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Minghetti A, Faude O, Hanssen H, Zahner L, Gerber M, Donath L. Sprint interval training (SIT) substantially reduces depressive symptoms in major depressive disorder (MDD): A randomized controlled trial. Psychiatry Res 2018; 265:292-297. [PMID: 29775886 DOI: 10.1016/j.psychres.2018.04.053] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/06/2018] [Accepted: 04/23/2018] [Indexed: 12/20/2022]
Abstract
Continuous aerobic exercise training (CAT) is considered a complementary treatment option in patients with major depressive disorder (MDD). Intermittent exercise training protocols, such as sprint interval training (SIT) have gained increasing popularity, but no studies on depressive symptoms following SIT in patients with MDD are available. Fifty-nine in-patients with MDD were randomly assigned to a SIT or CAT group. Medication was counterbalanced in both intervention arms. Both intervention groups received 3 weekly training sessions for 4-weeks (12 sessions in total). SIT comprised 25 bouts of 30 seconds at 80% of maximal power, whereas CAT consisted of 20 minutes of physical activity at 60% of maximal power. The training protocols were isocalorically designed. Maximal bicycle ergometer exercise testing yielded maximal and submaximal physical fitness parameters. The Beck-Depression-Inventory-II (BDI-II) was filled out by the patients before and after the intervention period. BDI-II scores substantially decreased in both groups with an effect size pointing towards a large effect (p < 0.001, ηp² = 0.70) while submaximal (0.07 < d < 0.89) and maximal (0.05 < d < 0.85) fitness variables improved in both groups. Short-term SIT leads to similar results as CAT in patients with MDD and can be regarded as a time-efficient and promising exercise-based treatment strategy.
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Affiliation(s)
- Alice Minghetti
- Department of Sport, Exercise and Health, University of Basel, Basel 4052, Switzerland.
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Basel 4052, Switzerland.
| | - Henner Hanssen
- Department of Sport, Exercise and Health, University of Basel, Basel 4052, Switzerland.
| | - Lukas Zahner
- Department of Sport, Exercise and Health, University of Basel, Basel 4052, Switzerland.
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel 4052, Switzerland.
| | - Lars Donath
- Department of Sport, Exercise and Health, University of Basel, Basel 4052, Switzerland; Department of Intervention Research in Exercise Training, German Sport University Cologne, Köln, Germany.
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Schuch F, Vancampfort D, Firth J, Rosenbaum S, Ward P, Reichert T, Bagatini NC, Bgeginski R, Stubbs B. Physical activity and sedentary behavior in people with major depressive disorder: A systematic review and meta-analysis. J Affect Disord 2017; 210:139-150. [PMID: 28033521 DOI: 10.1016/j.jad.2016.10.050] [Citation(s) in RCA: 323] [Impact Index Per Article: 46.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 10/16/2016] [Accepted: 10/23/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Low levels of physical activity (PA) and sedentary behavior (SB) are independent risk factors for cardiovascular disease and premature mortality in people with major depressive disorder (MDD). AIMS Investigate levels of PA and SB and their predictors in people with MDD. METHODS Electronic databases were searched from inception till 04/2016 for articles measuring PA and SB with a self-report questionnaire (SRQ) or objective measure (e.g. accelerometer) in people with MDD. Random-effects meta-analyses and meta-regression analyses were conducted. RESULTS Twenty-four eligible studies were identified including 2901 people with MDD (78.4% female, mean age=54 years; range: 21-77 years). People with MDD spent 126.0min (95%CI=91.9-160.1) per day engaging in all types of PA and spent 8.5hours (95%CI=7.51-9.62) during their waking day being sedentary. Compared to controls, people with MDD spent less time in total PA (SMD=-0.25, 95%CI=-0.03 to 0.15) and moderate to vigorous PA (SMD=-0.30, 95%CI=-0.40 to 0.21) and engaged in higher levels of SB (SMD=0.09, 95%CI=0.01-0.18). The proportion of people with MDD not meeting the recommended PA guidelines was 67.8% (n=13 studies), which was higher in studies relying on objective versus self-report measures (85.7% v 62.1%, p=0.04). People with MDD were more likely than controls to not meeting the recommended PA guidelines (OR = 1.50, 95%CI = 1.10–2.10). LIMITATIONS Heterogeneity was evident in most analyses. CONCLUSIONS Adults with MDD engage in low levels of PA and high levels of SB. PA and SB are independent predictors of mortality, therefore, future lifestyle interventions targeting both the prevention of SB and adoption and maintenance of PA are warranted.
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Affiliation(s)
- Felipe Schuch
- Unilasalle, Canoas, Brazil; Escola de Educação Física, Fisioterapia e Dança, Porto Alegre, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
| | - Davy Vancampfort
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven - University of Leuven, University Psychiatric Centre, Leuven-Kortenberg, Belgium
| | - Joseph Firth
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Simon Rosenbaum
- Department of Exercise Physiology, School of Medical Sciences, University of New South Wales, Liverpool NSW 2170, Sydney, Australia; The Black Dog Institute, University of New South Wales, Hospital Road, Prince of Wales Hospital, Randwick 2031, NSW, Australia
| | - Philip Ward
- School of Psychiatry, US Australia, Sydney and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Thaís Reichert
- Escola de Educação Física, Fisioterapia e Dança, Porto Alegre, Brazil
| | | | - Roberta Bgeginski
- Obstetrics and Gynecology Department, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK
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Hanssen H, Minghetti A, Faude O, Schmidt-Trucksäss A, Zahner L, Beck J, Donath L. Effects of Endurance Exercise Modalities on Arterial Stiffness in Patients Suffering from Unipolar Depression: A Randomized Controlled Trial. Front Psychiatry 2017; 8:311. [PMID: 29403399 PMCID: PMC5786741 DOI: 10.3389/fpsyt.2017.00311] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 12/26/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Psychiatric disorders are associated with a higher prevalence of cardiovascular disease and mortality. Regular exercise has been shown to reduce depressive symptoms and improve arterial stiffness as a biomarker of cardiovascular risk. We aimed to investigate the effects of different exercise modalities on depression severity index and arterial stiffness in patients suffering from unipolar depression. METHODS 34 patients suffering from unipolar depression [female: 25, male: 9, age: 37.8, Beck-Depression-Inventory-II (BDI-II) score: 31.0] were enrolled in this two-armed randomized controlled trial. Central hemodynamics, augmentation index at heart rate 75/min (AIx@75) and aortic pulse wave velocity (PWV) were obtained by an oscillometric monitoring device. Maximal bicycle ergometer exercise testing yielded maximal fitness parameters. Patients were assigned to either high-intensity low volume (HILV) or moderate continuous aerobic training (MCT). Both intervention groups trained three times a week during a 4-week intervention period. BDI-II were filled out by the patients before and after the intervention period. RESULTS We found moderate interaction effects on depression severity reduction [Formula: see text]. HILV showed a 85% beneficial effect in lowering BDI-II scores compared to MCT (HILV: pre: 28.8 (9.5), post: 15.5 (8.5), SMD = 1.48), MCT: (pre: 33.8 (8.5), post: 22.6 (7.5), SMD = 1.40). Reduction of AIx@75 was more pronounced after MCT (SMD = 0.61) compared to HILV (SMD = 0.08), showing 37% possibly beneficial effects of MCT over HILV. PWV remained unchanged in both training groups. CONCLUSION Both training regimes showed large effects on the reduction of depressive symptoms. While HILV was more effective in lowering depression severity, MCT was more effective in additionally lowering peripheral arterial stiffness. Exercise should be considered an important strategy for preventive as well as rehabilitative treatment in depression.
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Affiliation(s)
- Henner Hanssen
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Alice Minghetti
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Lukas Zahner
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Johannes Beck
- Klinikum Sonnhalde, Psychiatrie und Psychotherapie, Riehen, Switzerland
| | - Lars Donath
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.,Institute of Exercise Training and Computer Science in Sport, German Sport University Cologne, Köln, Germany
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Herbsleb M, Schulz S, Ostermann S, Donath L, Eisenträger D, Puta C, Voss A, Gabriel HW, Bär KJ. The relation of autonomic function to physical fitness in patients suffering from alcohol dependence. Drug Alcohol Depend 2013; 132:505-12. [PMID: 23664500 DOI: 10.1016/j.drugalcdep.2013.03.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2012] [Revised: 03/09/2013] [Accepted: 03/26/2013] [Indexed: 01/14/2023]
Abstract
BACKGROUND Reduced cardio-vascular health has been found in patients suffering from alcohol dependence. Low cardio-respiratory fitness is an independent predictor of cardio-vascular disease. METHODS We investigated physical fitness in 22 alcohol-dependent patients 10 days after acute alcohol withdrawal and compared results with matched controls. The standardized 6-min walk test (6 MWT) was used to analyze the relationship of autonomic dysfunction and physical fitness. Ventilatory indices and gas exchanges were assessed using a portable spiroergometric system while heart rate recordings were obtained separately. We calculated walking distance, indices of heart rate variability and efficiency parameters of heart rate and breathing. In addition, levels of exhaled carbon monoxide were measured in all participants to account for differences in smoking behaviour. Multivariate analyses of variance (MANOVA) were performed to investigate differences between patients and controls with regard to autonomic and efficiency parameters. RESULTS Patients walked a significantly shorter distance in comparison to healthy subjects during the 6 MWT. Significantly decreased heart rate variability was observed before and after the test in patients when compared to controls, while no such difference was observed during exercise. The efficiency parameters indicated significantly reduced efficiency in physiological regulation when the obtained parameters were normalized to the distance. DISCUSSION The 6 MWT is an easily applied instrument to measure physical fitness in alcohol dependent patients. It can also be used during exercise interventions. Reduced physical fitness, as observed in our study, might partly be caused by autonomic dysfunction, leading to less efficient regulation of physiological processes during exercise.
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Affiliation(s)
- Marco Herbsleb
- Pain & Autonomic Integrative Research (PAIR), Department of Psychiatry and Psychotherapy, University Hospital, Jena, Germany; Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University, Jena, Germany
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Berger S, Schulz S, Kletta C, Voss A, Bär KJ. Autonomic modulation in healthy first-degree relatives of patients with major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:1723-8. [PMID: 21651953 DOI: 10.1016/j.pnpbp.2011.05.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2011] [Revised: 05/10/2011] [Accepted: 05/24/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cardiac mortality is known to be increased in patients with major depression. Several studies have reported an imbalance within the autonomic nervous system (ANS) of patients with major depressive disorder (MDD) as one putative cause. Since a heritability of autonomic modulation was demonstrated in healthy subjects, we aimed to investigate autonomic modulation in first-degree relatives of patients with MDD to find potential autonomic imbalances. METHODS We included 30 patients with MDD, 30 of their first-degree relatives (siblings or offspring) and 30 matched healthy controls in our study. We obtained a high resolution electrocardiogram and beat to beat blood pressure measurements for 30 min at rest. Linear and nonlinear parameters of heart rate variability (HRV) and baroreflex sensitivity (BRS) were calculated. RESULTS Parameters of HRV and BRS did not differ significantly between relatives and controls. We found significant differences between patients and controls for some HRV and BRS parameters confirming results of previous studies. DISCUSSION Findings of our study suggest that an imbalance of autonomic function is related to patients with depression and not to first-degree relatives. Thus, a genetic background for autonomic dysfunction is rather unlikely.
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Affiliation(s)
- Sandy Berger
- Pain & Autonomics-Integrative Research, Department of Psychiatry and Psychotherapy, University Hospital, Philosophenweg 3, 07743 Jena, Germany
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Ventilatory inefficiency in major depressive disorder: a potential adjunct for cardiac risk stratification in depressive disorders? Prog Neuropsychopharmacol Biol Psychiatry 2010; 34:882-7. [PMID: 20398716 DOI: 10.1016/j.pnpbp.2010.04.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Revised: 03/12/2010] [Accepted: 04/08/2010] [Indexed: 11/21/2022]
Abstract
BACKGROUND Cardiopulmonary exercise testing (CPET) provides insights into ventilatory, cardiac and metabolic dysfunction in heart and lung diseases and might play a role in cardiac risk stratification in major depressive disorder (MDD). OBJECTIVE The VE/VCO(2)-slope indicates ventilatory efficiency and has been applied to stratify the cardiac risk in heart failure (HF). Therefore, the current study was conducted to evaluate and classify ventilatory efficiency and its relationship to physical fitness and disease severity in MDD. METHODS Exhaustive incremental exercise testing was completed by 15 female MDD patients and pair matched controls. The ventilatory threshold (VT) and the VE/VCO(2)-slope were assessed. Statistical analyses were conducted by means of MANOVAs and follow-up univariate ANOVAs. RESULTS In patients with MDD, significant different relative work rates and oxygen uptakes at the VT in comparison to healthy controls were observed. Furthermore, we found an increased VE/VCO(2)-slope in depressed patients. We additionally report an inverse relationship between the VE/VCO(2)-slope and peak power output as well as peak oxygen uptake solely in patients. We did not observe any association of assessed parameters with disease severity. CONCLUSION CPET measures indicate ventilatory inefficiency in patients with MDD. The elevated VE/VCO(2)-slope indicates that patients with MDD need to ventilate significantly more to a given amount of developing CO(2). Further investigations are needed to verify the application of the ventilatory classification system to stratify cardiovascular risk in depressive disorder.
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