The effects of physical exercise on depressive symptoms among the aged: a systematic review

Sjösten, Noora; Kivelä, Sirkka‐Liisa

doi:10.1002/gps.1494

Cited by 203 publications

(141 citation statements)

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“…149 Risk factors are felt to be similar to those in able-bodied persons, as well as the extent of the neurological impairment and the presence of medical comorbidities. 150 It has been well documented that there may be an inverse association between physical inactivity and mental health in both men and women 151 and that physical exercise has significant antidepressive effect [152][153][154][155] and may even improve cognitive function. It is known that SCI disturbs the hypothalamic-pituitary-adrenal axis, 156,157 which affects production of various hormones, including neuroendocrine stress hormones, for example, cortisol, growth hormone, endorphins and norepinephrine.…”

Section: Depressionmentioning

confidence: 99%

Functional electrical stimulation after spinal cord injury: current use, therapeutic effects and future directions

2007

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Repair of the injured spinal cord by regeneration therapy remains an elusive goal. In contrast, progress in medical care and rehabilitation has resulted in improved health and function of persons with spinal cord injury (SCI). In the absence of a cure, raising the level of achievable function in mobility and selfcare will first and foremost depend on creative use of the rapidly advancing technology that has been so widely applied in our society. Building on achievements in microelectronics, microprocessing and neuroscience, rehabilitation medicine scientists have succeeded in developing functional electrical stimulation (FES) systems that enable certain individuals with SCI to use their paralyzed hands, arms, trunk, legs and diaphragm for functional purposes and gain a degree of control over bladder and bowel evacuation. This review presents an overview of the progress made, describes the current challenges and suggests ways to improve further FES systems and make these more widely available.

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Section: Depressionmentioning

confidence: 99%

Functional electrical stimulation after spinal cord injury: current use, therapeutic effects and future directions

2007

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“…11 In a meta-analysis, Sjösten and Kivelä 12 reported that physical exercise was effective in treating depression, and especially in individuals with high baseline levels of depression. A meta-analysis of 90 studies involving patients with a chronic illness found that exercise had a small effect on reducing depressive symptoms, but stroke patients were not included.…”

Section: Introductionmentioning

confidence: 99%

Exercise for depressive symptoms in stroke patients: a systematic review and meta-analysis

Eng

Reime

2014

Clin Rehabil

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Objective-The objective was to conduct a systematic review and meta-analysis of studies that examined the effects of structured exercise on depressive symptoms in stroke patients.Methods-We searched for published randomized controlled trials which evaluated the effect of structured exercise programs (e.g., functional, resistance or aerobic training) on depressive symptoms. The mean effect size, a 95% confidence interval (CI) and I-squared (I 2 ) for heterogeneity were estimated. Sensitivity analyses were conducted.Results-Thirteen studies (n=1022) were included in the meta-analysis. Exercise resulted in less depressive symptoms immediately after the exercise program ended, SMD=−0.13 [95%CI = −0.26, −0.01], I 2 =6%, p=0.03, but these effects were not retained with longer term follow-up. Exercise appeared to have a positive effect on depressive symptoms across both the subacute (≤ 6 months post-stroke) and chronic stage of recovery (> 6 months). There was a significant effect of exercise on depressive symptoms when higher intensity studies were pooled, but not for lower intensity exercise protocols. Antidepressant medication use was not documented in the majority of studies and thus, its potential confounding interaction with exercise could not be assessed.Conclusions-Exercise may be a potential treatment to prevent or reduce depressive symptoms in individuals with sub-acute and chronic stroke.

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“…Several systematic reviews (Mead et al, 2009;Mead, Morley, Greig, McMurdo, & Lawlor, 2008; Lawlor & Hopker, 2001;Sjosten & Kivela, 2006) and a review of reviews (Daley, 2008) have concluded that exercise appeared to improve symptoms of depression, but that the methodological quality of available trials was often too poor to reach a robust conclusion. A further meta-analysis by Stathopoulou (Stathopoulou, Powers, Berry, Smits, & Otto, 2006, p. 188) concluded that "exercise can be a powerful intervention for clinical 3 depression", and another systematic review of the effect of exercise in clinically depressed adults by Krogh and colleagues found that there was a short-term positive effect of exercise on depression but no positive long-term effect (Krogh, Nordentoft, Sterne, & Lawlor, 2011).…”

Section: Introductionmentioning

confidence: 99%

Walking for depression or depressive symptoms: A systematic review and meta-analysis

Robertson

Jepson

et al. 2012

Mental Health and Physical Activity

201

121

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Problem: Depression is a common disorder worldwide. Most patients are treated within primary care and antidepressant treatment is not recommended for people with mild depression. Physical activity has been shown to alleviate depression but it is not known whether the less vigorous activity of walking -a potentially widely acceptable and safe intervention -confers such benefit.Method: Eleven databases were systematically searched for randomised controlled trials of walking as a treatment intervention for depression, from database inception until January 2012.Meta-analyses were carried out on all trials eligible for inclusion and on sub-groups of outdoor, indoor and group walking.Results: Of the 14,672 articles retrieved, eight trials met the inclusion criteria. The pooled standardised mean difference (effect size) was -0.86 [-1.12, -0.61] showing that walking has a statistically significant, large effect on symptoms of depression. However, there was considerable heterogeneity amongst the interventions and research populations and it is uncertain whether the results can be generalised to specific populations such as primary care patients.Conclusions: Walking has a statistically significant, large effect on the symptoms of depression in some populations, but the current evidence base from randomised, controlled trials is limited.Thus, while walking is a promising treatment for depression or depressive symptoms with few, if any, contraindications, further investigations to establish the frequency, intensity, duration and type(s) of effective walking interventions particularly in primary care populations would be beneficial for providing further recommendations to clinical practitioners.Keywords: depression, physical activity, walking, systematic review, meta-analysis 2 IntroductionDepression is an illness or mood disorder with a variety of symptoms, the most defining being an inexplicable, enduring feeling of sadness (loss of positive affect). It is categorised as mild, moderate or severe depending upon the number and severity of the symptoms (WHO, 2010). It is a common mental health problem, estimated in 2000 to be the fourth leading cause of disease burden worldwide (WHO, 2003;Ustun, Ayuso-Mateos, Chatterji, Mathers, & Murray, 2004). It causes a level of morbidity comparable to or worse than other common chronic diseases such as asthma and diabetes (Moussavi et al., 2007). In the UK over 75% of patients with depression are treated solely within primary care (NICE, 2010) where prevalence is estimated at 7% (Ostler et al., 2001).Depression is commonly treated with anti-depressant medications, psychological therapies or a combination of both. The efficacy of anti-depressants for mild depression has been questioned (Moncrieff & Kirsch, 2005) and they are not recommended to be used routinely by people with persistent sub-threshold depressive symptoms or mild depression in the first instance (NICE, 2010). There is also a range of side effects (Demyttenaere, 2003), many people do not like taking medicines (Ma...

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The effects of physical exercise on depressive symptoms among the aged: a systematic review

Abstract: Physical exercise may be efficient in reducing clinical depression and depressive symptoms in the short-term among the aged suffering from depression or a high amount of depressive symptoms. More well controlled studies are needed.

Cited by 203 publications

References 38 publications

Functional electrical stimulation after spinal cord injury: current use, therapeutic effects and future directions

Functional electrical stimulation after spinal cord injury: current use, therapeutic effects and future directions

Exercise for depressive symptoms in stroke patients: a systematic review and meta-analysis

Walking for depression or depressive symptoms: A systematic review and meta-analysis

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