Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials.

OBJECTIVE: To identify the optimal dose and modality of exercise for treating major depressive disorder, compared with psychotherapy, antidepressants, and control conditions. DESIGN: Systematic review and network meta-analysis. METHODS: Screening, data extraction, coding, and risk of bias assessment were performed independently and in duplicate. Bayesian arm based, multilevel network meta-analyses were performed for the primary analyses. Quality of the evidence for each arm was graded using the confidence in network meta-analysis (CINeMA) online tool. DATA SOURCES: Cochrane Library, Medline, Embase, SPORTDiscus, and PsycINFO databases. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Any randomised trial with exercise arms for participants meeting clinical cut-offs for major depression. RESULTS: 218 unique studies with a total of 495 arms and 14 170 participants were included. Compared with active controls (eg, usual care, placebo tablet), moderate reductions in depression were found for walking or jogging (n=1210, κ=51, Hedges' g -0.62, 95% credible interval -0.80 to -0.45), yoga (n=1047, κ=33, g -0.55, -0.73 to -0.36), strength training (n=643, κ=22, g -0.49, -0.69 to -0.29), mixed aerobic exercises (n=1286, κ=51, g -0.43, -0.61 to -0.24), and tai chi or qigong (n=343, κ=12, g -0.42, -0.65 to -0.21). The effects of exercise were proportional to the intensity prescribed. Strength training and yoga appeared to be the most acceptable modalities. Results appeared robust to publication bias, but only one study met the Cochrane criteria for low risk of bias. As a result, confidence in accordance with CINeMA was low for walking or jogging and very low for other treatments. CONCLUSIONS: Exercise is an effective treatment for depression, with walking or jogging, yoga, and strength training more effective than other exercises, particularly when intense. Yoga and strength training were well tolerated compared with other treatments. Exercise appeared equally effective for people with and without comorbidities and with different baseline levels of depression. To mitigate expectancy effects, future studies could aim to blind participants and staff. These forms of exercise could be considered alongside psychotherapy and antidepressants as core treatments for depression. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018118040.

Effects of Whole-Body Vibration Therapy in Patients with Fibromyalgia: A Systematic Literature Review.

Objective. To review the literature on the effects of whole-body vibration therapy in patients with fibromyalgia. Design. Systematic literature review. Patients. Patients with fibromyalgia. Methods. An electronic search of the literature in four medical databases was performed to identify studies on whole-body vibration therapy that were published up to the 15th of January 2015. Results. Eight articles satisfied the inclusion and exclusion criteria and were analysed. According to the Dutch CBO guidelines, all selected trials had a B level of evidence. The main outcomes that were measured were balance, fatigue, disability index, health-related quality of life, and pain. Whole-body vibration appeared to improve the outcomes, especially balance and disability index. Conclusion. Whole-body vibration could be an adequate treatment for fibromyalgia as a main therapy or added to a physical exercise programme as it could improve balance, disability index, health-related quality of life, fatigue, and pain. However, this conclusion must be treated with caution because the paucity of trials and the marked differences between existing trials in terms of protocol, intervention, and measurement tools hampered the comparison of the trials.

Using whole-body vibration training in patients affected with common neurological diseases: a systematic literature review.

OBJECTIVES: This systematic review critically evaluates the effects of whole body vibration (WBV) exercises on gait, balance, proprioception, strength, and health-related quality of life in patients with common neurological diseases. It specifically focuses on assessing the quality of reported studies and comparing quantitative results. DESIGN: This is a systematic literature review. RESULTS: A specific search strategy of 11 databases identified 13 published articles (5 studies of patients with Parkinson disease, 2 with cerebral palsy, 3 with multiple sclerosis, and 3 with stroke) that fulfilled the selection criteria. The quality of the articles was evaluated using a Physiotherapy Evidence Database scale and Dutch Institute for Healthcare Improvement guidelines. CONCLUSIONS: There is moderate evidence that one session of WBV has positive effects on strength, whereas there is a weak level of evidence that WBV could improve proprioception and health-related quality of life measures in neurological patients. With respect to long-term effects of WBV, there is minor evidence from the studies with the best methodological quality that WBV improves strength, proprioception, gait, and balance. Further research on the intervention is strongly needed.

Tilting Whole Body Vibration improves quality of life in women with fibromyalgia: a randomized controlled trial.

OBJECTIVES: The aim of this study was to analyze the effect of 12-week tilting Whole Body Vibration therapy (WBV) on Health Related Quality of Life (HRQoL) in fibromylagia (FM) within the context of a randomized control trial (ISRCTN16950947). SUBJECTS AND METHODS: Thirty-six (36) women with FM were randomly allocated to either an exercise or a control group. The women in the exercise group were assigned to a 12-week course of tilting WBV (12.5-Hz frequency; 3-mm amplitude). HRQoL was assessed using the Fibromyalgia Impact Questionnaire (FIQ) and a 15D questionnaire. RESULTS: A 12-week course of tilting WBV therapy was associated with improvements in FIQ scores (12%) but not in the 15D questionnaire. CONCLUSIONS: Tilting WBV was a feasible intervention that prevented the loss of HRQoL in previously physically untrained women with FM.