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Evidence on exercise prescription for additional Depression treatment: A meta-analysis of randomized controlled trials

Lara S F Carneiro

Objectives: The present study aimed to clarify (1) the effect of ET as a monotherapy or complementary treatment of pharmacological therapy; and (2) changes in the dose-response for different exercise prescription characteristics. 
Methods: We sought Randomized Controlled Trials (RCT) published in peer-reviewed journals between 2003-2019 in Scopus, Cochrane, Pubmed/Medline, ISI Web of Knowledge and APA PsycNET databases. We found 1,165 articles and selected 15 studies to this meta-analysis. RCTs with different ET and PT prescriptions were examined using the delta (pre and post-intervention) of a validated depression scale compared to the control group in different treatment conditions. 
Results: Standardized mean differences and confidence intervals (SMD, 95% CI) were found for ET with or without PT group (-0.45, -0.62 to -0.29), ET and PT group (-0.70, -1.00 to -0.40), and only ET group (- 0.39, -0.57to -0.21). The subgroup analyses showed a moderate and large SMD in favour of resistance training (-0.67, -1.22to -0.12), aerobic exercise 60-80% of maximum heart rate intensity (-0.56, -0.89 to - 0.23), 20 to 30 minutes (-0.59,-0.88 to -0.31) or 45 to 60 minutes (-0.55, -0.81 to -0.29) duration per session, and seven times per week (-0.75,-1.30 to -0.20).
Conclusions: ET plus PT showed a better effect on reducing depressive symptoms, and the exercise prescription that shows the best dose-response in subgroup analyses can be the target for ET in depression.