Department of Physical Education and Sport Science, Exercise Psychology and Quality of Life Laboratory, University of Thessaly, Trikala, Greece.
School of Surgery, Ear Science Centre, University of Western Australia, Perth, Australia.
BMC Public Health. 2019 Jul 12;19(1):941. doi: 10.1186/s12889-019-7238-7.
This study is a secondary analysis of the trial by Callaghan et al. (2011), which reported higher antidepressant effects for preferred intensity (n = 19) vs. prescribed intensity (n = 19) exercise of three sessions/week over four weeks in depressed women. In particular, the present study sought to examine whether greater clinically significant individual change/recovery was observed in the preferred compared to the prescribed exercise group.
The reliable change index and the C score criteria described by Jacobson and Truax (1991) were employed to determine clinical significance. These criteria examined if individual change in depression scores from pre- to post-intervention in the preferred intensity group were statistically significant beyond the standard error of difference derived from the active comparator prescribed group, and subsequently within a normal population range. Patients fulfilling the first or both criteria were classified as improved or recovered, respectively.
Post-intervention depression scores of six patients in the preferred intensity exercise group (32%) demonstrated statistically reliable improvement (p < 0.05) and recovery. Half of this subgroup started as moderately depressed. No patient demonstrated a reliable deterioration in depression. Due to a small sample size, it was impossible to determine whether patients on psychiatric medication or medication-free patients were equally benefited from preferred intensity exercise. Thirteen patients in the preferred intensity group (68%) displayed non-statistically significant change in post-intervention depression scores (p > 0.05), although eight of them showed a non-significant improvement in post-intervention depression scores and three could not technically show an improvement in depression due to floor effects (baseline depression within normal range).
Preferred intensity exercise of three sessions/week over four weeks led almost a third of the patients to record scores consistent with recovery from depression. Health professionals may consider that short-term preferred intensity exercise provides clinically significant antidepressant effects comparing favourably to exercise on prescription.
本研究是对 Callaghan 等人（2011 年）试验的二次分析，该试验报告称，在四周内每周三次进行三次/周的首选强度（n=19）运动比规定强度（n=19）运动对抑郁女性的抗抑郁效果更高。特别是，本研究旨在检查在首选运动组中是否观察到更大的个体临床显著变化/恢复。
采用 Jacobson 和 Truax（1991 年）描述的可靠变化指数和 C 分数标准来确定临床意义。这些标准检查了在首选强度组中，从干预前到干预后的抑郁评分个体变化是否在统计学上显著超出从活动对照组规定组得出的差异标准误差，并且随后在正常人群范围内。符合第一个或两个标准的患者分别被归类为改善或恢复。
在首选强度运动组的六名患者（32%）的干预后抑郁评分显示出统计学上可靠的改善（p<0.05）和恢复。其中一半的亚组开始时处于中度抑郁状态。没有患者表现出抑郁的可靠恶化。由于样本量小，无法确定服用精神药物或不服药的患者是否同样受益于首选强度运动。在首选强度组的 13 名患者（68%）中，干预后抑郁评分显示出非统计学上显著的变化（p>0.05），尽管其中 8 名患者在干预后抑郁评分显示出非显著改善，而 3 名患者由于地板效应（正常范围内的基线抑郁）无法在抑郁方面技术上显示改善。
四周内每周三次的首选强度运动使近三分之一的患者记录的抑郁恢复得分符合标准。健康专业人员可能会认为，短期首选强度运动提供了与规定运动相比具有临床意义的抗抑郁效果。
