Optimal exercise modality and dose to improve depression in children and adolescents: A systematic review and Bayesian network meta-analysis
- Forfatter(e)
- Hu, Jinping, Li, Dandan, Zhao, Yan, Deng, Yiran
- År
- 2026
- Tidsskrift
- Frontiers in Psychology Vol 17 2026, ArtID 1847609
- Volum
- 17
- Kategori(er)
- Depresjon og nedstemthet (inkl. både vansker og lidelse)
- Tiltakstype(r)
- Fysisk aktivitet
- Abstract
Objectives: To determine the comparative efficacy of different exercise interventions on depressive symptoms in children and adolescents and to explore the precise non-linear dose–response relationship using Bayesian model-based network meta-analysis.
Methods: A systematic search of four major databases (PubMed, Web of Science, PsycINFO, and Scopus) was conducted up to October 2024 for randomized controlled trials (RCTs). We employed pairwise, network, and dose–response metaanalyses to synthesize evidence regarding exercise modalities and dosage. Risk of bias was assessed using the Cochrane tool. Results: A total of 26 RCTs involving 3,507 participants were included. Network meta-analysis revealed that Group Training (SMD = −1.58, 95% CI: −2.54 to −0.62) and Aerobic Exercise (SMD = −0.60, 95% CI: −1.10 to −0.10) were effective interventions for alleviating depressive symptoms. In contrast, no statistically significant effects were observed for Mixed Training or Mind–Body Exercise, and the evidence for these modalities remained inconclusive. Dose–response modeling indicated a nonlinear curvilinear pattern rather than evidence of symptom worsening at higher doses. The minimum dose associated with a statistically significant effect was 360 METs-min/week, the estimated peak benefit occurred at 660 METs-min/week, and the effect attenuated and became statistically uncertain beyond 980 METs-min/week.
Conclusion: Group Training and Aerobic Exercise are the optimal intervention modalities, demonstrating high therapeutic potency and intervention efficiency, respectively. The identified therapeutic window (360–980 METs-min/week) supports a “low-dose initiation and moderation” prescription strategy. However, due to the heterogeneity of the included studies, these findings should be interpreted with caution, and future high-quality trials are warranted.
Systematic review registration: https://www.crd.york.ac.uk/prospero/display_ record.php?ID=CRD42024596771, Registration number: CRD42024596771.