Effect of Exercise on Depressive Symptoms in Adults With Neurologic Disorders: A Systematic Review and Meta-Analysis

Objectives: To review and quantify the effect of exercise on depression in adults with neurologic disorders. Data Sources: CINAHL, Cochrane Register of Controlled Clinical Trials, EMBASE, ERIC, MEDLENE, PsycINFO, PubMed, and SPORTDiscus were searched, with the last search performed in May 2014. Study Selection: Included were randomized controlled trials conducted in adults with a diagnosed neurologic disorder that compared an exercise intervention group with a control group and used depression as an outcome measure. Data Extraction: Depression data were extracted independently by 2 authors. Methodological quality was assessed independently by 2 authors. Data Synthesis: Forty-three full-length articles were reviewed, and 26 trials met our inclusion criteria. These trials represented 1324 participants with 7 different neurologic disorders: Alzheimer disease (n=4 trials), migraine (n=1), multiple sclerosis (n=13), Parkinson disease (n=2), spinal cord injury (n=1), stroke (n=2), and traumatic brain injury (n=3). Data measuring depression were extracted and effect sizes were computed for 23 trials. Results from a meta-analysis yielded an overall effect size of .28 (SE=.07; 95% confidence interval, .15.41; P=.00) favoring a reduction in depression outcomes after an exercise intervention compared with the control condition. Of note, interventions that met physical activity guidelines yielded an overall effect of .38 compared with .19 for studies that did not meet physical activity guidelines. Conclusions: This review provides evidence that exercise, particularly when meeting physical activity guidelines, can improve depressive symptoms in adults with neurologic disorders. (C) 2015 by the American Congress of Rehabilitation Medicine