The Effects of Aerobic and Resistance Exercise on Depression and Anxiety: Systematic Review With Meta-Analysis.
Harry Banyard, Karen-Leigh Edward, Loretta Garvey and 3 others
PMID 40432290WHAT IT FOUND
Prescribed aerobic, resistance, or mixed exercise reduced depression and anxiety symptoms in adults with diagnosed conditions compared to usual care.
Effects were large for depression and moderate for anxiety. The specific type of exercise did not change the benefit for depression.
Key findings
01Exercise interventions significantly reduced depression scores compared to control treatments, with a large overall effect size.
02Exercise interventions significantly reduced anxiety scores compared to control treatments, though based on fewer studies and with high heterogeneity.
03Subgroup analyses showed no significant difference in the benefit for depression between aerobic, resistance, or mixed exercise modes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
The quality of evidence is affected by high heterogeneity (I² > 85% for both outcomes), meaning the studies varied greatly in design and results. Many included studies had small sample sizes, with 18 studies having 50 participants or fewer. Blinding of participants and researchers was not possible in most trials, leading to a high risk of performance bias. Only 28% of studies reported sample size calculations, raising concerns about underpowered trials. The anxiety meta-analysis was based on only 12 studies, and the funnel plot suggested potential small-study effects or publication bias. Most studies did not meet the WHO physical activity guidelines for volume and intensity, so the optimal dose of exercise for mental health benefits remains unclear.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that more intense or longer-duration exercise is better. Most included studies did not meet WHO physical activity guidelines, yet still showed benefit. The effect sizes are derived from standardised mean differences, which do not translate directly to clinical score changes on specific tools like the PHQ-9 or GAD-7 without knowing the baseline severity.