CoChat
Sign Up
Cited by 38Physical Activity and HealthTreatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Comparing the efficacy of different types of exercise for the treatment and prevention of depression in youths: a systematic review and network meta-analysis

Open access
Zhang, Yihan, Li, Geng, Liu, Chengzhen, Guan, Jinliang, Zhang, Yuantong, Shi, Zifu·2023·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2023.1199510PMC PMC10272399
Open this paper in CoChat — free accountOpen PDF

Abstract

Purpose Depression disorder is the most commonly diagnosed type of mental illness among youths. Although a plethora of evidence suggests a positive relationship between exercise and lower levels of depression in youths, the findings regarding the variation in magnitude of this relationship are inconclusive with respect to the preventive and therapeutic effects of different types of exercise. This network meta-analysis aimed to determine the best type of exercise for the treatment and prevention of depression in youths. Methods A comprehensive search of databases, including PubMed, EMBASE, The Cochrane Library, Web of Science, PsychINFO, ProQuest, Wanfang, and CNKI, was conducted to identify relevant research on exercise interventions for depression in youth populations. The risk of bias in the included studies was evaluated using Cochrane Review Manager 5.4 according to the Cochrane Handbook 5.1.0 Methodological Quality Evaluation Criteria. The network meta-analysis was performed using STATA 15.1 to calculate the standardized mean difference (SMD) of all concerned outcomes. The node-splitting method was used to test the local inconsistency of the network meta-analysis. Funnel plots were used to evaluate the potential impact of bias in this study. Result Utilizing data extracted from 58 studies (10 countries, 4,887 participants), we found that for depressed youths, exercise is significantly better than usual care in reducing anxiety (SMD = −0.98, 95% CI [-1.50, −0.45]). For non-depressed youths, exercise is significantly better than usual care in reducing anxiety (SMD = −0.47, 95% CI [ −0.66, −0.29]). In the treatment of depression, resistance exercise (SMD = −1.30, 95% CI [ −1.96, −0.64]), aerobic exercise (SMD = −0.83, 95% CI [-1.10 −0.72]), mixed exercise (SMD = −0.67, 95% CI [−0.99, −0.35]), and mind-body exercise (SMD = −0.61, 95% CI [−0.84, −0.38]) all showed significant efficacy over usual care. For the prevention of depression, resistance exercise (SMD = −1.18, 95% CI [-1.65, −0.71]), aerobic exercise (SMD = −0.72, 95% CI [−0.98, −0.47]), mind-body exercise (SMD = −0.59, 95% CI [-0.93, −0.26]), and mixed exercise (SMD = −1.06, 95% CI [−1.37 to −0.75]) were all significantly effective compared to usual care. According to the test of the surface under the cumulative ranking score (SUCRA), the ranking of exercises for the treatment of depression in depressed youths is as follows: resistance exercise (94.9%) > aerobic exercise (75.1%) > mixed exercise (43.8%) > mind-body exercise (36.2%) > usual care (0%). For the prevention of depression in non-depressed youths, resistance exercise (90.3%) > mixed exercise (81.6%) > aerobic exercise (45.5%) > mind-body exercise (32.6%) > usual care (0%). Resistance exercise thus had the best comprehensive effect on both the treatment and prevention of depression in youths (clusterank value = 1914.04). Subgroup analyses show that a frequency of 3–4 times per week, a duration of 30–60 min, and a length of more than 6 weeks were found to be the most effective interventions for depression (P > 0.001). Conclusion This study provides compelling evidence that exercise is a viable intervention for improving depression and anxiety in young individuals. In addition, the study emphasizes the importance of selecting the appropriate type of exercise to optimize treatment and prevention. Specifically, the results suggest that resistance exercise, performed 3–4 times per week, with sessions lasting 30–60 min and a length of more than 6 weeks, yields optimal results for the treatment and prevention of depression in young individuals. These findings have significant implications for clinical practice, particularly given the challenges associated with implementing effective interventions and the economic burden of treating and preventing depression in young people. However, it is worth noting that additional head-to-head studies are necessary to confirm these findings and strengthen the evidence base. Nevertheless, this study provides valuable insights into the role of exercise as a potential treatment and preventative measure for depression in young people. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=374154 , identifier: 374154.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3389/fpsyt.2023.1199510

Cites

106 of 106 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Histone lactylation is a recently identified post-translational modification in which lactate-derived acyl groups are covalently attached to lysine residues, forming lysine lactylation (Kla).

    “Histone lactylation is a recently identified post-translational modification in which lactate-derived acyl groups are covalently attached to lysine residues, forming lysine lactylation (Kla).”

    From Histone modifications and depression: epigenetic mechanisms, therapeutic targets, and translational outlook (2026) · cites this paper as Zhang et al., 2023

    The Methods (§2.6) describe a network meta-analysis of exercise interventions, and the Discussion (§4.2) addresses exercise and depression in youths. Searches for histone lactylation, lysine lactylation (Kla), and lactate-derived acyl groups found no passage in our copy addressing the claimed modification. (LLM, conf=0.77)

    Experimental — accuracy not yet measured

  • Glycolysis-derived lactate acts as a direct precursor for histone Kla, linking metabolic state to chromatin regulation.

    “Glycolysis-derived lactate has been demonstrated to act as a direct precursor for histone Kla, linking metabolic state to chromatin regulation (Pu et al., 2021; Zhang et al., 2023).”

    From Histone modifications and depression: epigenetic mechanisms, therapeutic targets, and translational outlook (2026) · cites this paper as Zhang et al., 2023

    The Methods (section 2.6) describe a network meta-analysis of exercise interventions, and the supplied Discussion passage (section 4.2) concerns depression in youths. Searches for histone lactylation, Kla, lactate as a precursor, and chromatin regulation found no passage in our full-text copy addressing the attributed mechanism; page numbers were unavailable. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 11

  1. [64]Li N. Experiment on depression and physical exercise intervention among college students. J. Sport. (2001) 4: 32-6. 10.16237/j.cnki.cn44-1404/g8.2001.04.011 · DOI
  2. [65]Jiao H. Effects of aerobic exercise intervention on depression in teacher education college students. Chin J Health Psychol. (2010) 18: 939– 41. 10.13342/j.cnki.cjhp.2010.08.035 · DOI
  3. [70]Guan S Li Q Zhang S. The effect of strength training on depression and monoamine levels in depressed female college students. J Wuhan Instit Phys Educ. (2018) 10: 7— 4. 10.15930/j.cnki.wtxb · DOI
  4. [71]Li H. An experimental study of aerobics exercise to alleviate depression in female college students. J Taiyuan City Vocat Technol Coll. (2012) 9: 107– 9. 10.16227/j.cnki.tycs.2012.09.09736760533 · DOI
  5. [85]Yu L Xia J Yi G Chen J Zhao K. (2022). The effects of cheerleading integration inside and outside the classroom on depression and body self-esteem of depressed female college students. Psychol Month. (2022) 17: 5– 7+67. 10.19738/j.cnki.psy · DOI
  6. [96]Wenbo L. Research on the impact of ball sports intervention on college students' mental health. J Beijing Sport Univ. (2008) 7: 951– 3. 10.19582/j.cnki.11-3785/g8.2008.07.029 · DOI
  7. [105]He L. An experimental study on the effects of physical activity on college students' moods and emotions. J Beijing Sports Univ. (2007) 4: 481– 482+488. 10.19582/j.cnki.11-3785/g8 · DOI
  8. [106]Chen C. An experimental study on the effect of basketball on the mental health of general male college students. J Guangzhou Instit Phys Educ. (2009) 29: 80– 2. 10.13830/j.cnki.cn44-1129/g8.2009.06.020 · DOI
  9. [108]Fan Y. The effect of strength exercise on depression level of college students. Shandong Sports Sci Technol. (2003) 1: 47– 8. 10.14105/j.cnki.1009-9840.2003.01.019 · DOI
  10. [109]He Y Ji L. The effect of different types of physical exercise on depression level of college students and its psychological mediating variable (Body-esteem). Sports Sci. (2004) 5: 32– 35+52. 10.16469/j.css.2004.05.011 · DOI
  11. [146]Coalter F. The Social Benefits of Sport, Vol. 17. Edinburgh: SportScotland (2005).

Cited by

Sorted by citations

Related

Authors
Zhang, Y., Li, G., Liu, C., Guan, J., Zhang, Y., & Shi, Z.
Affiliations
Hunan Normal University (CN)
Corresponding author
Shi, Zifu
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2023-06-02
Volume
14
Pages
1199510-1199510
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2023.1199510
PMC
PMC10272399
OpenAlex
W4379231260
Cited by
38
References
106
Citations by year
2026: 11 · 2025: 12 · 2024: 14 · 2023: 1
FWCI
1.35
Type
journal article
Language
en
Update notices
corrigendum (2023-10-10)
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
adolescent depression, exercise intervention, depression prevention, resistance training, aerobic exercise, mind-body exercise, anxiety reduction, exercise type comparison, usual care comparison, risk of bias, depression treatment efficacy, school-based mental health programs, exercise duration, exercise frequency

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review