Samenvatting

Study design: Systematic review

Background: The World Health Organisation predicts that depression will create the second greatest burden of diseases by 2020 regarding cost effective prevention and intervention strategies. The evidence to support the benefits of exercise in offering protection from depression is growing, however more research is needed to acknowledge exercise as a treatment option for depression.

Objectives: To examine the psychological effects of aerobic physical activity either by itself or in combination with other therapy forms for adults diagnosed with dysthymia or major depression seen from a physiotherapeutic point of view.

Search Strategy: We searched PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cumalite Index of Nursing and Allied health, PEDro, Science Direct, Springer Link, SweMed+, DARE net, Helsebiblioteket, Helsenett and Academic Search Premier. We contacted physiotherapeutic professionals for additional information.

Selection Criteria: Systematic reviews, Randomized Controlled Trials, Controlled Clinical Trials, Meta Analyses, Non Randomised Studies and Pilot Studies assessing aerobic exercise forms as interventions for adults suffering from dysthymia or major depression.

Data Collection and analysis: Data was extracted based on a pilot tested self-made data extraction form. Two independent individuals controlled the data extracted. The PEDro scale was used to assess the methodological quality of Randomized Controlled Trials and Controlled Clinical Trials. Studies with a PEDro scale >4 were included. The Cochrane Checklist for Systematic Reviews was used to assess the quality of reviews.

Main Results: This review included a total number of 21 studies; 3 Systematic Reviews, 6 Reviews, 8 Randomised Controlled Trials or Controlled Clinical Trials, 3 Pilot-Studies and 1 Single Subject Design. The methodological qualities of the studies were mixed ranged from high to low quality. The included studies showed a positive outcome of exercise for depression for both short and long term interventions. Aerobic exercise was superior to placebo and equivalent to medication. All studies except one reported a significant reduction of depression scores in the depression scales used.

Authors' Conclusion: The evidence summarized in this review showed that aerobic exercise has a significant positive effect as an intervention for dysthymic disorder and major depression for people above 18 years of age. More research is needed to determine the psychological effects involved.