Web-based exercise interventions for patients with depressive and anxiety disorders: a systematic review of randomized controlled trials

Abstract

Objective: The number of people suffering from depression and/or anxiety has increased steadily due to the coronavirus disease 2019 (COVID-19) pandemic. In this context, web-based exercise interventions have emerged as a potential treatment strategy. The objective of this study was to synthetize evidence from randomized controlled trials regarding the effects of web-based exercise interventions on patients with depressive and/or anxiety disorders. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Six databases were searched (Cochrane Library, EBSCO, PubMed, SciELO, Scopus, and Web of Science), and eligible articles were identified according to a PICOS inclusion-exclusion approach (participants with depressive or anxiety disorders; web-based exercise interventions; active or passive control group; assessment of changes in depressive or anxiety disorders; randomized design). Primary outcomes were depressive and/or anxiety symptoms. The quality of evidence was assessed with Grading of Recommendations Assessment, Development, and Evaluation. Results: Of 7,846 search results, three studies met the inclusion criteria (172 participants between 18 and 65 years of age, 95.9% women). The web-based exercise interventions lasted 8-12 weeks and involved endurance training, yoga, or combined endurance and strength training. The comparators involved non-exercise controls or active controls. Compliance rates were low. Web-based exercise interventions were not superior to controls regarding anxiety symptoms, and only one study found benefits for depressive symptoms (p p 0.05). The quality of the cumulative evidence was low. Conclusion:The available data regarding the effects of web-based exercise interventions on depression and/or anxiety symptoms is scarce, the risk of bias is high, and the quality of the cumulative results is low. Currently, no clear recommendations can be provided. Registration number: PROSPERO CRD42021225938.

Web-based exercise therapy for the treatment of depression

“…This is in line with MDD exercise guidelines that recommend exercising within a range of 50 to 85% of maximum HR [17]. Alternative training options could be provided via an application when the regular training is difficult to perform for patients [15].…”

“…To date, few studies have addressed the reduction of depressive symptoms through web-based exercise. In a recent review, only three studies were included [15]. Two studies could not demonstrate an improvement of depressive symptoms compared to the control condition [19, 27], while one study demonstrated a favorable effect of web-based yoga [28].…”

“…Therefore, further randomized-controlled trials are needed. In addition, the effects of different exercise mode (e.g., resistance training, endurance training, relaxation) need to be investigated in future studies [15, 41].…”

“…This commentary addresses web-based exercise, defined as exercise interventions delivered via email, mobile app or website [15] as a promising therapeutic approach for the treatment of depressive symptoms. I summarize the current research in this area and offer an innovative perspective from the field of sports science on how exercise can be managed in this patient collective.…”

Effects of Physical Exercise on Executive Function in Adults with Depression: A Systematic Review and Meta-Analysis

“…Other systematic reviews have focused on the effects of exercise on depressive mood-related symptoms [ 24 , 39 , 40 , 41 , 42 ], although to date, only two previous reviews and meta-analyses have assessed the impact of physical exercise on cognitive symptoms in adults with depression [ 22 , 43 ], including global cognition and different cognitive domains as outcome measures (e.g., processing speed, attention/vigilance, verbal learning and memory, and visual learning and memory). Supplement The cognitive domains selected in both studies were categorized according to the structure of the MATRICS Consensus Cognitive Battery (MCCB) [ 44 ].…”