Best practice exercise for emerging depression in multiple sclerosis: A systematic review and meta-analysis.

IF 2.6 3区医学 Q1 REHABILITATION

Clinical Rehabilitation Pub Date : 2024-09-01 Epub Date: 2024-07-25 DOI:10.1177/02692155241262884

Kristiina Ahola, Diana Dorstyn, Nicole Prideaux

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引用次数: 0

Abstract

Objective: To examine the effects of instructor-led exercise on depression symptoms in adults with multiple sclerosis, with a focus on moderating factors to treatment response.

Data sources: Cochrane Library, Embase, PEDro, PsycINFO and PubMed databases were searched until 21 April 2024.

Review methods: The reporting quality of included studies assessed (PEDro and TESTEX scales). Hedges' g effect sizes were calculated and pooled using random and mixed-effects modelling.

Results: Twenty-two independent studies (k), representing 785 participants with relapsing remitting or progressive MS, were included. Individual studies varied in their reporting quality (PEDro range: 3-8) and did not routinely detail exercise parameters (TESTEX range: 5-13). Nonetheless, exercise reduced core symptoms of depression (g_w= .52, CI: .30-.73, P < .01). Treatment effects were, however, not maintained once training had ceased (g_w= -.53, CI: -.80 to .24, P ≤ .01, k = 5). Both aerobic and non-aerobic exercise groups experienced a significant (P < .01) reduction in depression scores. Larger gains were noted by those with better ambulation at baseline (P = .03).

Conclusion: Regular exercise can help to stabilise mood for people living with multiple sclerosis, regardless of session frequency or duration. Treatment efficacy could be maximised by addressing potential barriers for those with limited mobility, including exercise type, delivery and intensity. Protocol registered on Open Science Framework [https://osf.io/zfymq/].

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针对多发性硬化症新发抑郁症的最佳运动疗法：系统回顾和荟萃分析。

目的研究指导性运动对多发性硬化症成人患者抑郁症状的影响，重点关注治疗反应的调节因素：数据来源：对 Cochrane Library、Embase、PEDro、PsycINFO 和 PubMed 数据库进行了检索，截止日期为 2024 年 4 月 21 日：评估纳入研究的报告质量（PEDro 和 TESTEX 量表）。使用随机和混合效应模型计算并汇总赫奇斯效应大小：共纳入 22 项独立研究（k），代表 785 名复发性缓解或进行性多发性硬化症患者。各项研究的报告质量参差不齐（PEDro范围：3-8），而且没有常规详细的运动参数（TESTEX范围：5-13）。然而，运动可减轻抑郁症的核心症状（gw = .52，CI：.30-.73，P gw = -.53，CI：-.80 至 .24，P ≤ .01，k = 5）。有氧运动组和非有氧运动组都有显著的改善（P P = .03）：结论：定期锻炼有助于稳定多发性硬化症患者的情绪，与锻炼频率和持续时间无关。通过解决行动不便者可能遇到的障碍，包括运动类型、运动方式和强度，可以最大限度地提高治疗效果。协议已在开放科学框架[https://osf.io/zfymq/]上注册。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Rehabilitation 医学-康复医学

CiteScore

5.60

自引率

6.70%

发文量

117

审稿时长

4-8 weeks

期刊介绍： Clinical Rehabilitation covering the whole field of disability and rehabilitation, this peer-reviewed journal publishes research and discussion articles and acts as a forum for the international dissemination and exchange of information amongst the large number of professionals involved in rehabilitation. This journal is a member of the Committee on Publication Ethics (COPE)