Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials
BMJ Bayesian network meta-analysis spanning 218 studies and ~14,170 participants with major depression finds moderate effect sizes favouring walking/jogging, yoga, strength training, mixed aerobic exercise, and tai chi or qigong versus active controls; effects scaled with prescribed intensity, but CINeMA confidence was low to very low because almost all trials failed strict low risk-of-bias criteria.
Design
- Model: Bayesian arm-based network meta-analysis (PROSPERO CRD42018118040)
- Corpus: 218 unique studies, 495 arms, ~14,170 participants meeting MDD clinical thresholds
- Comparators: included active controls (e.g. usual care, placebo tablet) in primary contrasts
Pooled Hedges' g vs active controls (abstract headline examples)
- Walking or jogging: g −0.62 (95% CrI −0.80 to −0.45; κ = 51 study arms contributing)
- Yoga: g −0.55 (−0.73 to −0.36)
- Strength training: g −0.49 (−0.69 to −0.29)
- Mixed aerobic modalities: g −0.43 (−0.61 to −0.24)
- Tai chi or qigong: g −0.42 (−0.65 to −0.21)
Dose / acceptability
Abstract: benefits increased with prescribed intensity; strength training and yoga looked most acceptable (dropout narratives)—read supplement for SUCRA tables.
Evidence hygiene
Authors stress only one included trial met full Cochrane low risk-of-bias criteria → CINeMA confidence low for walking/jogging and very low for several other nodes—use alongside Krogh 2017 / Recchia 2022 rather than as standalone guideline replacement.
Publication
Noetel M, Sanders T, Gallardo-Gómez D, et al. BMJ. 2024 Feb 14;384:e075847. PMID 38355154.
Outcomes
- Effect Size (Cohen's d / SMD)-0.62d (Cohen's d)
- Effect Size (Cohen's d / SMD)-0.55d (Cohen's d)