title: Effect of exercise on depressive symptoms in adults with neurologic disorders: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To review and quantify the effect of exercise on depression in adults with neurologic disorders.
  
  
  METHODS
  CINAHL, Cochrane Register of Controlled Clinical Trials, EMBASE, ERIC, MEDLINE, PsycINFO, PubMed, and SPORTDiscus were searched, with the last search performed in May 2014.
  
  
  METHODS
  Included were randomized controlled trials conducted in adults with a diagnosed neurologic disorder that compared an exercise intervention group with a control group and used depression as an outcome measure.
  
  
  METHODS
  Depression data were extracted independently by 2 authors. Methodological quality was assessed independently by 2 authors.
  
  
  RESULTS
  Forty-three full-length articles were reviewed, and 26 trials met our inclusion criteria. These trials represented 1324 participants with 7 different neurologic disorders: Alzheimer disease (n=4 trials), migraine (n=1), multiple sclerosis (n=13), Parkinson disease (n=2), spinal cord injury (n=1), stroke (n=2), and traumatic brain injury (n=3). Data measuring depression were extracted and effect sizes were computed for 23 trials. Results from a meta-analysis yielded an overall effect size of .28 (SE=.07; 95% confidence interval, .15-.41; P=.00) favoring a reduction in depression outcomes after an exercise intervention compared with the control condition. Of note, interventions that met physical activity guidelines yielded an overall effect of .38 compared with .19 for studies that did not meet physical activity guidelines.
  
  
  CONCLUSIONS
  This review provides evidence that exercise, particularly when meeting physical activity guidelines, can improve depressive symptoms in adults with neurologic disorders.
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL. Electronic address: bcadams2@illinois.edu.
authors.forename: Brynn C
authors.initials: BC
authors.lastname: Adamson
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL.
authors.forename: Ipek
authors.initials: I
authors.lastname: Ensari
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Motl
mesh_terms: D003863:Depression / Q000453:epidemiology / Q000534:rehabilitation*; D015444:Exercise / Q000523:psychology; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D009422:Nervous System Diseases / Q000453:epidemiology / Q000523:psychology*; D016032:Randomized Controlled Trials as Topic
keywords: Affect; Depression; Exercise; Meta-Analysis; Nervous system diseases; Rehabilitation