Department of Physical Activity Sciences, Université du Québec à Montréal.
Research Center, CHU de Montréal.
Health Psychol. 2018 May;37(5):433-450. doi: 10.1037/hea0000578.
The present meta-analysis aimed to determine the overall effect of cognitive behavior therapy combined with physical exercise (CBTEx) interventions on depression, anxiety, fatigue, and pain in adults with chronic illness; to identify the potential moderators of efficacy; and to compare the efficacy of CBTEx versus each condition alone (CBT and physical exercise).
Relevant randomized clinical trials, published before July 2017, were identified through database searches in PubMed, PsycARTICLES, CINAHL, SportDiscus, and the Cochrane Central Register for Controlled Trials.
A total of 30 studies were identified. CBTEx interventions yielded small to large effect sizes for depression (standardized mean change [SMC] = -0.34, 95% CI [-0.53, -0.14]), anxiety (SMC = -0.18, 95% CI [-0.34, -0.03]), and fatigue (SMC = -0.96, 95% CI [-1.43, -0.49]). Moderation analyses revealed that longer intervention was associated with greater effect sizes for depression and anxiety outcomes. Low methodological quality was also associated with increased CBTEx efficacy for depression. When compared directly, CBTEx interventions did not show greater efficacy than CBT alone or physical exercise alone for any of the outcomes.
The current literature suggests that CBTEx interventions are effective for decreasing depression, anxiety, and fatigue symptoms but not pain. However, the findings do not support an additive effect of CBT and exercise on any of the 4 outcomes compared to each condition alone. (PsycINFO Database Record
本荟萃分析旨在确定认知行为疗法联合体育锻炼（CBTEx）干预对慢性病成人的抑郁、焦虑、疲劳和疼痛的总体效果；确定疗效的潜在调节因素；并比较 CBTEx 与每种单一条件（CBT 和体育锻炼）的疗效。
通过在 PubMed、PsycARTICLES、CINAHL、SportDiscus 和 Cochrane 对照试验中心注册处进行数据库搜索，确定了之前在 2017 年 7 月之前发表的相关随机临床试验。
共确定了 30 项研究。CBTEx 干预对抑郁（标准化均数变化[SMC] = -0.34，95%CI [-0.53，-0.14]）、焦虑（SMC = -0.18，95%CI [-0.34，-0.03]）和疲劳（SMC = -0.96，95%CI [-1.43，-0.49]）的疗效为小到中等。调节分析显示，干预时间较长与抑郁和焦虑结果的较大效应大小相关。低方法学质量也与抑郁的 CBTEx 疗效增加相关。当直接比较时，CBTEx 干预在任何结局上都没有显示出比 CBT 单独或体育锻炼单独更有效的效果。
目前的文献表明，CBTEx 干预对降低抑郁、焦虑和疲劳症状有效，但对疼痛无效。然而，与每种单一条件相比，这些发现并不支持 CBT 和运动对这 4 个结局中的任何一个有累加效应。
