The acute effects of aerobic exercise on sleep in patients with depression: study protocol for a randomized controlled trial

Changes of Serum C-Reactive Protein Level in Patients With Depressive Disorders After Treatment With Agomelatine Combined With Aerobic Exercise and Its Significance

OBJECTIVE

Depressive disorders constitute a series of debilitating diseases. This study investigated the therapeutic effect of agomelatine (AG) combined with aerobic exercise (AE) on patients with moderate-severe depression (MSD) and the changes of the serum C-reactive protein (CRP) level in patients after treatment as well as its significance.

METHODS

A total of 178 MSD patients were randomly assigned to the AG group (N = 90) and AG + AE group (N = 88). The severity of depressive disorders and anhedonia was assessed using the Hamilton Rating Scale for Depression (HAM-D), Beck Depression Inventory, and Snaith-Hamilton Pleasure Scale scores. The serum CRP level in MSD patients was detected by turbidity assay. Patients were defined as remitters, responders, and nonresponders according to the HAM-D 17 score, and the treatment efficacy was analyzed, followed by evaluation of the serum CRP level in patients with different treatment responses. Finally, the adverse reactions of patients during treatment were statistically analyzed.

RESULTS

After treatment, the HAM-D, Beck Depression Inventory, and Snaith-Hamilton Pleasure Scale scores and the serum CRP level of the 2 groups were reduced, and changes in the AG + AE group was more significant than that in the AG group. The clinical efficacy of the AG + AE group was better than that of the AG group. After treatment, the serum levels of CRP in remitters and responders were reduced, but not significantly in nonresponders. The incidence of adverse events in the AG + AE group was lower than that in the AG group.

CONCLUSION

AG + AE reduced the serum level of CRP in MSD patients and had good therapeutic effects on MSD patients.

Curative effect of pop light music on depression patients based on improved fuzzy algorithm

With the aggravation of many social psychological and psychological stress factors, the high incidence rate of depression and depression has become a major problem which puzzles people’s health and even endangers life. Non drug therapy has become an effective alternative to drug therapy, which is in line with the new trend of natural medicine in the world. This paper will use the real world research method (RWS) to conduct a clinical trial of pop light music in the treatment of depression. Based on the fuzzy algorithm, a comprehensive evaluation system for the treatment of depression was established. By comparing and analyzing the main efficacy indexes between music group and traditional medicine group, we found that the cure rate, clinical control rate, significant efficiency, effective rate and ineffective rate of music therapy group were significantly better than those of drug group. Through the analysis of seven factors of HAMD (Hamilton Depression Scale) scale, we found that pop light music can improve the sleep status and physical symptoms of patients, and the improvement degree of music therapy is significantly better than that of drug therapy.

Study on Adjuvant Medication for Patients with Mild Cognitive Impairment Based on VR Technology and Health Education

In order to improve the efficiency of auxiliary medication for patients with mild cognitive impairment, this paper proposes a method based on VR technology and health education. Sixty elderly patients with COPD and MCI admitted to a hospital from January 2019 to February 2020 were randomly divided into a control group and study group, with 50 cases in each group. On the basis of conventional drug therapy, health education, and respiratory muscle training, patients in the control group received routine lung rehabilitation training, while patients in the study group received lung rehabilitation training using the BioMaster virtual scene interactive rehabilitation training system. Both groups continued training for 12 weeks. Lung function indexes, 6-minute walking distance, COPD assessment test (CAT) score, and Montreal Cognitive Function Assessment Scale (MoCA) score were compared between the 2 groups before training and 4, 8, and 12 weeks after training. The experimental results show that, in the study group, the percentage of FEV₁ in the predicted value at 8 weeks after training, the percentage of FEV₁ in the predicted value at 12 weeks after training, and FEV₁/FVC were higher than those in the control group (P < 0.05). There was no significant difference in 6-minute walking distance, CAT score, and MoCA score between the two groups before training (P > 0.05). Twelve weeks after training, patients in the study group had a longer 6-minute walking distance, a lower CAT score, and a higher MoCA score than those in the control group (P < 0.05). It is proved that the application of virtual reality technology in lung rehabilitation training of elderly COPD patients with MCI is effective, which can effectively improve the lung function, cognitive function, and exercise tolerance of the patients and reduce the symptoms of dyspnea and the efficiency of medication.

The acute effects of aerobic exercise on sleep in patients with unipolar depression: a randomized controlled trial

STUDY OBJECTIVES

Insomnia increases the risk of negative disease trajectory, relapse, and suicide in patients with depression. We aimed at investigating the effects of a single bout of aerobic exercise, performed after 02:00 pm, on the subsequent night's sleep in patients with depression.

METHODS

The study was designed as a two-arm parallel-group, randomized, outcome assessor-blinded, controlled, superiority trial. Patients between 18 and 65 years of age with a primary diagnosis of unipolar depression were included. The intervention was a single 30-minute bout of moderate aerobic exercise. The control group sat and read for 30 minutes. The primary outcome was sleep efficiency measured by polysomnography. Secondary outcomes were other polysomnographic variables, subjective sleep quality, daytime sleepiness, mood states, and adverse events.

RESULTS

Ninety-two patients were randomized to the exercise (N = 46) or control group (N = 46). There were no clinically relevant differences at baseline. Intent-to-treat analysis ANCOVA of follow-up sleep efficiency, adjusted for baseline levels and minimization factors, did not detect a significant effect of the allocation (β = -0.93, p = 0.59). There was no evidence for significant differences between both groups in any other objective or subjective sleep outcomes, daytime sleepiness, or adverse events. The intervention had an immediate positive effect on mood states, including depressiveness (β = -0.40, p = 0.003).

CONCLUSIONS

This is the first trial to study the effects of a single bout of aerobic exercise on sleep in patients with depression to the best of our knowledge. Aerobic exercise had no effect on sleep efficiency but had a strong beneficial effect on mood and did not increase adverse outcomes. These results add to the growing body of evidence that, contrary to sleep hygiene recommendations, exercise after 02:00 pm is not detrimental for sleep.

CLINICAL TRIAL REGISTRATION

Clinicaltrials.gov, https://clinicaltrials.gov/ct2/show/NCT03673397. Protocol registered on September 17, 2018.

The Acute Effects of Aerobic Exercise on Nocturnal and Pre-Sleep Arousal in Patients with Unipolar Depression: Preplanned Secondary Analysis of a Randomized Controlled Trial

Unipolar depression is associated with insomnia and autonomic arousal. The aim of this study was to quantify the effect of a single bout of aerobic exercise on nocturnal heart rate variability and pre-sleep arousal in patients with depression. This study was designed as a two-arm, parallel-group, randomized, outcome assessor-blinded, controlled, superiority trial. Patients with a primary diagnosis of unipolar depression aged 18-65 years were included. The intervention consisted of a single 30 min moderate-intensity aerobic exercise bout. The control group sat and read for 30 min. The primary outcome of interest was RMSSD during the sleep period assessed with polysomnography. Secondary outcomes were additional heart rate variability outcomes during the sleep and pre-sleep period as well as subjective pre-sleep arousal. A total of 92 patients were randomized to either the exercise (N = 46) or the control (N = 46) group. Intent-to-treat analysis ANCOVA of follow-up sleep period RMSSD, adjusted for baseline levels and minimization factors, did not detect a significant effect of the allocation (β = 0.12, p = 0.94). There was no evidence for significant differences between both groups in any other heart rate variability measure nor in measures of cognitive or somatic pre-sleep arousal. As this is the first trial of its kind in this population, the findings need to be confirmed in further studies. Patients with depression should be encouraged to exercise regularly in order to profit from the known benefits on sleep and depressive symptoms, which are supported by extensive literature.

Validity of the Polar H7 Heart Rate Sensor for Heart Rate Variability Analysis during Exercise in Different Age, Body Composition and Fitness Level Groups

This work aims to validate the Polar H7 heart rate (HR) sensor for heart rate variability (HRV) analysis at rest and during various exercise intensities in a cohort of male volunteers with different age, body composition and fitness level. Cluster analysis was carried out to evaluate how these phenotypic characteristics influenced HR and HRV measurements. For this purpose, sixty-seven volunteers performed a test consisting of the following consecutive segments: sitting rest, three submaximal exercise intensities in cycle-ergometer and sitting recovery. The agreement between HRV indices derived from Polar H7 and a simultaneous electrocardiogram (ECG) was assessed using concordance correlation coefficient (CCC). The percentage of subjects not reaching excellent agreement (CCC > 0.90) was higher for high-frequency power (PHF) than for low-frequency power (PLF) of HRV and increased with exercise intensity. A cluster of unfit and not young volunteers with high trunk fat percentage showed the highest error in HRV indices. This study indicates that Polar H7 and ECG were interchangeable at rest. During exercise, HR and PLF showed excellent agreement between devices. However, during the highest exercise intensity, CCC for PHF was lower than 0.90 in as many as 60% of the volunteers. During recovery, HR but not HRV measurements were accurate. As a conclusion, phenotypic differences between subjects can represent one of the causes for disagreement between HR sensors and ECG devices, which should be considered specifically when using Polar H7 and, generally, in the validation of any HR sensor for HRV analysis.