Meta-analysis of the effects of multimodal physical therapy on improving depression

Table 1 Features of the studies included in this review’s quantitative synthesis

Ref.	Study format	Sample	Measurement	Results
Singh et al[16]	Randomized controlled trial	128119 participants	Edinburgh Postnatal Depression Scale	For a wide variety of adults, including the general population, individuals with documented psychological disorders, and those with chronic illnesses, physical activity was very useful for reducing symptoms of depression, anxiety, and psychological distress
Laird et al[17]	Randomized controlled trial	4016 individuals	Epidemiological Studies Depression Scale	Investigated whether in older adults with and without chronic illnesses if achieving lower physical activity thresholds could be helpful for public health programs aimed at lowering the incidence of depression
Philippot et al[18]	Randomized controlled trial	52 adolescent patients	Hospital Anxiety and Depression Scale	The effectiveness of that treatment method has been demonstrated by the reduction in depressed symptoms displayed by teenage patients with depression who undergo organized workout as an additional treatment as part of their overall psychological care
Zhou et al[19]	Randomized, placebo-controlled, and double-blinded trial	84 patients	Montgomery-Asberg Depression Rating Scale	According to the experiment, promethazine administered intraoperatively can help neurosurgery patients who have moderate-to-severe depression symptoms without compromising safety
Arsh et al[20]	Randomized controlled trial	1363 patients	Hamilton Depression Scale	While exercise can successfully lessen the intensity of depression symptoms, it does not appear to have a significant impact on glycemic management
Recchia et al[21]	Randomized controlled trial	2441 participants	Validated depression scales	In young people and adolescents, physical activity therapies can be utilized to lessen depressive symptoms
Noetel et al[22]	Randomized controlled trial	14170 participants	Beck Depression Inventory, Hamilton Depression Rating Scale	Assurance for jogging or walking was inadequate, and it was extremely low for additional therapies
Loi et al[23]	Randomized controlled trial	212 patients	Geriatric Depression Scale-15	For care givers of individuals with dementia, a physical activity intervention might not be as helpful in reducing signs of depression as it would be for other types of caretakers

Table 2 Moderator evaluation of procedural characteristics

Procedural characteristics	Number of participants	Impact size estimates	95%CI	SMD	P values	Variability	Meta-regression
Method of initial depression diagnosis
Organized clinical conversation	112	6	-2.23 to -0.53	-0.92	P = 0.0003	Q = 4.16, P = 0.4, df = 2, T2 = 0, I2 = 0%	Q-between = 4.43, df = 1, P = 0.1
Self-report scale	335	9	-0.81 to -0.53	-0.54	P = 0.0019	Q = 12.18, P = 0.11, df = 9, T2 = 0.0025, I2 = 34.9%
Type of testing group
Active group	130	8	-0.85 to 0.33	-0.47	P = 0.1674	Q = 3.73, P = 0.62, df = 6, T2 = 0, I2 = 0%	Q-between = 3.72, df = 1, P = 0.19
Passive group	315	10	-0.94 to -0.45	-0.79	P = 0.006	Q = 13.55, P = 0.04, df = 8, T2 = 0.0804, I2 = 51.8%

CI: Confidence interval; SMD: Standardized mean deviation.

Table 3 Moderator analysis on physical activity characteristics

Physical activity characteristics	Number of participants	Impact size estimates	95%CI	SMD	P values	Variability	Meta-regression
Type of exercise
Exercise treatment without sports	287	11	-0. 94 to -0.25	-0.65	P = 0.001	P = 0.24, df = 10, Q = 9.34, T2 = 0.0317, I2 = 8.5%	Between Q = 0, P = 0.01, df = 1
Game-based physical activity	195	5	-0.204 to -0.21	-0.67	P = 0.1015	P = 0.02, df = 4, Q = 8.64, T2 = 0.1565, I2 = 70.9%
Energy levels
Low	145	5	-0.56 to 0.34	-0.09	P = 0.5455	P = 0.95, Q = 0.46, df = 1, T2 = 0, I2 = 0%	Between Q = 7.72, P = 0.02, df = 1
Medium	185	6	-0.37 to -0.56	-0.96	P = 0.0002	Q = 5.7, P = 0.20, df = 2, T2 = 0.0745, I2 = 34.9%
High	135	6	-0.96 to -0.23	-0.74	P = 0.0056	Q = 3.23, P = 0.65, df = 5, T2 = 0, I2 = 0%
Environment
Physical exercise and educational atmosphere	201	8	-0.87 to -0.07	-0.58	P = 0.0157	Q = 4.14, P = 0.75, df = 6, T2 = 0, I2 = 0%	Between Q = 0.95, P = 0.29, df = 1
Physical activity	245	8	-3.03 to -0.18	-0.74	P = 0.00475	Q = 13.45, P = 0.03, df = 6, T2 = 0.1423, I2 = 67.3%
Duration of therapy with physical activity
Session duration	-	-	-	-	-	-	Q-balance = 0.46, P = 0.36, df = 1, R2 = 0%
Weekly session count	-	-	-	-	-	-	Q-balance = 0.06, P = 0.65, df = 1, R2 = 0%
Total number of weeks	-	-	-	-	-	-	Q-balance = 0.44, P = 0.53, df = 1, R2 = 0%
Total duration	-	-	-	-	-	-	Q-balance = 0.001, P = 0.01, df = 1, R2 = 0%

CI: Confidence interval; SMD: Standardized mean deviation.