Department of Physical Education, Beijing Language and Culture University, Beijing, China.
Department of Kinesiology and Health, Center of Alcohol and Substance Use Studies, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
Sports Med. 2023 Sep;53(9):1765-1788. doi: 10.1007/s40279-023-01869-2. Epub 2023 Jun 27.
Exercise is a promising nonpharmacological intervention to improve executive function (EF). However, results from randomized trials and meta-analyses examining the effects of exercise on working memory in adults with depression are mixed, and the influence of exercise on EF, as well as the key moderators of the relationship, remain inconclusive.
The present systematic review with meta-analysis examined the influence of exercise interventions on EF in adults with depression, and the influence of key moderating variables.
Electronic searches were conducted using Embase, Cochrane Central, Scopus, Ovid MEDLINE, PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang Database, and Weipu Database up to 25 June 2022, and updated on 16 January 2023. Randomized controlled trials (RCTs) examining the effects of exercise training on EF in adults with depression were included. A three-level meta-analysis based on a random-effects model was applied in R. Study quality was assessed using the Physiotherapy Evidence Database (PEDro) scale.
A total of 14 RCTs that evaluated 1201 adults with depression were included. The results indicated that exercise significantly improved global EF [g = 0.180; 95% confidence intervals (CI) = 0.038, 0.323], and the subdomains of working memory (g = 0.182; 95% CI = 0.015, 0.350), cognitive flexibility (g = 0.222; 95% CI = 0.048, 0.395), and reasoning/planning (g = 0.889; 95% CI = 0.571, 1.206). In subgroup analyses, significant improvements in EF were only observed for aerobic exercise (g = 0.203; 95% CI = 0.023, 0.382), moderate-to-vigorous intensity exercise (g = 0.200; 95% CI = 0.022, 0.379), exercise performed three or more times per week (g = 0.207; 95% CI = 0.026, 0.388), in sessions ≤ 60 min (g = 0.173; 95% CI = 0.003, 0.343), and in program durations lasting at least 13 weeks (g = 0. 248; 95% CI = 0.034, 0.462).
This meta-analysis demonstrates the benefits of exercise training for improving EF and the subdomains of working memory, cognitive flexibility, and reasoning/planning in adults with depression. Future randomized clinical trials are warranted to determine the therapeutic effects of exercise training on EF and cognitive symptoms in depressed patients.
运动是一种很有前途的非药物干预措施，可以改善执行功能（EF）。然而，关于运动对成年人抑郁症患者工作记忆影响的随机试验和荟萃分析的结果喜忧参半，运动对 EF 的影响以及关系的关键调节因素仍不确定。
本系统评价和荟萃分析旨在研究运动干预对抑郁症成年人 EF 的影响，以及关键调节变量的影响。
截至 2022 年 6 月 25 日，使用 Embase、Cochrane 中央、Scopus、Ovid MEDLINE、PubMed、Web of Science、中国国家知识基础设施、万方数据库和维普数据库进行电子检索，并于 2023 年 1 月 16 日进行了更新。纳入了评估运动训练对抑郁症成年人 EF 影响的随机对照试验（RCT）。使用 R 中的基于随机效应模型的三级荟萃分析。使用物理治疗证据数据库（PEDro）量表评估研究质量。
共有 14 项 RCT 评估了 1201 名抑郁症成年人，结果表明运动显著改善了整体 EF [g=0.180；95%置信区间（CI）=0.038，0.323]，以及工作记忆（g=0.182；95%CI=0.015，0.350）、认知灵活性（g=0.222；95%CI=0.048，0.395）和推理/计划（g=0.889；95%CI=0.571，1.206）等子领域的 EF。在亚组分析中，仅在有氧运动（g=0.203；95%CI=0.023，0.382）、中等至剧烈强度运动（g=0.200；95%CI=0.022，0.379）、每周运动 3 次或以上（g=0.207；95%CI=0.026，0.388）、每次运动时间≤60 分钟（g=0.173；95%CI=0.003，0.343）和运动持续时间至少 13 周（g=0.248；95%CI=0.034，0.462）的情况下，EF 得到了显著改善。
本荟萃分析表明，运动训练可改善抑郁症成年人的 EF 及其子领域的工作记忆、认知灵活性和推理/计划。需要进一步的随机临床试验来确定运动训练对抑郁症患者 EF 和认知症状的治疗效果。
