PDF(Pubmed)
Abstract：
BACKGROUND: Exercise has been identified as a promising non-pharmacological therapy for the management of depression, but there is still controversy over which type is most effective. We aimed to compare and rank the types of exercise that improve depression in postmenopausal women by quantifying information from randomized controlled trials (RCTs).
METHODS: The PubMed, Web of Science, SPORTDiscus, CNKI, The Cochrane Library, PsycINFO, EMBASE, and CINAHL Plus databases were searched to identify articles published from inception to 1 March 2024 reporting RCTs that examined the effectiveness of exercise on depression in postmenopausal women. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for RCTs. The quality of the evidence for each comparison was graded using the online confidence in network meta-analysis tool (CINeMA). Standardized mean differences (SMDs) were calculated using the mean and standard deviation of pre-to-post intervention changes and then pooled using a random effects model in a pairwise meta-analysis using Review Manager 5.4. Then, a frequentist network meta-analysis was conducted using a random effects model was conducted to evaluate the efficacy of different exercise types using the network package of Stata 15.
RESULTS: This study included 26 studies involving 2,170 participants. The pairwise meta-analysis revealed that exercise had a significant positive effect on depression in postmenopausal women (SMD = -0.71, 95% confidence interval [CI] = -0.94 to -0.48; I2 = 78%). The network meta-analysis revealed that mind-body exercise (SMD = -0.97, 95% CI = -1.28 to -0.67), aerobic exercise (SMD = -0.58, 95% CI = -0.88 to -0.27) and multicomponent exercise (SMD = -0.57, 95% CI = -1.15 to -0.002) significantly reduced depression compared to the control intervention. Mind-body exercise had the highest probability of being the most effective intervention. Exercise interventions also showed positive effects on anxiety. Most studies were judged to have some concerns regarding their risk of bias, and the confidence in evidence was often very low according to CINeMA.
CONCLUSIONS: For postmenopausal women, there is very low to moderate quality evidence that exercise interventions are an effective antidepressant therapy, with mind-body exercise most likely being the optimal type.
BACKGROUND: This meta-analysis was prospectively registered with PROSPERO (registration number: CRD42024505425).
METHODS: The PubMed, Web of Science, SPORTDiscus, CNKI, The Cochrane Library, PsycINFO, EMBASE, and CINAHL Plus databases were searched to identify articles published from inception to 1 March 2024 reporting RCTs that examined the effectiveness of exercise on depression in postmenopausal women. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for RCTs. The quality of the evidence for each comparison was graded using the online confidence in network meta-analysis tool (CINeMA). Standardized mean differences (SMDs) were calculated using the mean and standard deviation of pre-to-post intervention changes and then pooled using a random effects model in a pairwise meta-analysis using Review Manager 5.4. Then, a frequentist network meta-analysis was conducted using a random effects model was conducted to evaluate the efficacy of different exercise types using the network package of Stata 15.
RESULTS: This study included 26 studies involving 2,170 participants. The pairwise meta-analysis revealed that exercise had a significant positive effect on depression in postmenopausal women (SMD = -0.71, 95% confidence interval [CI] = -0.94 to -0.48; I2 = 78%). The network meta-analysis revealed that mind-body exercise (SMD = -0.97, 95% CI = -1.28 to -0.67), aerobic exercise (SMD = -0.58, 95% CI = -0.88 to -0.27) and multicomponent exercise (SMD = -0.57, 95% CI = -1.15 to -0.002) significantly reduced depression compared to the control intervention. Mind-body exercise had the highest probability of being the most effective intervention. Exercise interventions also showed positive effects on anxiety. Most studies were judged to have some concerns regarding their risk of bias, and the confidence in evidence was often very low according to CINeMA.
CONCLUSIONS: For postmenopausal women, there is very low to moderate quality evidence that exercise interventions are an effective antidepressant therapy, with mind-body exercise most likely being the optimal type.
BACKGROUND: This meta-analysis was prospectively registered with PROSPERO (registration number: CRD42024505425).
摘要：
背景：运动已被确定为一种有希望的非药物治疗抑郁症，但是关于哪种类型最有效仍然存在争议。我们旨在通过量化来自随机对照试验（RCTs）的信息，对改善绝经后妇女抑郁的运动类型进行比较和排名。
方法：PubMed，WebofScience,SPORTDiscus,CNKI,科克伦图书馆,PsycINFO,EMBASE,本研究检索了CINAHLPlus数据库,以确定从研究开始到2024年3月1日发表的报告RCT的文章,这些文章研究了运动对绝经后女性抑郁症的疗效.使用修订后的Cochrane偏倚风险工具评估偏倚风险。使用网络荟萃分析工具（CINeMA）的在线置信度对每个比较的证据质量进行分级。使用干预前后变化的均值和标准差计算标准化均值差异（SMD），然后在使用ReviewManager5.4的成对荟萃分析中使用随机效应模型进行汇总。然后，我们使用随机效应模型进行了频繁的网络荟萃分析,以使用Stata15的网络包评估不同运动类型的疗效.
结果：这项研究包括26项研究，涉及2,170名参与者。成对的荟萃分析显示，运动对绝经后妇女的抑郁有显著的积极影响（SMD=-0.71，95%置信区间[CI]=-0.94至-0.48；I2=78%）。网络荟萃分析显示，身心锻炼(SMD=-0.97，95%CI=-1.28至-0.67)，与对照组相比，有氧运动（SMD=-0.58，95％CI=-0.88至-0.27）和多成分运动（SMD=-0.57，95％CI=-1.15至-0.002）显着降低了抑郁。身心锻炼是最有效的干预措施的可能性最高。运动干预对焦虑也显示出积极的影响。大多数研究被认为对它们的偏见风险有一些担忧，根据CINeMA，对证据的信心通常很低。
结论：对于绝经后妇女，有非常低到中等质量的证据表明运动干预是一种有效的抗抑郁治疗，身心锻炼最有可能是最佳类型。
背景：这项荟萃分析在PROSPERO进行了前瞻性注册（注册编号：CRD42024505425）。
方法：PubMed，WebofScience,SPORTDiscus,CNKI,科克伦图书馆,PsycINFO,EMBASE,本研究检索了CINAHLPlus数据库,以确定从研究开始到2024年3月1日发表的报告RCT的文章,这些文章研究了运动对绝经后女性抑郁症的疗效.使用修订后的Cochrane偏倚风险工具评估偏倚风险。使用网络荟萃分析工具（CINeMA）的在线置信度对每个比较的证据质量进行分级。使用干预前后变化的均值和标准差计算标准化均值差异（SMD），然后在使用ReviewManager5.4的成对荟萃分析中使用随机效应模型进行汇总。然后，我们使用随机效应模型进行了频繁的网络荟萃分析,以使用Stata15的网络包评估不同运动类型的疗效.
结果：这项研究包括26项研究，涉及2,170名参与者。成对的荟萃分析显示，运动对绝经后妇女的抑郁有显著的积极影响（SMD=-0.71，95%置信区间[CI]=-0.94至-0.48；I2=78%）。网络荟萃分析显示，身心锻炼(SMD=-0.97，95%CI=-1.28至-0.67)，与对照组相比，有氧运动（SMD=-0.58，95％CI=-0.88至-0.27）和多成分运动（SMD=-0.57，95％CI=-1.15至-0.002）显着降低了抑郁。身心锻炼是最有效的干预措施的可能性最高。运动干预对焦虑也显示出积极的影响。大多数研究被认为对它们的偏见风险有一些担忧，根据CINeMA，对证据的信心通常很低。
结论：对于绝经后妇女，有非常低到中等质量的证据表明运动干预是一种有效的抗抑郁治疗，身心锻炼最有可能是最佳类型。
背景：这项荟萃分析在PROSPERO进行了前瞻性注册（注册编号：CRD42024505425）。
