Re: Effects of exercise on depression: a systematic review and network meta-analysis of randomized controlled trials

To the editor
A comprehensive approach with evidence-based exercise prescription in primary care
Study findings (1) could significantly change the way primary care physicians approach depression prevention and management, particularly in terms of prescribing exercise. We strongly believe that these findings will improve the practicality and effectiveness of exercise prescription in primary care settings.

This study provides compelling evidence supporting the effectiveness of various exercise methods in reducing symptoms of depression (1). This allows primary care physicians to make solid, evidence-based recommendations tailored to each individual patient's unique preferences, abilities, and needs.

In research, various exercise methods, such as walking, jogging, strength training, yoga, tai chi, and qi gong, have emerged as effective interventions for depression (1). This diversity allows primary care physicians to present patients with a variety of options, thereby increasing adherence and the likelihood of success.

Additionally, this study indicates that certain exercise methods may be more effective for certain demographic groups or individual characteristics (1). For example, strength training may be more beneficial for women, while yoga may prove more effective for older adults. This highlights the importance of taking an individualized approach when prescribing exercise, taking into account factors such as age, gender, preferences and baseline health status.

The study also provides practical recommendations regarding exercise intensity, duration, and frequency based on the observed dose-response relationship (1). Primary care physicians can use this information to help patients develop individualized exercise plans tailored to their abilities and goals.

Additionally, this study suggests that exercise can complement traditional depression treatments such as cognitive behavioral therapy and pharmacotherapy. Primary care physicians can integrate exercise prescription into comprehensive treatment plans to provide patients with a holistic approach to managing depression.

When seeing patients with suspected depression or other mental health problems, primary care physicians can discuss research evidence and encourage and engage patients in exercise. These discussions can lead to common decision-making regarding exercise prescription that takes into account benefits, risks, and preferences to enhance adherence.
Primary care physicians play an important role in monitoring patient progress with exercise interventions and providing ongoing support and encouragement. This includes tracking mood changes, addressing adherence barriers, and adjusting exercise prescriptions as needed.

In addition to treating depression, primary care physicians can recommend physical activity as a preventive measure (2, 3, 4). By encouraging regular exercise as part of a healthy lifestyle, doctors can reduce your risk of developing depression and improve your overall mental health.

It is noteworthy that primary care physicians can proactively address barriers to exercise in primary care settings and empower patients to take an active role in their health (2,3 ). By providing support, resources, and strategies to overcome obstacles, patients can make informed choices and adopt healthier lifestyles.

Understanding the unique barriers faced by individual patients allows primary care physicians to adjust exercise recommendations accordingly, increasing the likelihood of feasibility and sustainability in specific situations. (2, 3, 4).
Addressing barriers fosters trust and rapport between patients and health care providers, creating a supportive environment where patients feel safe seeking guidance and assistance.

Recognizing the importance of addressing issues that can lead to discontinuation of an exercise program, primary care physicians can proactively intervene to prevent dropout and promote long-term adherence to exercise interventions. can. This becomes particularly important after the results of this study, given the effectiveness of exercise interventions in the management of depression.

The results of this study allow primary care physicians to view exercise as a realistic and effective intervention for the prevention and management of depression. By incorporating evidence-based exercise prescription into daily clinical practice, physicians can improve patient outcomes and contribute to improvements in comprehensive mental health care.

References:

(1). Noetel M, Saunders T, Gallardo-Gomez D, Taylor P, del Pozo Cruz B, van den Hoek D, Smith JJ, Mahoney J, Spatis J, Moresi M, Pagano R, Pagano L, Vasconcelos R, Arnott H, Burley B , Parker P, Biddle S, Lonsdale C. Effects of exercise on depression: a systematic review and network meta-analysis of randomized controlled trials. B.M.J. 2024-02-14;384:e075847. doi:10.1136/bmj-2023-075847. PMID: 38355154; PMCID: PMC10870815.

(2). Burtscher J, Strasser B, D'Antona G, Millet GP, Burtscher M. How much resistance exercise is beneficial for healthy aging and longevity? J Sports Health Science May 2023;12(3):284- 286. doi: 10.1016/j.jshs.2022.11.004. Epub 2022 11 7. PMID: 36356853; PMCID: PMC10199130.

(3). Desapriya E, Dutt A, Gunaratna D, Paik I. The potential of exercise as a COVID-19 prevention strategy. Am J Premed. 2023 Jul;65(1):169-170. doi: 10.1016/j.amepre.2023.02.022. PMID: 37344036; PMCID: PMC10277321.

(Four). Warburton DE, Nicol CW, Bredin SS. 2006. Health benefits of physical activity: Evidence. CMAJ 174: 801–809.