Authors of a systematic review and network meta-analysis aimed to determine the optimal dose and modality of exercise for treating major depressive disorder (MDD), in comparison with psychotherapy, antidepressants, and control conditions. The analysis included 218 unique studies with 495 arms and 14,170 participants, focusing on randomized trials involving exercise for individuals meeting clinical criteria for MDD. The primary analysis utilized Bayesian arm-based, multilevel network meta-analyses, and the Confidence in Network Meta-Analysis tool was employed to grade the quality of evidence.

The results revealed moderate reductions in depression symptoms for various forms of exercise compared with active controls like usual care or placebo. Walking or jogging, yoga, strength training, mixed aerobic exercises, and tai chi or qigong were found to be effective, with the effects of exercise being proportional to the prescribed intensity. Among these, walking or jogging, yoga, and strength training were notably effective, with strength training and yoga also being the most acceptable modalities. However, confidence in these results was low to very low due to the risk of bias in the studies, with only one study meeting Cochrane criteria for a low risk of bias.

Reference: Noetel M, Sanders T, Gallardo-Gómez D, et al. Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials. BMJ. 2024;384:e075847. doi: 10.1136/bmj-2023-075847.