title: Exercise improves cardiorespiratory fitness in people with depression: A meta-analysis of randomized control trials.
abstract: OBJECTIVE
  Cardiorespiratory fitness (CRF) is an independent predictor of cardiovascular disease and all-cause mortality. CRF improves in response to exercise interventions, yet the effectiveness of such interventions to improve CRF among people with depression is unclear. We conducted a systematic review and meta-analysis to evaluate whether CRF improves in people with depression in exercise randomized control trials (RCTs).
  
  
  METHODS
  Three authors identified RCTs from a recent Cochrane review and conducted updated searches of major electronic databases. We included RCTs of exercise interventions in people with depression (including major depressive disorder (MDD) and above-threshold depressive symptoms) that reported CRF (defined as predicted maximal oxygen uptake (VO2max predicted) or peak oxygen uptake (VO2peak)) versus a control condition. A random effects meta-analysis was conducted.
  
  
  RESULTS
  Seven unique RCTs including 8 aerobic exercise interventions for depression were eligible, including 293 people allocated to exercise (mean age=40.3 years, range=27.2-64.7 years and 35-100% female) and 205 allocated to control conditions. Across all studies exercise results in a significant increase in CRF (g=0.64, 95%CI=0.32-0.96, p<0.001) equating to a mean increase of 3.05 ml/kg/min. Results remained significant when restricted to MDD only (N=5, g=0.41, 95%CI=0.18-0.64, p<0.001) and in high quality studies (N=5, g=0.60, 95%CI=0.19-1.00, p=0.004).
  
  
  CONCLUSIONS
  People with depression can achieve clinically relevant improvements in CRF in response to exercise interventions. Targeting 'fitness' rather than 'fatness' may be another feasible intervention strategy in this population.
authors.affiliation: Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London Box SE5 8 AF, United Kingdom. Electronic address: brendonstubbs@hotmail.com.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: Rosenbaum
authors.affiliation: KU Leuven University of Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven-University of Leuven, Z.org Leuven, Campus Kortenberg, Kortenberg, Belgium.
authors.forename: Davy
authors.initials: D
authors.lastname: Vancampfort
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, Australia.
authors.forename: Philip B
authors.initials: PB
authors.lastname: Ward
authors.affiliation: Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil; Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Felipe B
authors.initials: FB
authors.lastname: Schuch
mesh_terms: D003863:Depression / Q000503:physiopathology*; D003865:Major Depressive Disorder / Q000503:physiopathology*; D015444:Exercise / Q000502:physiology* / Q000523:psychology; D006801:Humans; D010809:Physical Fitness / Q000502:physiology* / Q000523:psychology; D016032:Randomized Controlled Trials as Topic
keywords: Cardiorespiratory fitness; Cardiovascular disease; Depression; Exercise; Physical activity