Depression and Exercise: A Clinical Review and Management Guideline

Ranjbar, Elaheh; Memari, Amir Hossein; Hafizi, Sina; Shayestehfar, Monir; Mirfazeli, Fatemeh Sadat; Eshghi, Mohammad Ali

doi:10.5812/asjsm.6(2)2015.24055

Cited by 41 publications

(33 citation statements)

References 43 publications

(47 reference statements)

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“…Altogether, the data presented here suggests that moderate PA—a target that is practical, well tolerated, and likely to optimize exercise adherence—optimizes BDNF and plasticity, particularly in persons with depression. PA's relative low-risk profile, ease of implementation, and absence of side effects [ 260 ] have led to the incorporation of PA into basic clinical management protocols for MDs [ 261 , 262 ]. Undoubtedly, future efforts to improve population health should consider the ability of lifestyle factors to prevent and treat mental disorders [ 263 ] by optimization of neuroplasticity substrates, particularly when coupled with rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

Brain-Derived Neurotrophic Factor, Depression, and Physical Activity: Making the Neuroplastic Connection

Phillips¹

2017

Neural Plasticity

314

209

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Brain-derived neurotrophic factor (BDNF) is a neurotrophin that is vital to the survival, growth, and maintenance of neurons in key brain circuits involved in emotional and cognitive function. Convergent evidence indicates that neuroplastic mechanisms involving BDNF are deleteriously altered in major depressive disorder (MDD) and animal models of stress. Herein, clinical and preclinical evidence provided that stress-induced depressive pathology contributes to altered BDNF level and function in persons with MDD and, thereby, disruptions in neuroplasticity at the regional and circuit level. Conversely, effective therapeutics that mitigate depressive-related symptoms (e.g., antidepressants and physical activity) optimize BDNF in key brain regions, promote neuronal health and recovery of function in MDD-related circuits, and enhance pharmacotherapeutic response. A greater knowledge of the interrelationship between BDNF, depression, therapeutic mechanisms of action, and neuroplasticity is important as it necessarily precedes the derivation and deployment of more efficacious treatments.

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Section: Discussionmentioning

confidence: 99%

Brain-Derived Neurotrophic Factor, Depression, and Physical Activity: Making the Neuroplastic Connection

Phillips¹

2017

Neural Plasticity

314

209

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“…In present clinical practice, the role of physical exercise as an add-on therapy in the management of QoL, depressive symptoms and cognitive impairment in chronic brain disorders remains elusive [226][227][228]. Management guidelines sometimes suggest physical exercise in treatment of, e.g., physical health, motor symptoms, falls and fatigue in chronic brain disorders but lack in clarity over the effectiveness of physical exercise on the studied symptoms [229][230][231][232][233][234][235].…”

Section: Current Clinical Practicementioning

confidence: 99%

Physical exercise improves quality of life, depressive symptoms, and cognition across chronic brain disorders: a transdiagnostic systematic review and meta-analysis of randomized controlled trials

et al. 2019

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We performed a meta-analysis to synthesize evidence on the efficacy and safety of physical exercise as an add-on therapeutic intervention for quality of life (QoL), depressive symptoms and cognition across six chronic brain disorders: Alzheimer's disease, Huntington's disease, multiple sclerosis, Parkinson's disease, schizophrenia and unipolar depression. 122 studies (= k) (n = 7231) were included. Exercise was superior to treatment as usual in improving QoL (k = 64, n = 4334, ES = 0.40, p < 0.0001), depressive symptoms (k = 60, n = 2909, ES = 0.78, p < 0.0001), the cognitive domains attention and working memory (k = 21, n = 1313, ES = 0.24, p < 0.009), executive functioning (k = 14, n = 977, ES = 0.15, p = 0.013), memory (k = 12, n = 994, ES = 0.12, p = 0.038) and psychomotor speed (k = 16, n = 896, ES = 0.23, p = 0.003). Meta-regression showed a dose-response effect for exercise time (min/week) on depressive symptoms (β = 0.007, p = 0.012). 69% of the studies that reported on safety, found no complications. Exercise is an efficacious and safe add-on therapeutic intervention showing a medium-sized effect on QoL and a large effect on mood in patients with chronic brain disorders, with a positive dose-response correlation. Exercise also improved several cognitive domains with small but significant effects.

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“…The PA recommendations for adults with NCDs were derived from a detailed content analysis of 59 source recommendations and texts: arthrosis (hip and knee) [37][38][39][40][41][42][43][44][45][46][47][48][49][50][51]; type 2 diabetes mellitus [52][53][54][55]; COPD [56][57][58][59][60][61]; clinically stable ischemic heart disease [62][63][64][65]; stroke [66][67][68][69][70][71][72][73][74][75][76][77]; clinical depression [78][79][80][81][82][83][84]; and chronic non-specific back pain [85][86]…”

Section: Physical Activity Recommendations Existing Physical Activitymentioning

confidence: 99%

German recommendations for physical activity and physical activity promotion in adults with noncommunicable diseases

Geidl

Abu‐Omar

Weege

et al. 2020

Int J Behav Nutr Phys Act

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Background: Existing physical activity guidelines predominantly focus on healthy age-stratified target groups. The objective of this study was to develop evidence-based recommendations for physical activity (PA) and PA promotion for German adults (18-65 years) with noncommunicable diseases (NCDs). Methods: The PA recommendations were developed based on existing PA recommendations. In phase 1, systematic literature searches were conducted for current PA recommendations for seven chronic conditions (osteoarthrosis of the hip and knee, chronic obstructive pulmonary disease, stable ischemic heart disease, stroke, clinical depression, and chronic non-specific back pain). In phase 2, the PA recommendations were evaluated on the basis of 28 quality criteria, and high-quality recommendations were analysed. In phase 3, PA recommendations for seven chronic conditions were deducted and then synthesised to generate generic German PA recommendations for adults with NCDs. In relation to the recommendations for PA promotion, a systematic literature review was conducted on papers that reviewed the efficacy/effectiveness of interventions for PA promotion in adults with NCDs. Results: The German recommendations for physical activity state that adults with NCDs should, over the course of a week, do at least 150 min of moderate-intensity aerobic PA, or 75 min of vigorous-intensity aerobic PA, or a combination of both. Furthermore, muscle-strengthening activities should be performed at least twice a week. The promotion of PA among adults with NCDs should be theory-based, specifically target PA behaviour, and be tailored to the respective target group. In this context, and as an intervention method, exercise referral schemes are one of the more promising methods of promoting PA in adults with NCDs. Conclusion: The development of evidence-based recommendations for PA and PA promotion is an important step in terms of the initiation and implementation of actions for PA-related health promotion in Germany. The German recommendations for PA and PA promotion inform adults affected by NCDs and health professionals on how much PA would be optimal for adults with NCDs. Additionally, the recommendations provide professionals entrusted in PA promotion the best strategies and interventions to raise low PA levels in adults with NCDs. The formulation of specific PA recommendations for adults with NCDs and their combination with recommendations on PA promotion is a unique characteristic of the German recommendations.

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Depression and Exercise: A Clinical Review and Management Guideline

Cited by 41 publications

References 43 publications

Brain-Derived Neurotrophic Factor, Depression, and Physical Activity: Making the Neuroplastic Connection

Brain-Derived Neurotrophic Factor, Depression, and Physical Activity: Making the Neuroplastic Connection

Physical exercise improves quality of life, depressive symptoms, and cognition across chronic brain disorders: a transdiagnostic systematic review and meta-analysis of randomized controlled trials

German recommendations for physical activity and physical activity promotion in adults with noncommunicable diseases

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