Joy of living through exercise - a qualitative study of clinically referred adolescents’ experiences of moderate to vigorous exercise as treatment for depression

Serrander, Maria; Bremander, Ann; Jarbin, Håkan; Larsson, Ingrid

doi:10.1080/08039488.2021.1909128

Cited by 12 publications

(17 citation statements)

References 31 publications

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“…The support increased the motivation to maintain exercise, which is in line with earlier findings from healthy adolescents [28,30] and adults with depression [44]. Providing support during an exercise intervention by healthcare professionals and personal trainers is required for the participators to attain adherence [45]. Social support may help adolescents and adults with depression to overcome psychological barriers, such as low self-esteem and lack of motivation towards exercise [32][33][34]46].…”

Section: Discussionsupporting

confidence: 82%

Adolescents’ Experiences of Facilitators for and Barriers to Maintaining Exercise 12 Months after a Group-Based Intervention for Depression

Sunesson

Haglund

Bremander

et al. 2021

IJERPH

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Exercise can improve health among adolescents with depression. Understanding facilitators for and barriers to maintaining exercise among adolescents with depression may increase adherence to exercise and consequently improve health. The aim was to explore adolescents’ experiences of facilitators for and barriers to maintaining exercise after a group-based exercise intervention for depression. Interviews (n = 14) were conducted 12 months after the exercise intervention. A qualitative content analysis was used to extract facilitators and barriers. Facilitators for maintaining exercise among adolescents with depression were (1) greater self-esteem by having companionship while exercising and by achieving exercise results and (2) having a supportive environment in terms of accessibility and coaching. Barriers to maintaining exercise were (1) disease burden due to fatigue, social anxiety, and a lack of drive, and (2) lack of a supportive environment including a lack of social support, as well as structural support. In conclusion, facilitating enhanced self-esteem and continuous support for exercising are important for adolescents with depression to maintain exercise. The disease burden of depression is a substantial barrier that needs to be considered to maintain exercise. The findings can contribute to the development of services that promote and coordinate exercise as a treatment among adolescents with depression.

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Section: Discussionsupporting

confidence: 82%

Adolescents’ Experiences of Facilitators for and Barriers to Maintaining Exercise 12 Months after a Group-Based Intervention for Depression

Sunesson

Haglund

Bremander

et al. 2021

IJERPH

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“…The manageability of the intervention was based on a supportive environment, where supportive and encouraging adults and the feeling of belonging to a peer group were important. Support from those around the teenagers, such as family, healthcare professionals, coaches, and fellow group members, was important and facilitated adherence and commitment to the exercise intervention [ 18 , 19 ]. In the present study, extensive support from health professionals, with reminders, phone calls, pep talks, and personal participation in sessions, together with family support, was of utmost importance for compliance, albeit it might be challenging to implement in usual care [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…The meaningfulness of the exercise intervention was based on the adolescents’ experiences of the positive impact of exercise on daily life routines, such as sleep, diet, school attendance, and schoolwork. The experiences of increased energy and well-being remained one year after the exercise intervention stopped [ 18 ]. This is suggested as an important finding, given that meaningfulness, the motivational component of SOC, is thought to be accountable for the maintenance of manageability and comprehensibility [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…They were diagnosed with mild to moderate persistent depression (duration 1.4–5.3 years, median 2.2 years) according to the DSM-5 criteria. The participants also suffered from significant comorbidities, such as ADHD, anxiety syndromes, and PTSD, as described in detail elsewhere [ 18 , 29 ]. All participants reported an exercise level below 150 min/week moderate exercise or 75 min/week intensive exercise prior to the intervention.…”

Section: Methodsmentioning

confidence: 99%

“…People with depression who are invited to participate in exercise interventions often change their health behaviour, which can be challenging [8,17]. After completing an exercise intervention aimed at lowering depressive symptoms, many adolescents describe positive changes in their attitudes to exercise and in relation to their exercise habits [8,18]. Qualitative studies describing long-term evaluations of health behaviour after an exercise intervention for adolescent depression are scarce, but Sunesson et al (2021) identified improved self-esteem and a supportive environment as facilitators in the maintenance of exercise one year after participating in the intervention, while disease burden and a lack of a supportive environment were identified as barriers [19].…”

Section: Introductionmentioning

confidence: 99%

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Adolescents’ Long-Term Experiences of Manageability, Comprehensibility, and Meaningfulness of a Group-Based Exercise Intervention for Depression

Reinodt

Haglund

Bremander

et al. 2022

IJERPH

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Physical exercise is a potentially effective treatment for adolescents with mild to moderate depression. However, there is a lack of long-term follow-ups to reveal adolescents’ experiences of exercise as a treatment for depression. The salutogenic concept of sense of coherence (SOC), comprising the domains manageability, comprehensibility, and meaningfulness is important to understand behaviour change. This study aimed to describe adolescents’ long-term experiences of manageability, comprehensibility, and meaningfulness of a group-based exercise intervention for depression. Fourteen adolescents with persistent depression were recruited from a psychiatric outpatient clinic and interviewed one year after participating in a 14-week moderate to vigorous exercise intervention for depression. An abductive qualitative content analysis was conducted, based on the three SOC domains manageability, comprehensibility, and meaningfulness. The results revealed that participation in the intervention was made manageable by a supportive environment, including: the intervention design, togetherness with peer group, and encouragement from adults. The comprehensibility of the intervention emerged through the insights regarding health benefits of exercise and the aim of the intervention. Meaningfulness was achieved through improved health behaviour, well-being and self-esteem, along with strengthened belief in the future and increased commitment to everyday life. The group-based exercise intervention was experienced as manageable, comprehensible, and meaningful.

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Validation of the maximal cardiopulmonary exercise test in adolescents with major depressive disorder and comparison of cardiorespiratory fitness with sex- and age-related control values

Wenzel,

Bongers,

Schlagheck

et al. 2023

Eur J Pediatr

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Endurance training has been shown to be effective in treating adolescents with major depressive disorder (MDD). To integrate endurance training into the therapeutic setting and the adolescents' daily lives, the current performance status of the adolescents should be accurately assessed. This study aims to examine adolescents with MDD concerning exhaustion criteria during a cardiopulmonary exercise test (CPET), as well as to compare the values obtained thereon with sex- and age-related control values. The study included a retrospective examination of exhaustion criteria ((i) oxygen consumption (V̇O2) plateau, (ii) peak respiratory exchange ratio (RERpeak) > 1.0, (iii) peak heart rate (HRpeak) ≥ 95% of the age-predicted maximal HR, and (iv) peak blood lactate concentration (BLCpeak) > 8.0 mmol⋅L−1) during a graded CPET on a cycle ergometer in adolescents with MDD (n = 57). Subsequently, maximal V̇O2, peak minute ventilation, V̇O2 at the first ventilatory threshold, and peak work rate of participants who met at least two of four criteria were compared with published control values using an independent-sample t-test. Thirty-three percent of the total population achieved a V̇O2 plateau and 75% a RERpeak > 1.0. The HR and BLC criteria were met by 19% and 22%, respectively. T-test results revealed significant differences between adolescents with MDD and control values for all outcomes. Adolescents with MDD achieved between 56% and 83% of control values. Conclusions: The study shows that compared with control values, fewer adolescents with MDD achieve the exhaustion criteria on a CPET and adolescents with MDD have significantly lower cardiorespiratory fitness. Clinical trial registration: No. U1111-1145–1854. What is Known:• It is already known that endurance training has a positive effect on depressive symptoms. What is New:• A relevant proportion of adolescents with major depressive disorder do not achieve their V̇O2max during a graded cardiopulmonary exercise test.• Adolescents with major depressive disorder have significantly lower cardiorespiratory fitness compared to sex- and age-related control values.

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Joy of living through exercise - a qualitative study of clinically referred adolescents’ experiences of moderate to vigorous exercise as treatment for depression

Abstract: Larsson (2021): Joy of living through exercise -a qualitative study of clinically referred adolescents' experiences of moderate to vigorous exercise as treatment for depression, Nordic Journal of Psychiatry,

Cited by 12 publications

References 31 publications

Adolescents’ Experiences of Facilitators for and Barriers to Maintaining Exercise 12 Months after a Group-Based Intervention for Depression

Adolescents’ Experiences of Facilitators for and Barriers to Maintaining Exercise 12 Months after a Group-Based Intervention for Depression

Adolescents’ Long-Term Experiences of Manageability, Comprehensibility, and Meaningfulness of a Group-Based Exercise Intervention for Depression

Validation of the maximal cardiopulmonary exercise test in adolescents with major depressive disorder and comparison of cardiorespiratory fitness with sex- and age-related control values

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