ACTIVEDEP: a randomised, controlled trial of a home-based exercise intervention to alleviate depression in middle-aged and older adults

Abstract

Objective: To evaluate the efficacy of a home-based exercise programme added to usual medical care for the treatment of depression. Design: Prospective, two group parallel, randomised controlled study. Setting: Community-based. Patients: 200 adults aged 50 years or older deemed to be currently suffering from a clinical depressive illness and under the care of a general practitioner. Interventions: Participants were randomly allocated to either usual medical care alone (control) or usual medical care plus physical activity (intervention). The intervention consisted of a 12-week home-based programme to promote physical activity at a level that meets recently published guidelines for exercise in people aged 65 years or over. Main outcome measurements: Severity of depression was measured with the structured interview guide for the Montgomery-Asberg Depression Rating Scale (SIGMA), and depression status was assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Results: Remission of depressive illness was similar in both the usual care (59%) and exercise groups (63%; OR = 1.18, 95% CI 0.61 to 2.30) at the end of the 12-week intervention, and again at the 52-week follow-up (67% vs 68%) (OR=1.07, 95% CI 0.56 to 2.02). There was no change in objective measures of fitness over the 12-week intervention among the exercise group. Conclusions: This home-based physical activity intervention failed to enhance fitness and did not ameliorate depressive symptoms in older adults, possibly due to a lack of ongoing supervision to ensure compliance and optimal engagement

Effects of Aerobic Exercise on Patients with Mental Illness in a Veterans Inpatient Psychiatric Unit: A Review of the Literature

“…However, the articles were found to be a collection of different methods and designs. Designs ranging from qualitative studies (Firth et al, 2016;McArdle, McGale, & Gaffney, 2012) to quantitative (Bonsaksen & Lerdal, 2012;Oretel-Knochel et al, 2014;Pfaff et al, 2014;Powers et al, 2015;Strassnig et al, 2015;Subramaniapillai et al, 2016;Toups et al, 2017) and a mix-method design (Browne, Mihas, & Penn, 2016). Methods found were exploratory (Bonsaksen & Lerdal, 2012;Browne et al, 2016;Firth et al, 2016), experimental (Oretel-Knochel et al, 2014;Strassnig et al, 2015;Toups et al, 2017), ethnographic (McArdle et al, 2012, prospective (Pfaff et al, 2014), pilot (Powers et al, 2015), and cross-sectional (Bonsaksen & Lerdal, 2012;Subramaniapillai et al, 2016).…”

“…Mental illness diagnoses were a focus of the sample groups for the reviewed studies, which included depression or major depressive disorder (MDD), anxiety, schizophrenia, bipolar disorder, and posttraumatic stress disorder (PTSD). Six of the articles were related to depression and MDD (Bonsaksen & Lerdal, 2012;Browne et al, 2016;McArdle et al, 2012;Oretel-Knochel et al, 2014;Pfaff et al, 2014;Toups et al, 2017) and one PTSD (Powers et al, 2015). Exercise as an intervention was found to be beneficial in six studies for treating mental illnesses (Firth et al, 2016;McArdle et al, 2012;Oretel-Knochel et al, 2014;Powers et al, 2015;Strassnig et al, 2015;Toups et al, 2017) along with other related subthemes.…”

“…Studies were conducted in different facilities. Some settings were inpatient based on a psychiatric unit (Bonsaksen & Lerdal, 2012;Oretel-Knochel et al, 2014), outpatient (Browne et al, 2016;Firth et al, 2016;Subramaniapillai et al, 2016;Toups et al, 2017), physical training facilities (McArdle et al, 2012;Strassnig et al, 2015), home-based (Pfaff et al, 2014), and other settings otherwise not noted or vague in description (Powers et al, 2015). While the samples were not vague, there were a variety of sample sizes and diagnoses that were included.…”

“…Studies were based in Norway (Bonsaksen & Lerdal, 2012), United States (Brown et al, 2015;Powers et al, 2015;Strassnig et al, 2015;Toups et al, 2017), Canada (Subramaniapillai et al, 2016), Australia (Pfaff et al, 2014), Germany (Oretel-Knochel et al, 2014), Ireland (McArdle et al, 2012), and the United Kingdom (Firth et al, 2016). Studies were conducted in different facilities.…”

“…Studies included sample sizes from (N = 9) the smallest sample (Powers et al, 2015) to (N = 200) the largest sample of subjects (Pfaff et al, 2014) giving a mean sample size for the review of 64.2. Some studies had an even representation of male and female subjects while others had skewed numbers of males (McArdle et al, 2012) and females (Powers et al, 2015).…”