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Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials

51app 2024; 384 doi: (Published 14 February 2024) Cite this as: 51app 2024;384:e075847

Linked Editorial

Exercise for the treatment of depression

Rapid Response:

Re: Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials

Dear Editor
A Comprehensive Approach through Evidence-Based Exercise Prescriptions in Primary Care
The study findings (1) have the potential to significantly reshape how primary care physicians approach the prevention and management of depression, especially in terms of prescribing exercise. We strongly believe that these findings can improve the practicality and efficacy of exercise prescriptions within primary care settings.

The study provides compelling evidence supporting the effectiveness of various exercise modalities in alleviating symptoms of depression (1). This empowers primary care physicians to make recommendations grounded in solid evidence, tailored to the unique preferences, abilities, and needs of individual patients.

A diverse range of exercise modalities-such as walking, jogging, strength training, yoga, tai chi, and qigong-emerge as effective interventions for depression in the research (1). This diversity enables primary care physicians to present patients with a variety of options, thereby increasing the likelihood of adherence and success.

Furthermore, the study indicates that certain exercise modalities may be more effective for specific demographic groups or personal characteristics (1). For example, strength training might be more beneficial for women, while yoga could prove more effective for older adults. This underscores the importance of adopting an individualized approach, considering factors like age, sex, preferences, and baseline health status when prescribing exercise.

The study also offers practical recommendations regarding exercise intensity, duration, and frequency based on observed dose-response relationships (1). Primary care physicians can utilize this information to assist patients in developing personalized exercise plans aligned with their capabilities and goals.

Additionally, the research suggests that exercise can complement traditional treatments for depression, such as cognitive-behavioral therapy and pharmacotherapy. Primary care physicians can integrate exercise prescriptions into comprehensive treatment plans, providing patients with holistic approaches to managing depression.

In consultations with patients suspected of depression or other mental well-being issues, primary care physicians can discuss the study's evidence, empowering and engaging patients to participate in exercises. These discussions can lead to shared decision-making regarding exercise prescriptions, considering benefits, risks, and preferences to enhance adherence.
Primary care physicians can play a crucial role in monitoring patients' progress with exercise interventions, offering ongoing support and encouragement. This involves tracking mood changes, addressing adherence barriers, and adjusting exercise prescriptions as needed.

Beyond treating depression, primary care physicians can advocate for physical activity as a preventive measure (2, 3, 4). By encouraging regular exercise as part of a healthy lifestyle, physicians can help reduce the risk of developing depression and improve overall mental health.

It's worth noting that primary care physicians can actively address barriers to exercise in primary care settings, empowering patients to take an active role in their health (2, 3). Providing support, resources, and strategies to overcome obstacles enables patients to make informed choices and adopt healthier lifestyles.

Understanding the unique barriers faced by individual patients allows primary care physicians to tailor exercise recommendations, accordingly, increasing the likelihood of feasibility and sustainability within specific contexts (2, 3, 4).
Addressing barriers fosters trust and rapport between patients and healthcare providers, creating a supportive environment where patients feel comfortable seeking guidance and assistance.

Recognizing the importance of addressing issues that may lead to discontinuation of exercise programs, primary care physicians can proactively intervene, preventing dropout and promoting long-term adherence to exercise interventions. This becomes especially critical after the study's results, given the effectiveness of exercise interventions in managing depression.

The study findings empower primary care physicians to view exercise as a realistic and effective intervention for preventing and managing depression. By integrating evidence-based exercise prescriptions into routine clinical practice, physicians can enhance patient outcomes and contribute to comprehensive mental health care improvements.


(1). Noetel M, Sanders T, Gallardo-Gómez D, Taylor P, Del Pozo Cruz B, van den Hoek D, Smith JJ, Mahoney J, Spathis J, Moresi M, Pagano R, Pagano L, Vasconcellos R, Arnott H, Varley B, Parker P, Biddle S, Lonsdale C. Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials. 51app. 2024 Feb 14;384:e075847. doi: 10.1136/bmj-2023-075847. PMID: 38355154; PMCID: PMC10870815.

(2). Burtscher J, Strasser B, D'Antona G, Millet GP, Burtscher M. How much resistance exercise is beneficial for healthy aging and longevity? J Sport Health Sci. 2023 May;12(3):284-286. doi: 10.1016/j.jshs.2022.11.004. Epub 2022 Nov 7. PMID: 36356853; PMCID: PMC10199130.

(3). Desapriya E, Dhatt A, Gunaratna D, Pike I. Potential of Exercise as a COVID-19 Prevention Strategy. Am J Prev Med. 2023 Jul;65(1):169-170. doi: 10.1016/j.amepre.2023.02.022. PMID: 37344036; PMCID: PMC10277321.

(4). Warburton DE, Nicol CW, Bredin SS. 2006. Health benefits of physical activity: The evidence. CMAJ 174: 801–809.

Competing interests: No competing interests

19 February 2024
Ediriweera Desapriya
51app Associate
Shaluka Manchanayake, Hasara Illuppelle, Peter Tiu, Crystal Ma
Department of Pediatrics, Faculty of Medicine- University of British Columbia
Faculty of Medicine | Pediatrics, University of British Columbia | BC Children's Hospital | 4480 Oak St, Vancouver, BC V6H 0B3