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Effect and acceptability of different exercise modes on adult patients with clinically diagnosed depression: a network meta-analysis

2025 network meta-analysis (58 articles / 62 RCTs, n=3,751) in clinically diagnosed depression reports all three pooled exercise classes—aerobic, mind-body, and resistance training—beat routine/waitlist controls (P<0.05) while mind-body exercise showed higher efficacy than aerobic exercise (SMD −0.43; 95% CI −0.82 to −0.04); acceptability rankings favoured aerobic exercise over mind-body and resistance training.

Design

  • Corpus: 58 publications / 62 RCTs, n = 3,751 adults with clinically diagnosed depression
  • Exercise classes pooled: aerobic, mind-body, resistance training
  • Framework: PRISMA-NMA + CINeMA confidence grading

Efficacy vs control (abstract)

All three modalities significantly outperformed routine control / waitlist on depression scales (P < 0.05).

Head-to-head (abstract)

  • Mind-body vs aerobic: SMD −0.43 (95% CI −0.82 to −0.04; P < 0.05) favouring mind-body
  • SUCRA efficacy ranking: mind-body (94.1%) > resistance (81.0%) > aerobic (63.9%)

Acceptability (abstract)

SUCRA acceptability: aerobic (67.1%) > mind-body (61.5%) > resistance (39.3%)

Evidence hygiene

“Mind-body” bundles heterogeneous programmes (often Tai chi / yoga-like curricula)—do not merge pooled ranks with single-brand trials. Dropout/acceptability differences may drive real-world effectiveness away from SUCRA rankings.

Publication

Zhang S, Yang J, Chen J, et al. Sci Rep. 2025 Sep 29;15(1):33478. doi: 10.1038/s41598-025-14648-y. PMID 41022903.

Outcomes

  • Effect Size (Cohen's d / SMD)
    -0.43
    d (Cohen's d)
  • SUCRA efficacy ranking (abstract): mind-body exercise 94.1% > resistance training 81.0% > aerobic exercise 63.9%; acceptability ranking favoured aerobic exercise.
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