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Wunram HL, Kasparbauer AM, Oberste M, Bender S. [Movement as a Neuromodulator: How Physical Activity Influences the Physiology of Adolescent Depression]. ZEITSCHRIFT FUR KINDER- UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2023; 52:77-93. [PMID: 37851436 DOI: 10.1024/1422-4917/a000954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Movement as a Neuromodulator: How Physical Activity Influences the Physiology of Adolescent Depression Abstract: In the context of adolescent depression, physical activity is becoming increasingly recognized for its positive effects on neuropathology. Current scientific findings indicate that physical training affects the biological effects of depression during adolescence. Yet the pathophysiology of adolescent depression is not yet fully understood. Besides psychosocial and genetic influences, various neurobiological factors are being discussed. One explanation model describes a dysfunction of the hypothalamus-pituitary-adrenal axis (HPA axis) with a sustained elevation in cortisol concentration. Recent studies highlight neuroimmunological processes and a reduced concentration of growth factors as causative factors. These changes appear to lead to a dysregulation of the excitation and inhibition balance of the cerebral cortex as well as to cerebral morphological alterations. Regular physical training can potentially counteract the dysregulation of the HPA axis and normalize cortisol levels. The release of proinflammatory cytokines is inhibited, and the expression of growth factors involved in adult neurogenesis is stimulated. One should ensure the synergistic interaction of biological and psychosocial factors when designing the exercise schedule (endurance or strength training, group or individual sports, frequency, duration, and intensity). Addressing these open questions is essential when integrating physical activity into the guidelines for treating depressive disorders in children and adolescents.
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Affiliation(s)
- Heidrun Lioba Wunram
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Uniklinik Köln, Medizinische Fakultät der Universität zu Köln, Deutschland
- Kinderklinik Uniklinik Köln, Medizinische Fakultät der Universität zu Köln, Deutschland
- Geteilte Erstautorenschaft
| | - Anna-Maria Kasparbauer
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Uniklinik Köln, Medizinische Fakultät der Universität zu Köln, Deutschland
- Geteilte Erstautorenschaft
| | - Max Oberste
- Institut für Medizinische Statistik und Bioinformatik, Universität zu Köln, Deutschland
| | - Stephan Bender
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Uniklinik Köln, Medizinische Fakultät der Universität zu Köln, Deutschland
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Zhang CS, Cheng L, Chen X, Wang Y, Wei S, Sun J. The strategies of exercise intervention for adolescent depression: A meta-analysis of randomized controlled trials. Front Psychol 2023; 13:974382. [PMID: 36687827 PMCID: PMC9846179 DOI: 10.3389/fpsyg.2022.974382] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/25/2022] [Indexed: 01/06/2023] Open
Abstract
Purpose This study aimed to investigate the effect of exercise intervention, and analyze exercise intervention strategies for adolescent depression through a meta-analysis of RCTs. Methods Accordance to PRISMA guidelines, PubMed, Medline, EBSCO, Web of Science, SPORTDiscus, PsycINFO, ProQuest, and CNKI were searched for eligible records. Peer-reviewed studies were included if they met the following criteria: population (mean age of 10-18 years), intervention (physical activity, sport, or exercise), and outcomes (depression, adherence, ITT, dropout, adverse events, follow-up report). The protocol of this systematic review was registered in PROSPERO (CRD42022321683). Effect sizes calculations and methodological quality of exercise intervention (TESTEX scale) were carried out. The certainty of evidence was assessed by GRADE framework. Results Thirteen randomized controlled trials were eligible for this review, which comprised a total of 433 adolescents. Compared with the control treatment, the effect of exercise on adolescent depression was moderate (SMD = -0.65, 95%CI: -1.03 to -0.27, p < 0.01). Heterogeneity was substantial (T 2 = 0.30, I 2 = 67%, p < 0.01). The moderating effect analysis showed that exercise intervention characteristics (organization form, exercise frequency, exercise intensity, exercise type, and single exercise session duration) of included studies varied greatly revealing multiple factors that may impact the antidepressant effect of exercise on adolescent depression (I 2 > 50%, p < 0.05). Three studies show that the positive effect of exercise on reducing depression in adolescents remained 40 weeks after the intervention. Moreover, owing to the included studies contained methodological limitations, the certainty of evidence was reduced to moderate level. Conclusion This study shows that exercise intervention has a moderate and sustained positive effect on adolescent depression. Our results recommended that adolescents with depression undertake moderate to high intensity group mixed exercise for more than 12 weeks, 20 to 60 min/time, more than 3 times/week. Additionally, our study also shows that the antidepressant effects remained for a long time after the end of exercise interventions. However, following the GRADE framework, we rated the certainty of evidence the primary meta-analysis as moderate evidence due to some limitations of included studies. Therefore, rigorous studies are still needed to verify the results. Systematic review registration [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=321683], identifier [CRD42022321683].
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Affiliation(s)
- Chang Sheng Zhang
- School of Physical Education, Chengdu Sport University, Chengdu, China
| | - Liang Cheng
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Xiaoan Chen
- School of Sports Science, Jishou University, Jishou, Hunan, China
| | - Yi Wang
- School of Sports Science, Jishou University, Jishou, Hunan, China
| | - Shuguang Wei
- Department of Psychology, College of Education, Hebei Normal University, Hebei, China
| | - Jinxiu Sun
- School of Sports Science, Jishou University, Jishou, Hunan, China
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Bonanni R, Cariati I, Romagnoli C, D’Arcangelo G, Annino G, Tancredi V. Whole Body Vibration: A Valid Alternative Strategy to Exercise? J Funct Morphol Kinesiol 2022; 7:jfmk7040099. [PMID: 36412761 PMCID: PMC9680512 DOI: 10.3390/jfmk7040099] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Several studies agree that mechanical vibration can induce physiological changes at different levels, improving neuromuscular function through postural control strategies, muscle tuning mechanisms and tonic vibration reflexes. Whole-body vibration has also been reported to increase bone mineral density and muscle mass and strength, as well as to relieve pain and modulate proprioceptive function in patients with osteoarthritis or lower back pain. Furthermore, vibratory training was found to be an effective strategy for improving the physical performance of healthy athletes in terms of muscle strength, agility, flexibility, and vertical jump height. Notably, several benefits have also been observed at the brain level, proving to be an important factor in protecting and/or preventing the development of age-related cognitive disorders. Although research in this field is still debated, certain molecular mechanisms responsible for the response to whole-body vibration also appear to be involved in physiological adaptations to exercise, suggesting the possibility of using it as an alternative or reinforcing strategy to canonical training. Understanding these mechanisms is crucial for the development of whole body vibration protocols appropriately designed based on individual needs to optimize these effects. Therefore, we performed a narrative review of the literature, consulting the bibliographic databases MEDLINE and Google Scholar, to i) summarize the most recent scientific evidence on the effects of whole-body vibration and the molecular mechanisms proposed so far to provide a useful state of the art and ii) assess the potential of whole-body vibration as a form of passive training in place of or in association with exercise.
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Affiliation(s)
- Roberto Bonanni
- Department of Clinical Sciences and Translational Medicine, “Tor Vergata” University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Ida Cariati
- Department of Clinical Sciences and Translational Medicine, “Tor Vergata” University of Rome, Via Montpellier 1, 00133 Rome, Italy
- Correspondence:
| | - Cristian Romagnoli
- Sport Engineering Lab, Department of Industrial Engineering, “Tor Vergata” University of Rome, Via Politecnico 1, 00133 Rome, Italy
| | - Giovanna D’Arcangelo
- Department of Systems Medicine, “Tor Vergata” University of Rome, Via Montpellier 1, 00133 Rome, Italy
- Centre of Space Bio-Medicine, “Tor Vergata” University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Giuseppe Annino
- Department of Systems Medicine, “Tor Vergata” University of Rome, Via Montpellier 1, 00133 Rome, Italy
- Centre of Space Bio-Medicine, “Tor Vergata” University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Virginia Tancredi
- Department of Systems Medicine, “Tor Vergata” University of Rome, Via Montpellier 1, 00133 Rome, Italy
- Centre of Space Bio-Medicine, “Tor Vergata” University of Rome, Via Montpellier 1, 00133 Rome, Italy
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Changes in the TMS-evoked potential N100 in the dorsolateral prefrontal cortex as a function of depression severity in adolescents. J Neural Transm (Vienna) 2022; 129:1339-1352. [PMID: 36029418 PMCID: PMC9550695 DOI: 10.1007/s00702-022-02539-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/12/2022] [Indexed: 12/03/2022]
Abstract
Studies using transcranial magnetic stimulation with simultaneous electroencephalography (TMS-EEG) revealed an imbalance between cortical excitation and inhibition (E/I) in the dorsolateral prefrontal cortex (DLPFC) in depression. As adolescence is a developmental period with an increase in depression prevalence and profound neural changes, it is crucial to study the relationship between depression and cortical excitability in adolescence. We aimed to investigate the cortical excitability of the DLPFC in adolescents with depression and a dependency of the TMS-evoked potential N100 on the depression severity. 36 clinical patients (12–18 years of age; 21 females) with a major depressive episode were assessed twice in a longitudinal design: shortly after admission (T0) and after six weeks of intervention (T1). GABA-B-mediated cortical inhibition in the left and right DLPFC, as assessed by the N100, was recorded with EEG. Significantly higher depression scores were reported at T0 compared to T1 (p < 0.001). N100 amplitudes were significantly increased (i.e., more negative) at T0 compared to T1 (p = 0.03). No significant hemispheric difference was found in the N100 component. The correlation between the difference in depression severity and the difference in N100 amplitudes (T0–T1) obtained during stimulation of the left DLPFC did not remain significant after correction for testing in both hemispheres. Higher N100 amplitudes during a state of greater depression severity are suggestive of an E/I imbalance in the DLPFC in adolescents with an acute depressive episode. The N100 reduction potentially reflects a normalization of DLPFC over inhibition in association with decreased depressive symptomatology, indicating severity dependency.
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Lee B, Shin E, Song I, Chang B. Depression in Adolescence and Brain-Derived Neurotrophic Factor. Front Mol Neurosci 2022; 15:947192. [PMID: 35875661 PMCID: PMC9302599 DOI: 10.3389/fnmol.2022.947192] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/20/2022] [Indexed: 12/27/2022] Open
Abstract
The incidence of depression among adolescents has been rapidly increasing in recent years. Environmental and genetic factors have been identified as important risk factors for adolescent depression. However, the mechanisms underlying the development of adolescent depression that are triggered by these risk factors are not well understood. Clinical and preclinical studies have focused more on adult depression, and differences in depressive symptoms between adolescents and adults make it difficult to adequately diagnose and treat adolescent depression. Brain-derived neurotrophic factor (BDNF) is known to play a critical role in the pathophysiology of many psychiatric disorders, including depression. However, there are still few studies on adolescent depression. Therefore, in this review paper, the causes and treatment of adolescent depression and the function of BDNF are investigated.
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Wang X, Cai ZD, Jiang WT, Fang YY, Sun WX, Wang X. Systematic review and meta-analysis of the effects of exercise on depression in adolescents. Child Adolesc Psychiatry Ment Health 2022; 16:16. [PMID: 35227300 PMCID: PMC8886903 DOI: 10.1186/s13034-022-00453-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 02/18/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Depression is widespread among adolescents and seriously endangers their quality of life and academic performance. Developing strategies for adolescent depression has important public health implications. No systematic review on the effectiveness of physical exercise for adolescents aged 12-18 years with depression or depressive symptoms has previously been conducted. This study aims to systematically evaluate the effect of physical exercise on adolescent depression in the hope of developing optimum physical exercise programs. METHODS Nine major databases at home and abroad were searched to retrieve randomized controlled trials (RCTs) on exercise interventions among adolescents with depression or depressive symptoms. The retrieval period started from the founding date of each database to May 1, 2021. The methodological quality of the included articles was evaluated using the modified PEDro scale. A meta-analysis, subgroup analysis, sensitivity analysis, and publication bias tests were then conducted. RESULTS Fifteen articles, involving 19 comparisons, with a sample size of 1331, were included. Physical exercise significantly reduced adolescent depression (standardized mean difference [SMD] = - 0.64, 95% CI - 0.89, - 0.39, p < 0.01), with a moderate effect size, in both adolescents with depression (SMD = -0.57, 95% CI - 0.90, - 0.23, p < 0.01) and adolescents with depressive symptoms (SMD = - 0.67, 95% CI - 1.00, - 0.33, p < 0.01). In subgroups of different depression categories (depression or depressive symptoms), aerobic exercise was the main form of exercise for the treatment of adolescents with depression. For adolescents with depression, interventions lasting 6 weeks, 30 min/time, and 4 times/week had optimum results. The effects of aerobic exercise and resistance + aerobic exercise in the subgroup of adolescents with depressive symptoms were significant, while the effect of physical and mental exercise (yoga) was not significant. For adolescents with depressive symptoms, aerobic exercise lasting 8 weeks, 75-120 min/time, and 3 times/week had optimum results. Physical exercise with moderate intensity is a better choice for adolescents with depression and depressive symptoms. CONCLUSIONS Physical exercise has a positive effect on the improvement of depression in adolescents. The protocol for this study was registered with INPLASY (202170013). DOI number is 10.37766/inplasy2021.7.0013. Registration Date:2021.7.06.
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Affiliation(s)
- Xiang Wang
- grid.412543.50000 0001 0033 4148School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Zhi-dong Cai
- grid.412543.50000 0001 0033 4148School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Wan-ting Jiang
- grid.412543.50000 0001 0033 4148School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Yan-yan Fang
- grid.412543.50000 0001 0033 4148School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Wen-xin Sun
- grid.412543.50000 0001 0033 4148School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Xing Wang
- School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438, China.
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ElDeeb AM, Atta HK, Osman DA. Effect of whole body vibration versus resistive exercise on premenstrual symptoms in adolescents with premenstrual syndrome. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2020. [DOI: 10.1186/s43161-020-00002-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Premenstrual syndrome (PMS) is a cyclic disorder that affects social activities, interpersonal relationship, and educational productivity of adolescents. Therefore, this study aimed to compare the effect of whole body vibration (WBV) and resistive exercise on premenstrual symptoms in adolescents with PMS.
Methods
Sixty adolescents, aged 16–19 years and with body mass index > 19.9 kg/m2, participated in the study. They were randomly assigned to three groups equal in number. Control group received magnesium (Mg) (250 g) and vitamin B6 supplementation once daily. Resistive exercise group received the same supplementations and resistive exercise for three times/week, while the WBV group received the same supplementations and WBV training three times/week for 12 weeks. Premenstrual syndrome questionnaire (PMSQ) was used to evaluate premenstrual symptoms, including anxiety symptoms (PMS-A), depression symptoms (PMS-D), craving symptoms (PMS-C), hyperhydration symptoms (PMS-H), other symptoms, cramp, and low back pain.
Results
Pair-wise comparison test revealed a significant decrease (p = 0.000) in PMS-A, PMS-C, PMS-D, PMS-H, other symptoms, cramp, and low back pain of the resistive exercise group and WBV group after treatment. However, there was only a significant decrease in PMS-C (p = 0.03) of the control group after treatment. Post hoc test showed no significant difference (p > 0.05) between the resistive group and WBV group in all PMS symptoms after treatment.
Conclusions
Passive muscular training using WBV has a similar effect to resistive exercise on premenstrual symptoms that affect the quality of life in adolescents with PMS.
Trial registration
PACTR, PACTR201908589835132. Registered 26 June 2019—retrospectively registered.
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Heinze K, Cumming J, Dosanjh A, Palin S, Poulton S, Bagshaw AP, Broome MR. Neurobiological evidence of longer-term physical activity interventions on mental health outcomes and cognition in young people: A systematic review of randomised controlled trials. Neurosci Biobehav Rev 2020; 120:431-441. [PMID: 33172601 DOI: 10.1016/j.neubiorev.2020.10.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 10/11/2020] [Accepted: 10/17/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To investigate putative neurobiological mechanisms that link longer-term physical activity interventions to mental health and cognitive outcomes using randomised controlled trials in children, adolescents and young adults. DATA SOURCES A range of medical and psychological science electronic databases were searched (MEDLINE, EMBASE, Scopus, Web of Science, PsychINFO). REVIEW METHODS Original research studies were selected, data were extracted and quality was appraised. RESULTS Sixteen primary papers were included, ranging from healthy and community samples to subclinical and clinical populations across a variety of age ranges and using different neurobiological measures (e.g. magnetic resonance imaging, electroencephalography, cortisol, brain-derived neurotropic factor). DISCUSSION The majority of studies report improvement in mental health and cognition outcomes following longer-term physical activity interventions which coincide with neurobiological alterations, especially neuroimaging alterations in activation and electrophysiological parameters in frontal areas. Future research should include measures of pre-existing fitness and target those who would benefit the most from this type of intervention (e.g. those with a lower level of fitness and at risk for or with mental health problems).
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Affiliation(s)
- Kareen Heinze
- School of Psychology, University of Birmingham, Edgbaston, UK; Institute for Mental Health, University of Birmingham, Edgbaston, UK; Centre for Human Brain Health, University of Birmingham, Edgbaston, UK.
| | - Jennifer Cumming
- Institute for Mental Health, University of Birmingham, Edgbaston, UK; School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, UK.
| | - Amrita Dosanjh
- School of Psychology, University of Birmingham, Edgbaston, UK.
| | - Sophia Palin
- School of Psychology, University of Birmingham, Edgbaston, UK.
| | - Shannen Poulton
- School of Psychology, University of Birmingham, Edgbaston, UK.
| | - Andrew P Bagshaw
- School of Psychology, University of Birmingham, Edgbaston, UK; Centre for Human Brain Health, University of Birmingham, Edgbaston, UK.
| | - Matthew R Broome
- School of Psychology, University of Birmingham, Edgbaston, UK; Institute for Mental Health, University of Birmingham, Edgbaston, UK; Centre for Human Brain Health, University of Birmingham, Edgbaston, UK.
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Oberste M, Medele M, Javelle F, Lioba Wunram H, Walter D, Bloch W, Bender S, Fricke O, Joisten N, Walzik D, Großheinrich N, Zimmer P. Physical Activity for the Treatment of Adolescent Depression: A Systematic Review and Meta-Analysis. Front Physiol 2020; 11:185. [PMID: 32265725 PMCID: PMC7096373 DOI: 10.3389/fphys.2020.00185] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 02/17/2020] [Indexed: 12/31/2022] Open
Abstract
Background: A noticeable proportion of adolescents with depression do not respond to guideline recommended treatment options. This systematic review and meta-analysis investigated the effectiveness of physical activity interventions as an alternative or complementary treatment for adolescents (12-18 years) with depression. The characteristics of the physical activity treatment that were most effective in reducing symptoms in adolescents with depression and the impact of methodological shortcomings in the existing research were also examined. Methods: Medline, PsycINFO, SPORTDiscus, ProQuest, and CENTRAL were searched for eligible records. Effect size estimates were pooled based on the application of a random-effects model. Potential moderation by physical activity characteristics (i.e., intensity, type, context, and time frame) and methodological features (i.e., type of control group and diagnostic tool to identify depression at baseline) was investigated by means of subgroup analyses and meta-regressions. The certainty of evidence was assessed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. The primary outcome was the antidepressant effect of physical activity at postintervention measurement time point. As secondary outcomes, the sustainability of effects after the end of physical activity treatment and the acceptability of physical activity treatments were assessed. Overall, 10 studies were included in the qualitative synthesis and 9 studies involving 431 patients were included in the quantitative synthesis. Results: A moderate, significant antidepressant effect of physical activity was found (Hedges' g = -0.47, 95% CI = -0.71 to -0.24). Heterogeneity was small (T2 = 0.0313, I 2 = 27%, p = 0.18). However, the certainty of evidence was downgraded to low because the included studies contained serious methodological limitations. Moderator analyses revealed that session intensity significantly moderated the antidepressant effect of physical activity. Moreover, noticeably smaller effect sizes were found in studies that used non-physical activity sham treatments as control treatments (e.g., playing board games), compared to studies that used no control group treatments. Only three studies assessed the sustainability of effects after the end of physical activity treatment. The results suggest that the antidepressant effects further increase after the end of physical activity interventions. There was no significant difference in dropout risk between the physical activity and control groups. Conclusions: This review suggests that physical activity is effective in treating depression in adolescents. Physical activity sessions should be at least moderately intense [rate of perceived exertion (RPE) between 11 and 13] to be effective. Furthermore, our results suggest that physical activity treatments are well accepted. However, the low methodological quality in included studies might have led to effect overestimation. Therefore, more studies with higher methodological quality are needed to confirm the recommendation for physical activity treatments in adolescents with depression.
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Affiliation(s)
- Max Oberste
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Marie Medele
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
| | - Florian Javelle
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Heidrun Lioba Wunram
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
- Children's Hospital, Medical Faculty, University of Cologne, Cologne, Germany
| | - Daniel Walter
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP) at the University Hospital Cologne, Cologne, Germany
| | - Wilhelm Bloch
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
| | - Oliver Fricke
- Chair of Child and Adolescent Psychiatry, Witten/Herdecke University, Department of Child and Adolescent Psychiatry, Psychotherapy and Child Neurology, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany
| | - Niklas Joisten
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - David Walzik
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Nicola Großheinrich
- Department of Social Sciences, Catholic University of Applied Science of North Rhine – Westphalia, Cologne, Germany
| | - Philipp Zimmer
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
- Department of “Performance and Health (Sports Medicine)”, Institute of Sport and Sport Science, Technical University Dortmund, Dortmund, Germany
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