title: Exercise therapy improves both mental and physical health in patients with major depression.
abstract: OBJECTIVE
  to present clinical guidelines for exercise therapy in depressed patients derived from recent meta-analyses.
  
  
  METHODS
  four meta-analyses on effects of physical exercise on mental and physical in depression were analysed.
  
  
  RESULTS
  For mild to moderate depression the effect of exercise may be comparable to antidepressant medication and psychotherapy; for severe depression exercise seems to be a valuable complementary therapy to the traditional treatments. Depression is associated with a high incidence of co-morbid somatic illnesses, especially cardiovascular diseases, type 2 diabetes and metabolic syndrome. Exercise is extremely powerful in preventing and treating these diseases. Physical exercise is an outstanding opportunity for the treatment of patients who have a mix of mental and physical health problems. Exercise therapy also improves body image, patient s coping strategies with stress, quality of life and independence in activities of daily living in older adults.
  
  
  CONCLUSIONS
  Physical therapists should be aware, that several characteristics of major depression (e.g. loss of interest, motivation and energy, generalised fatigue, a low self-worth and self-confidence, fear to move, and psychosomatic complaints) and physical health problems interfere with participation in exercise. Therefore, motivational strategies should be incorporated in exercise interventions to enhance the patients' motivation and adherence in exercise programs. Implications for Rehabilitation For mild to moderate depression, the effect of exercise may be comparable with antidepressant medication and psychotherapy; for severe depression, exercise seems to be a valuable complementary therapy to the traditional treatments. Exercise therapy also improves physical health, body image, patient's coping strategies with stress, quality of life, and independence in activities of daily living in older adults. Motivational strategies should be incorporated in exercise interventions to enhance the patients' motivation.
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven , Leuven , Belgium .
authors.forename: Jan
authors.initials: J
authors.lastname: Knapen
authors.forename: Davy
authors.initials: D
authors.lastname: Vancampfort
authors.forename: Yves
authors.initials: Y
authors.lastname: Moriën
authors.forename: Yannick
authors.initials: Y
authors.lastname: Marchal
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D002318:Cardiovascular Diseases / Q000517:prevention & control* / Q000628:therapy; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000150:complications* / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control* / Q000628:therapy; D019317:Evidence-Based Medicine; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D008019:Life Style; D015201:Meta-Analysis as Topic; D024821:Metabolic Syndrome / Q000517:prevention & control* / Q000628:therapy; D009042:Motivation; D011788:Quality of Life
keywords: Depressive disorder; metabolic syndrome; physical therapy