Effect of exercise intervention on depression in children and adolescents: a systematic review and network meta-analysis

Effects of a 16-week dance intervention on loneliness and self-esteem in left behind children: a randomised controlled trial

Loneliness and low self-esteem are among the more prominent mental health problems among left-behind children, but most of the current research stays in cross-sectional surveys, with fewer studies proposing specific solutions. In addition, although the effective impact of dance interventions on loneliness and self-esteem has been demonstrated, the impact in the group of left-behind children remains under-explored. Therefore, this study validated the effectiveness of a dance intervention on loneliness and self-esteem in left-behind children through a 16-week randomised controlled trial. Stratified sampling was used to select one primary school from each of the 14 cities in Hunan Province, with a maximum of 100 children recruited from each primary school. Independent researchers used SPSS 29.0 to randomly assign the eligible 1270 participants to the Experimental group (n = 635) and Control group (n = 635) in a 1:1 ratio. The Experimental group performed 45 min of moderate-intensity dance training five times a week. The Control group maintained their original living conditions. Participants were measured three times using the Children's Loneliness Scale and Rosenberg's Self-Esteem Scale: baseline (T0), after 8 weeks (T1), and post-intervention (16 weeks, T2). Linear mixed-effects models for repeated measures were used to test the effects of time, group and time × group interactions. (a) The average age of the 1261 participants was 10 years (SD = 3.52), with high levels of loneliness (42.48 ± 12.04) and low levels of self-esteem (26.75 ± 6.39). (b) There was a significant negative correlation between loneliness and self-esteem among the LBC (p < 0.001, r = - 0.390). (c) After the dance intervention, the LBC's loneliness significantly decreased [F (2, 1258) = 74.516, ηp2 = 0.106, p < 0.001] and their self-esteem significantly increased [F (2, 1258) = 73.64, ηp2 = 0.104, p < 0.001]. A 16-week dance intervention is an effective strategy to improve loneliness and self-esteem in LBC. Given the acceptability and practicality of the dance intervention, it could be included in a health programme to improve loneliness and self-esteem in LBC.

Could physical activity promote indicators of physical and psychological health among children and adolescents? An umbrella review of meta-analyses of randomized controlled trials

BACKGROUND

We performed an umbrella review to synthesize evidence on the effects of physical activity (PA) interventions on indicators of physical and psychological health among children and adolescents, including body mass index (BMI), blood pressure (BP), depressive symptoms, and cognitive function.

METHODS

PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched from inception through 31 July 2023. We included meta-analyses of randomized controlled trials exploring the effects of PA interventions on BMI, BP, depressive symptoms, or cognitive function in healthy or general children and adolescents. Standard Mean Difference (SMD) was calculated for continuous outcome indicators, while Relative Risk (RR) was calculated for categorical outcome indicators.

RESULTS

A total of 21 meta-analyses were included. The evidence for the effects of PA interventions on reducing BMI [n = 68,368, SMD = - 0.04, 95% confidence interval (CI) = - 0.07 to - 0.01, P = 0.012, I2 = 46.6%], relieving diastolic BP (n = 8204, SMD = - 1.16, 95% CI = - 2.12 to - 0.20, P = 0.018, I2 = 83.1%), preventing depressive symptoms (n = 5146, SMD = - 0.21, 95% CI = - 0.31 to - 0.12, P < 0.001, I2 = 29.0%), and promoting cognitive function (n = 19,955, SMD = 0.40, 95% CI = 0.27-0.54, P < 0.001, I2 = 88.0%) was all weak but significant (class IV evidence). Subgroup analyses demonstrated that school-based and after-school PA interventions, curricular PA interventions, and PA interventions emphasizing enjoyment were more effective in reducing BMI, while curricular PA and sports programs achieved greater executive function.

CONCLUSION

PA interventions could weakly reduce BMI, relieve BP, prevent depressive symptoms, and promote cognitive function in general children and adolescents. Targeted interventions on PA should be a priority to promote physical and psychological health for children and adolescents, especially the curricular PA emphasizing enjoyment in the school settings.

The impact of aerobic exercise on depression in young people: A meta regression and meta-analysis

OBJECTIVE

This systematic review aimed to 1) update the existing evidence on the antidepressant effects of aerobic exercise (AE) in youth. 2) Investigate any potential dose‒response relationships between AE interventions and depressive symptom reduction. 3) Provide evidence-based insights to inform future research and clinical depression treatment.

METHODS

Employing the PRISMA and PERSiST guidelines, a comprehensive search across nine databases (Web of Science, PubMed, Scopus, PsycINFO, SportDiscus, CINAHL, Medline, Embase, and CNKI) yielded a total of 782 relevant studies. Following rigorous selection criteria, 26 eligible studies (comprising 22 different samples) were included in the analysis, featuring a combined sample size of 1308 participants. The meta-analysis was conducted via R.

RESULTS

AE notably decreased depressive symptoms among youth [g = -0.92; 95% CI (-1.16, -0.69); p < 0.01]. Significant dose‒response relationships were observed across age groups [β = -0.06; 95% CI (-0.12, 0.00), p < 0.05], the intensity [β = -0.03; 95% CI (-0.06, 0.00); p < 0.05], and the duration ^ 2 [β = 0.001, 95% CI (0.001, 0.002), p < 0.05] of the AE intervention.

CONCLUSIONS

Aerobic exercise interventions can effectively alleviate depressive symptoms in youth. A moderate-intensity AE program, lasting 25-40 min and conducted three times a week for 9-15 weeks, can increase alleviation of depression.

Behavioral Counseling for Weight Management by Pediatric Nurse Practitioners: A Quantitative Cross-Sectional Study

INTRODUCTION

This study assessed counseling by pediatric nurse practitioners (PNPs) for management of overweight and obesity.

METHOD

Using a cross-sectional design, 1,058 PNPs completed a one-time survey regarding counseling for healthy body weight, physical activity, and consumption of protein, fruits and vegetables.

RESULTS

Study findings suggest PNPs are using behavioral counseling for weight management in pediatric patients. Counseling was more frequent for healthy body weight, fruit and vegetable intake, and physical activity than for protein consumption and muscle strengthening. Furthermore, when PNPs counseled for healthy body weight they were also more likely to counsel for physical activity (OR = 25.99 [95% CI: 19.25, 35.11]), fruit and vegetable intake (OR = 22.35 [95% CI: 16.71, 29.88]), protein intake (OR = 9.82 [95% CI: 7.60, 12.69]), and muscle strengthening (OR = 6.41 [95% CI: 4.98, 8.24]).

DISCUSSION

PNPs are counseling for healthy body weight and necessary behavioral tools, but increased emphasis on muscle strengthening may benefit overweight and obese youth.

The effects of aerobic exercise for depression: An umbrella review of systematic reviews and meta-analyses

OBJECTIVE

This review aims to determine whether aerobic exercise is beneficial in treating depression in adults in general.

METHODS

Review of systematic reviews and meta-analyses related to RCTs. PubMed, MEDLINE, PsycINFO, Embase, and Cochrane databases of systematic reviews were searched extensively between September 2009 and September 2023. An extensive search was conducted using MeSH terms, including ''depression'', ''depressive disorder'', ''depressive symptoms'', ''exercise'', ''aerobic exercise'', ''aerobic training'', ''walking'', ''running'', ''jogging'', ''bicycling'', ''physical activity'', ''adult (limiters 18-65 years)'', ''meta-analyses'' and ''systematic reviews''.

RESULT

In the initial search of the titles and abstracts of reviews, 2345 articles were found. 46 full-text reviews were selected for carefully scrutinized. A total of seven reviews were included in the analysis, and two of them were meta-analyses, which included 42 RCTs. The results of four reviews evaluated the effectiveness of aerobic exercise on depression. Moreover, two reviews examined the efficacy of aerobic exercise as an add-on intervention for depression treatment, one of which was a subgroup analysis. According to two reviews, aerobic exercise improved CRF in people with depression and affected people with MDD from a neurobiological standpoint.

CONCLUSION

This umbrella review systematically evaluated the efficacy of aerobic exercise in treating adult depression, revealing substantial evidence that supports its potential to alleviate depressive symptoms. The positive synthesis of findings advocates for integrating aerobic exercise as a non-pharmacological treatment option. Nevertheless, additional research is essential to confirm these benefits and optimize exercise protocols for depression management.

Effects of different types of exercise intensity on improving health-related physical fitness in children and adolescents: a systematic review

A substantial body of empirical evidence reveals that physical activity is associated with a wide range of positive physical and mental health outcomes. However, an absence of comprehensive syntheses is observed concerning the varying effects of different exercise intensities on the improvement of physical health among children and adolescents. The aim of this review is to systematically investigate the effects of different exercise intensities on the physical fitness of children and adolescents, to analyses the optimal exercise intensities for improving physical fitness, and to provide a relevant theoretical basis for optimizing school physical education curricula. A systematic search strategy was used in this study in four online databases (PubMed, Scopus, EBSCO and Web of Science). Intervention studies that met the inclusion criteria underwent a thorough screening process, and their methodological quality was assessed utilizing the PEDro scale. The selected literature was systematically analyzed and evaluated through induction, summary, analysis, and evaluation. These findings indicate that high-intensity exercise training exerts significant positive effects on body composition, cardiopulmonary function and muscle fitness in children and adolescents. Therefore, we suggest that schools should focus on high-intensity sports in their physical education curriculum, which can further improve the student's PHYSICAL FITNESS.

Empowered and engaged: Group exercise for adolescent depression - perspectives from adolescents, parents and healthcare professionals

Objectives

Depression is increasing and is a leading cause of disease burden among adolescents. Available evidence-based treatments with medication or psychotherapy have modest effects. Aerobic exercise is a hopeful alternative as an augmenter or a stand-alone treatment. Qualitative studies have shown that participants in group exercise for adolescent depression experienced improved mood and a sense of achievement, commitment and empowerment. This study aimed to explore not only adolescents' but also parents' and healthcare professionals' experiences of a group exercise intervention for adolescents with depression.

Methods

Nine adolescents who had participated in a group aerobic exercise intervention for 12 weeks, eight parents and two healthcare professionals were interviewed. We used a latent qualitative content analysis with an inductive approach that resulted in nine sub-categories, three categories and an overarching theme.

Results

The experiences of a group exercise intervention for adolescents with depression were expressed in the overarching theme 'Group exercise for adolescent depression promotes empowerment and engagement in everyday life', based on three categories: exercise alleviates depressive symptoms, exercise contributes to balance in life and exercise promotes self-esteem. However, there was variation in our results, in that not all participants experienced improvements from exercising. Adolescents described more varied experiences, while parents and healthcare professionals mainly expressed positive views.

Conclusions

Our findings suggest that group exercise for adolescent depression promotes empowerment and engagement in everyday life, according to adolescents, and more clearly so according to parents and healthcare professionals.

Validation of the maximal cardiopulmonary exercise test in adolescents with major depressive disorder and comparison of cardiorespiratory fitness with sex- and age-related control values

Endurance training has been shown to be effective in treating adolescents with major depressive disorder (MDD). To integrate endurance training into the therapeutic setting and the adolescents' daily lives, the current performance status of the adolescents should be accurately assessed. This study aims to examine adolescents with MDD concerning exhaustion criteria during a cardiopulmonary exercise test (CPET), as well as to compare the values obtained thereon with sex- and age-related control values. The study included a retrospective examination of exhaustion criteria ((i) oxygen consumption (V̇O2) plateau, (ii) peak respiratory exchange ratio (RERpeak) > 1.0, (iii) peak heart rate (HRpeak) ≥ 95% of the age-predicted maximal HR, and (iv) peak blood lactate concentration (BLCpeak) > 8.0 mmol⋅L-1) during a graded CPET on a cycle ergometer in adolescents with MDD (n = 57). Subsequently, maximal V̇O2, peak minute ventilation, V̇O2 at the first ventilatory threshold, and peak work rate of participants who met at least two of four criteria were compared with published control values using an independent-sample t-test. Thirty-three percent of the total population achieved a V̇O2 plateau and 75% a RERpeak > 1.0. The HR and BLC criteria were met by 19% and 22%, respectively. T-test results revealed significant differences between adolescents with MDD and control values for all outcomes. Adolescents with MDD achieved between 56% and 83% of control values.   Conclusions: The study shows that compared with control values, fewer adolescents with MDD achieve the exhaustion criteria on a CPET and adolescents with MDD have significantly lower cardiorespiratory fitness.   Clinical trial registration: No. U1111-1145-1854. What is Known: • It is already known that endurance training has a positive effect on depressive symptoms. What is New: • A relevant proportion of adolescents with major depressive disorder do not achieve their V̇O2max during a graded cardiopulmonary exercise test. • Adolescents with major depressive disorder have significantly lower cardiorespiratory fitness compared to sex- and age-related control values.