Many studies have shown that exercise reduces clinicianrated
and self-reported depressive symptoms, increases
remission rates, and improves psychosocial function for
individuals with depression. Exercise is shown to be effective
in a wide range of populations across the life span
and in special populations (eg, pregnant women). In addition,
improvements have been made using exercise in a
variety of settings (eg, group vs individual, supervised vs
unsupervised) and when exercise is conducted alone or in
combination with other antidepressant treatments, such as
pharmacotherapy or psychotherapy. Although the bulk of
research in this area clearly has been conducted with aerobic
exercise, the benefi ts are not limited to aerobic exercise,
as other activities (eg, weight training) also have been associated
with reduced depressive symptomatology. In spite of
the evidence supporting the use of exercise as a treatment
for depression, some methodologic limitations must be considered
in developing future randomized controlled trials.
These limitations include the following: 1) sample heterogeneity,
with respect to both diagnosis of depression and
concomitant treatments; 2) lack of adequate control groups;
3) inadequate diagnostic evaluation; 4) small sample sizes;
5) failure to use intent-to-treat analyses; and 6) inadequate
evaluation of symptoms (eg, only self-reported symptoms
or unblinded evaluations). Many trials currently under way
have been designed to address these limitations and will
inform the fi eld regarding the clinical utility of exercise and
guide future research in this area [