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Effects of exercise on depression in patients with rheumatic diseases: a systematic review and meta-analysis

Auswirkungen von körperlicher Betätigung auf eine Depression bei Patienten mit rheumatischen Erkrankungen: systematische Übersicht und Metaanalyse

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Abstract

Objective

To assess the effects of exercise intervention on depression in rheumatic diseases by means of a meta-analysis.

Methods

The Cochrane Library, Embase, Medline, PubMed, and relevant records were searched. The qualities of randomized controlled trials were evaluated. Meta-analysis of the obtained related data was completed using RevMan 5.3. Heterogeneity was also evaluated with χ2 test and I2.

Results

Twelve RCTs were reviewed. Compared with baseline, the meta-analysis results showed that there was significant difference in the improvement of depression assessed by HADs, BDI, CES‑D, and AIMS in patients with rheumatic diseases (post exercise vs. baseline, −0.73 [−1.05, −0.4], P < 0.0001, I2 = 0%). In subgroup analysis, although none of these trends in BDI and CES‑D subgroups were significant at P < 0.05, there were clear trends towards improvement in depression.

Conclusion

As an alternative or supplementary treatment, the effect of exercise on rheumatism is obvious. Rheumatologists can consider exercise as an integral part of the treatment of patients with rheumatism.

Zusammenfassung

Ziel

Um die Auswirkungen körperlicher Betätigung auf eine Depression bei Patienten mit rheumatischen Erkrankungen zu untersuchen, wurde eine Metaanalyse erstellt.

Methoden

Dazu wurden die Datenbanken Cochrane Library, Embase, Medline, PubMed und relevante Dokumente durchsucht. Die Qualität der randomisierten kontrollierten Studien (RCT) wurde bewertet. Unter Einsatz der Review-Manager-Software RevMan 5.3 der Cochrane Collaboration wurde die Metaanalyse der erfassten geeigneten Daten vervollständigt. Auch die Heterogenität wurde beurteilt, dazu wurden der χ2-Test und I2 verwendet.

Ergebnisse

Es wurden 12 RCT ausgewertet. Im Vergleich zur Baseline zeigten die Ergebnisse der Metaanalyse, dass ein signifikanter Unterschied hinsichtlich der Verbesserung einer Depression, beurteilt anhand von Hospital Anxiety Depression Scale (HADS), Beck-Depressions-Inventar (BDI), Center for Epidemiological Studies Depression Scale (CES-D) und Arthritis Impact Measurement Scales (AIMS), bei Patienten mit rheumatischen Erkrankungen bestand (nach körperlicher Betätigung vs. Baseline: −0,73 [−1,05 bis −0,4]; p < 0,0001; I2 = 0 %). In der Subgruppenanalyse gab es eine deutliche Tendenz zu einer Verbesserung der Depression, obwohl keiner dieser Trends in den Subgruppen BDI und CES‑D bei p < 0,05 signifikant war.

Schlussfolgerung

Als alternative oder ergänzende Behandlung ist der Effekt von körperlicher Betätigung auf rheumatische Erkrankungen offensichtlich. Körperliche Betätigung kann von Rheumatologen als integraler Bestandteil der Behandlung von Patienten mit rheumatischen Erkrankungen betrachtet werden.

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Acknowledgements

This work was supported by the Science and Technology Project of Nantong City (MSZ21043).

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Authors and Affiliations

  1. Nanjing University of Traditional Chinese Medicine, 210023, Nanjing, China

    Yanfeng Bao & Chun Cheng

  2. Department of Rheumatology, Affiliated Hospital of Nantong University, 226001, Nantong, China

    Yanfeng Bao, Qian Liang, Juan Ji, Chen Dong & Rui Zhao

  3. Medical College, Nantong University, 226001, Nantong, China

    Qian Liang & Chen Dong

  4. Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, China

    Qian Liang, Chen Dong & Rui Zhao

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  1. Yanfeng Bao
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Correspondence to Chen Dong or Rui Zhao.

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Conflict of interest

Y. Bao, Q. Liang, J. Ji, C. Cheng, C. Dong, and R. Zhao declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies mentioned were in accordance with the ethical standards indicated in each case.

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Ulf Müller-Ladner, Bad Nauheim

Uwe Lange, Bad Nauheim

Yanfeng Bao and Qian Liang contributed equally to this work.

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Bao, Y., Liang, Q., Ji, J. et al. Effects of exercise on depression in patients with rheumatic diseases: a systematic review and meta-analysis. Z Rheumatol 83 (Suppl 1), 40–47 (2024). https://doi.org/10.1007/s00393-023-01321-w

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  • DOI: https://doi.org/10.1007/s00393-023-01321-w

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