post-intervention (Week 12, T2). Repeated measures analysis of variance (ANOVA) was performed for statistical analysis with a significance level of p.05, and Cohen’s d effect size was calculated to evaluate the magnitude of intervention effects. Results The total SDSS score of the intervention group significantly decreased from 8.6 ± 2.1 at T0 to 5.2 ± 1.8 at T2 (p.001, d = 1.75), with particularly notable improvements in sub-items such as occupational roles, social withdrawal, and family functioning (p.01). The total SDS score of the intervention group also showed a significant reduction in the degree of social functioning impairment, decreasing from 18.3 ± 4.0 at T0 to 12.1 ± 3.5 at T2 (p.001, d = 1.65). In contrast, the control group showed no statistically significant changes in either score from T0 to T2 (p.05). Repeated measures analysis of variance confirmed significant interaction effects between time and group in social functioning scores (SDSS: F = 16.54, p.001; SDS: F = 14.89, p.001). Discussion Ten-week swimming training effectively promotes social function reconstruction in patients with depression, as evidenced by reduced social deficits and restored role functioning. Results indicate that structured, group-based aquatic exercise may serve as an effective complementary intervention for depression rehabilitation through mechanisms such as improving psychophysiological status and providing a supportive social environment. This study provides preliminary evidence for integrating swimming into comprehensive rehabilitation programs for depression. Future research should extend follow-up duration to assess the sustainability of effects and further explore specific physiological and psychological mediating mechanisms to optimize training protocols and achieve individualized rehabilitation.
Zheng et al. (Sun,) studied this question.