Cited by 239Physical Activity and HealthDementia and Cognitive Impairment ResearchTranscranial Magnetic Stimulation Studies

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Physical exercise improves quality of life, depressive symptoms, and cognition across chronic brain disorders: a transdiagnostic systematic review and meta-analysis of randomized controlled trials

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Dauwan, Meenakshi, Begemann, Marieke J. H., Slot, Margot I. E., Lee, Edwin H. M., Scheltens, Philip, Sommer, Iris E. C.·2021·Journal of Neurology

DOI 10.1007/s00415-019-09493-9PMC PMC7990819

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Abstract

We performed a meta-analysis to synthesize evidence on the efficacy and safety of physical exercise as an add-on therapeutic intervention for quality of life (QoL), depressive symptoms and cognition across six chronic brain disorders: Alzheimer’s disease, Huntington’s disease, multiple sclerosis, Parkinson’s disease, schizophrenia and unipolar depression. 122 studies ( = k ) ( n = 7231) were included. Exercise was superior to treatment as usual in improving QoL ( k = 64, n = 4334, ES = 0.40, p < 0.0001), depressive symptoms ( k = 60, n = 2909, ES = 0.78, p < 0.0001), the cognitive domains attention and working memory ( k = 21, n = 1313, ES = 0.24, p < 0.009), executive functioning ( k = 14, n = 977, ES = 0.15, p = 0.013), memory ( k = 12, n = 994, ES = 0.12, p = 0.038) and psychomotor speed ( k = 16, n = 896, ES = 0.23, p = 0.003). Meta-regression showed a dose–response effect for exercise time (min/week) on depressive symptoms ( β = 0.007, p = 0.012). 69% of the studies that reported on safety, found no complications. Exercise is an efficacious and safe add-on therapeutic intervention showing a medium-sized effect on QoL and a large effect on mood in patients with chronic brain disorders, with a positive dose–response correlation. Exercise also improved several cognitive domains with small but significant effects.

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Fig. 1 PRISMA flow chart of the literature search. AD Alzheimer’s disease, HD Huntington’s disease, MS multiple sclerosis, PD Parkinson’s disease, Sz schizophrenia, UD unipolar depressionCC BY · PubMed Central

Fig. 2 Meta-analysis of the effect of physical exercise on quality of life. Effect sizes (ES) per study and the overall ES are in Hedges’ g with corresponding p values and sample size of the intervention and control group. Standardized residual z scores of ES were used to detect outlier studiesCC BY · PubMed Central

Fig. 3 Meta-analysis of the effect of physical exercise on depressive symptoms. Effect sizes (ES) per study and the overall ES are in Hedges’ g with corresponding p values and sample size of the intervention and control group. Standardized residual z scores of ES were used to detect outlier studiesCC BY · PubMed Central

Fig. 4 Meta-analysis of the effect of physical exercise on the cognitive domains (from top to down) attention and working memory, executive functioning, memory, psychomotor speed, verbal fluency and global cognition. Effect sizes (ES) per study and the overall ES are in Hedges’ g with corresponding p values and sample size of the intervention and control group. Standardized residual z scores of ES were used to detect outlier studiesCC BY · PubMed Central

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“Excluding eight outliers [75, 101, 104, 108, 112, 159, 220, 221], seven small studies (n < 20) [68, 82, 87, 95, 190, 207, 225] and two”
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See all 239

Authors: Dauwan, M., Begemann, M. J. H., Slot, M. I. E., Lee, E. H. M., Scheltens, P., & Sommer, I. E. C.
Affiliations: University Medical Center Groningen (NL)
University Medical Center Utrecht (NL)
Queen Mary Hospital (CN)
Amsterdam Neuroscience (NL)
Corresponding author: Dauwan, Meenakshi
ORCID: Dauwan, Meenakshi
Begemann, Marieke J. H.
Slot, Margot I. E.
Lee, Edwin H. M.
Scheltens, Philip
Sommer, Iris E. C.
Venue: Journal of Neurology
Publisher: Springer Science and Business Media LLC
Published: 2019-08-14
Volume: 268
Issue: 4
Pages: 1222-1246
ISSN: 0012-1037 (ISSN-L)
0340-5354
1432-1459
DOI: 10.1007/s00415-019-09493-9
PMC: PMC7990819
OpenAlex: W2968168409
Cited by: 239
References: 261
Citations by year: 2026: 23 · 2025: 45 · 2024: 42 · 2023: 44 · 2022: 45 · 2021: 19 · 2020: 16 · 2019: 5
FWCI: 2.52
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0 (tdm)
creativecommons.org/licenses/by/4.0 (vor)
Locations: Journal of Neurology (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Pure Amsterdam UMC (acceptedVersion, cc-by)
NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion, other-oa)
University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Funders: zonmw (40-00812-98-13009)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
Keywords: physical activity, quality of life, depressive symptoms, cognition, Alzheimer's disease, Huntington's disease, multiple sclerosis, Parkinson's disease, schizophrenia, major depressive disorder, executive function, memory, attention, working memory, psychomotor speed, dose-response relationship, exercise safety, adjunctive therapy
MeSH terms: Cognition, Depression, Humans, Parkinson Disease, Quality of Life, Exercise, Randomized Controlled Trials as Topic

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Physical exercise improves quality of life, depressive symptoms, and cognition across chronic brain disorders: a transdiagnostic systematic review and meta-analysis of randomized controlled trials

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