Review Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials, 2024, Noetel et al

Discussion in 'Other health news and research' started by JohnTheJack, Mar 11, 2024.

  1. JohnTheJack

    JohnTheJack Moderator Staff Member

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    Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials
    BMJ 2024; 384 doi: https://doi.org/10.1136/bmj-2023-075847 (Published 14 February 2024)
    Cite this as: BMJ 2024;384:e075847

    Michael Noetel, senior lecturer1, Taren Sanders, senior research fellow2, Daniel Gallardo-Gómez, doctoral student3, Paul Taylor, deputy head of school4, Borja del Pozo Cruz, associate professor56, Daniel van den Hoek, senior lecturer7, Jordan J Smith, senior lecturer8, John Mahoney, senior lecturer9, Jemima Spathis, senior lecturer9, Mark Moresi, lecturer4, Rebecca Pagano, senior lecturer10, Lisa Pagano, postdoctoral fellow11, Roberta Vasconcellos, doctoral student2, Hugh Arnott, masters student2, Benjamin Varley, doctoral student12, Philip Parker, pro vice chancellor research13, Stuart Biddle, professor1415, Chris Lonsdale, deputy provost13

    Abstract
    Objective
    To identify the optimal dose and modality of exercise for treating major depressive disorder, compared with psychotherapy, antidepressants, and control conditions.

    Design
    Systematic review and network meta-analysis.

    Methods
    Screening, data extraction, coding, and risk of bias assessment were performed independently and in duplicate. Bayesian arm based, multilevel network meta-analyses were performed for the primary analyses. Quality of the evidence for each arm was graded using the confidence in network meta-analysis (CINeMA) online tool.

    Data sources
    Cochrane Library, Medline, Embase, SPORTDiscus, and PsycINFO databases.
    Eligibility criteria for selecting studies Any randomised trial with exercise arms for participants meeting clinical cut-offs for major depression.

    Results
    218 unique studies with a total of 495 arms and 14 170 participants were included. Compared with active controls (eg, usual care, placebo tablet), moderate reductions in depression were found for walking or jogging (n=1210, κ=51, Hedges’ g −0.62, 95% credible interval −0.80 to −0.45), yoga (n=1047, κ=33, g −0.55, −0.73 to −0.36), strength training (n=643, κ=22, g −0.49, −0.69 to −0.29), mixed aerobic exercises (n=1286, κ=51, g −0.43, −0.61 to −0.24), and tai chi or qigong (n=343, κ=12, g −0.42, −0.65 to −0.21).

    The effects of exercise were proportional to the intensity prescribed. Strength training and yoga appeared to be the most acceptable modalities. Results appeared robust to publication bias, but only one study met the Cochrane criteria for low risk of bias. As a result, confidence in accordance with CINeMA was low for walking or jogging and very low for other treatments.

    Conclusions Exercise is an effective treatment for depression, with walking or jogging, yoga, and strength training more effective than other exercises, particularly when intense. Yoga and strength training were well tolerated compared with other treatments.

    Exercise appeared equally effective for people with and without comorbidities and with different baseline levels of depression. To mitigate expectancy effects, future studies could aim to blind participants and staff.

    These forms of exercise could be considered alongside psychotherapy and antidepressants as core treatments for depression.


    Except read this thread that absolutely destroys it

    https://twitter.com/user/status/1767020308622430245


    A study making false claims about exercise as a treatment? Surely not.
     
    Murph, EzzieD, rvallee and 5 others like this.
  2. Hutan

    Hutan Moderator Staff Member

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    Thanks JTJ
    I've read the threads and quoted threads for as long as I could. The review looks truly awful, in a multitude of ways. Here's some of the content for people not on twitter.

     
  3. rvallee

    rvallee Senior Member (Voting Rights)

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    Oooh, it has to be that study that only had a single certainty rating that isn't very low, and that one is still low...

    It is!

    Effect-of-exercise-for-depression-systematic-review.png

    Would you look at that, like a mirror of the ME studies, all of which are either highly biased, or biased, and vastly overhype pre-determined opinions that have no relation to the data.

    The fact that this "study" is titled as if they are looking at whether it is effective, but their objective clearly and overtly assumes that it is says it all. I've been saying this for years, and I have not changed my mind: literally all of this body of research will be eventually entirely discredited, at its very best infamous for vastly overestimating and overhyping mediocre results out of a GIGO process. It will be studied as the peak era of pseudoscience, and be the "collapsed bridges" lessons of medicine that engineering fields all share, a growing phase that medicine sadly hasn't gone through yet.

    The dance being such a positive outlier is so obviously in the same category as "we gave candies to this group and it just happened to be the group that gave the best rating".

    In the end what this entire body of evidence amounts to is that people enjoy things they enjoy, and that there are relatively small and mostly imperceptible benefits to exercise, which come at a cost, and if that cost is lowered it provides more benefits, but most of the obstacles are socioeconomic so the idea of medical prescribing is just the height of foolishness. If exercise were as good for health as it's been touted, the main difficulty would be in getting people to exercise less, most people would be borderline addicted to it.
     

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