Exercise and the Treatment of Depression a Review of the Exercise Program Variables

Abstract

Context:

There is an increasing interest to notice how exercise affects depression symptoms. Although recent findings confirm the positive result of exercise on depression, there is no articulate guideline regarding advice on exercise for patients with depression. The following review aims at presenting the contemporary literature regarding the nature of depression, exercise, the underlying mechanisms and the management of an do program in individuals with depression.

Evidence Acquisition:

Nosotros searched electronic databases including Cochrane Library, PubMed, ISI web of knowledge and PsychInfo (from January 2000 to October 2014). We reviewed the systematic reviews, meta-analyses, and large-scale randomized control trials on effects of practice on low.

Results:

Recent evidence has emerged on characteristics of effective exercise programs and those patients with low that will most do good from the do programs. However due to the methodological weaknesses and inconsistencies of studies, conclusions must be fabricated with caution.

Conclusions:

We accept provided a number of recommendations for clinicians and researchers who plan to use exercise protocols in depression.

Keywords

Depression Exercise Encephalon Physical Activity Depressive Symptoms Antidepressant Outcome

1. Context

Increasing incidence of depression with almost 340 million people that have been involved worldwide places a huge brunt on our health. In this way, depression will be the 2d cause of mortality and morbidity, only after heart disease in 2020 (1). Diagnostic and Statistical Manual of Mental Disorders places greater emphasis on depressive mood or loss of interest as the main symptoms of low (2). Nonetheless, findings show that depression is often accompanied past other problems such as depression level of concrete activity (3). Furthermore, a lot of research has been done to assess how physical action (e.g. exercise) and depression influence each other (four-6). Indeed, the big result sizes especially in clinically depressed samples indicate that exercise is an effective handling for major depressive disorder (MDD) (7). The main results from several meta-analyses show that do has an antidepressant effect compared with control conditions that ranges from slightly moderate to very large (8, 9). Although some studies indicate that exercise does not differ from traditional handling (antidepressant medication or psychotherapy) in reducing depression symptoms (10), exercise combined with psychotherapy appears to produce even better results than either by itself (xi). Moreover, exercise training is cheap and at that place is no stigma attached to exercise (12, 13). In other words, practice is safety and has no side effects, thus it is more reliable than medications peculiarly for some patients such as pregnant women and children (14, 15). Deslandes et al. reported that clinically depressed patients could significantly reduce the dose of medication when they exercised (16, 17). Furthermore, in a 6 calendar month follow-upwardly report, Babyak et al. (18) showed that depressed patients, assigned to the aerobic training plan, were less likely to relapse than patients who were assigned to receive medication treatment. Many people with depression limited frustration about the usual intendance, citing reasons such as inadequate symptom direction, unacceptable side effects, and inadequate methods for coping (19). Information shows that negative attitudes to psychotherapy have led to increased involvement in alternative treatment options for low. Keeping in mind that practice shows no medication side effects such as withdrawal symptoms (20), weight gain , dry oral cavity, or insomnia (21), but shows potential health benefits, such every bit weight reduction, it is highly recommended to use practise as an adjunctive treatment for depression (22). New findings ostend that exercise can be recommended as a first-line treatment for balmy to moderate depression; as an adjunct to medications (23); as an alternative to cognitive behavioral therapy (11); and in preventing depression in clinical too equally healthy populations (24-26). However, many questions are still open. For case, it is not clear what type of do can comprehend a wide range of patients with depression. We aimed to present the electric current state of knowledge on the nature of the relationship between exercise and low and present the current country of art in management of an exercise program for individuals with depression.

two. Evidence Acquisition

We reviewed papers published from Jan 2000 to October 2014, consulting the following databases: Cochrane Library, PubMed, ISI web of knowledge, and PsychInfo. We developed a search strategy for each electronic database using the combination of word terms: depression, major low, depressive symptoms, physical activity, practice, intervention, treatment, and antidepressant furnishings. Nosotros also manually searched reference lists of selected papers for further relevant publications. Finally we reviewed the scientific articles included systematic reviews, meta-analyses and big-scale randomized control studies examining the efficacy of do treatments for low.

3. Results

3.1. Patients' Characteristics

Before deciding to propose do as a handling for individuals with depression, it is recommended to monitor the important variables and enroll eligible patients in intervention programs. Sociodemographics (e.g. age, sex, race/ethnicity, marital status, and occupation), body mass index (BMI), level of disability, family history of depression, level of physical activity, genetic, and personality factors tin influence the extent to which physical activity and depressive symptoms are related on an individual footing. General health indices should also exist considered at initial assessment sessions (27). Furthermore, patients' perceptions and views nearly therapy; history of contempo major stressful life events (28), mobility status and the need of assistive device, and available facilities and instruments should be considered during patient enrollment. It is also important to ensure that acceptable supervision and follow upwards services are available (29). Still, presence of the post-obit items may decrease the success rate of exercise treatment: suicidal tendency, psychosis, mania, medical atmospheric condition making do hard, hospitalization or surgery in the past month and changes in antidepressant medication dosing over the past month (30). Existing theories and models indicate how biological, psychosocial, and environmental factors mediate the upshot of practice on depression (Figures 1 and 2) (31). For instance, when considering socioeconomic class and educational level, people with higher education levels and income status may have more information nearly treatment options and the likelihood of success in relieving low than those with lower levels (32). Family history of low is a proxy for genetics, which modifies the relation betwixt concrete activeness and depressive symptoms (33). It is also important to consider gender differences in designing exercise programs since women report more depressive symptoms and less frequently involve in physical activity than men (34). Indeed practise can be recommended for people with depressive disorders within every demographic grouping independent of their socioeconomic status, though a stronger result has been indicated in women, people over historic period xl, and individuals with obesity or disability (32, 35) (see Box one). Keeping in mind different types of depression (MDD, mild depression, not-clinical population with depressive symptoms), exercise can be recommended depending on individual needs and preferences. Meta-assay studies indicate that clinical patients with moderate to severe depression who did exercises, written report greater reductions in depressive symptoms than other patients. Some authors are still concerned nigh compliance of depressive patients with their exercise program; though others believe that even patients with MDD are able to consummate an exercise plan like to healthy controls (7, 36). Studying other types of low has been of recent involvement in the literature (Box 2). For instance, findings have clearly illustrated that do during pregnancy benefits mental and physical health of the mother and fetus with depression hazard of injury (37). Information technology is as well shown that exercise can be effective as an adjunctive handling for postnatal depression though many aspects of this interaction remain provisional and require confirmation (38).

Figure 1. Biological Effects of Do on Patients with Depression

Figure 2. Psychosocial Effects of Exercise on Patients With Low

Box 1. Patients With Low Who May Particularly Benefit From Exercise Programs

Patients Characteristics
≤ xx or ≥ 40 years onetime
Higher educational condition
Higher physical condition
Females rather than males
Untrained patients
Those with balmy to moderate depression

Box 2. Depressive Disorders Other Than Major Low That May Benefit From Exercise Programs

Types of Depression	Definition
Dysthymia	Dysthymia is a mild just long-term form of depression. Symptoms usually last for at least 2 years.
Atypical depression	This blazon involves only some of the symptoms of major depression. Common symptoms of singular depression include increased appetite or weight gain, sleepiness or excessive slumber, and feeling extremely sensitive to rejection.
Seasonal depression	Seasonal depression, too known as winter depression or blues, summer low or blues, was considered a mood disorder in which people who take normal mental health throughout nearly of the yr, experience depressive symptoms in the wintertime or summer.
Bipolar low	Bipolar disorder (manic-depressive disorder) is diagnosed in individuals experiencing episodes of a frenzied mood known every bit mania, typically alternate with episodes of low.
Postnatal low	Postnatal depression or postpartum depression is a type of clinical depression which can affect women, and less often men, typically later on childbirth. It usually develops in the first four to 6 weeks after childbirth, even may develop after several months. However many women are non enlightened they have the status. Mutual symptoms are low mood, feeling unable to cope and difficulty sleeping.
Premenstrual syndrome	Premenstrual syndrome is a collection of emotional symptoms, with or without physical symptoms, related to a adult female's menstrual bike.

iii.2. Exercise Characteristics

Later on a long discussion on the question nigh type of practise, information technology seems that both aerobic (due east.k. running, swimming) and anaerobic (e.g. resistance training) exercises are constructive in decreasing low symptoms and enhancing positive mood in patients (11).

Yet, there are a few difficulties related to resistance grooming interventions. They demand more than physical space, fiscal investment and qualified supervision. This may suggest the aerobic exercise as an easier option to apply (39). For example, walking as an aerobic do may be a cost-effective choice for the treatment of low though stationary cycles or treadmill are alternatives (40, 41). Surprisingly, recent data show that increasing lifestyle physical activities (due east.grand. occupational, recreational, household, and transportation) may also assistance to decrease depressive symptoms (42). Another important question is whether grouping or individual exercise programs influence depression outcomes equally (43). There are many benefits achieved via grouping exercise, as enhancing the perception of enjoyment, feeling of belonging in a social context and social support (44). Grouping exercises are recommended specially for women, adolescents, people under stressful weather and chronically ill people (45). It seems that opportunities available through the grouping exercises, such every bit connection, sharing experiences, social skills training, and motivating and encouraging temper tin help to decrease depressive symptoms (10). On the other hand, a few people may prefer to bring together individual exercise programs. Studies indicated the value of individual piece of work out sessions in skill grooming, and too a realistic goal setting due to the patient power. The individual exercise sessions have an additive effect on improving participant compliance for treatment plan (46). Another strategy is the utilize of supervised exercise programs. A few studies back up that supervised do may assistance to heighten adherence to intervention programs though there are many aspects which remain to exist elucidated (11). Withal, nevertheless the decision of how constantly to pursue each strategy (e.g. group program, supervised practise) rests on the judgment of the investigator or practitioner (BOX iii). There are also many controversies nigh the all-time intensity of exercise programme to improve depressive symptoms. For example, it has been shown that in that location is no meaning difference between a loftier intensity aerobic practise (65-75% VO₂max reserve), low intensity aerobic exercise (xl-55% VO_twomax reserve), or a stretching program in the reduction of depressive symptoms (46). Regarding practise duration, there is no significant difference between training three and five days/ week. Furthermore, similar to the recommendations from the American College of Sports Medicine, an energy expenditure of 17 kcal/ kg/ week or at to the lowest degree 150 min/week will be the all-time practice for handling of patients with depression (47). Considering all factors, it is recommended that moderate-intensity training (lxx% of one-repetition maximum) and 30 minutes on almost, if not all days of the week in adults and twice a week in elderly subjects is the all-time status to achieve immediate, large, and indelible anti-depressant furnishings . Also it is recommended that the positive effects of practice are larger when continued at to the lowest degree 10 weeks and, preferably, greater than 15 weeks (Box 3). As a caution, in that location is no linear correlation between intensity of practice and its positive effects since too high-intensity exercise may create hatred toward it and take negative consequences (48). Another important implication for practitioners is that the context of physical activity (e.g. where, when, and with whom) may be more important than the absolute intensity, duration and frequency of exercise. The success rate of practice therapy is also associated with adherence to the exercise program. Equally a strategy to retain subjects in the exercise group, using music or games and including enjoyable, preferred, and recreational activities are helpful (49). Also, behavioral techniques (e.g. class handouts, daily logs) may facilitate adherence to the home exercise programs (50). For example, the daily exercise logs tin can play a key motivator for regular practice during the intervention menstruum and assist to develop advisable goals, reach self-regulation, and adhere to interventions (51). Farther, advice modalities including telephone interviews, consultations, texting, leaflets, and utilise of word-of-mouth could also be implemented by intervention team (27).

Box 3. The Characteristics of an Exercise Program That Will Maximize the Anti-Depressive Backdrop ^a

Exercise Characteristics
Structured do (SIGN and Dainty)
Aerobic do (e.m. cycling), resistance exercise (e.g. weight lifting ) or mixed exercise
Supervised exercise (SIGN and NICE)
Low to moderate intensity (regarding patient preference)
45 min to 1 h/ session (NICE)
At least three to 4 times weekly, ≥ 150 min/week
Course duration ≥ 10 weeks (Nice)
Individually tailored practise
Practice as an adjunct therapy to medication

^a Abbreviations: Squeamish, National Institute for Health and Care Excellence; SIGN, Scottish Intercollegiate Guidelines Network.

3.iii. A Multidisciplinary Approach

It is very beneficial to encourage physicians and practise specialists to work in collaboration on depression and exercise treatments. It seems that most medical professionals have piddling or no training in practice programs and exercise specialists are non familiar with the clinical population especially depressed patients. Physicians' recommendation is often limited to "get more do" while the practice specialist may suggest physical activities that are not actually useful for patients with depression. However, with a multidisciplinary team, it is possible to prescribe an exercise plan more safely, efficiently, operatively, objectively, and realistic (52). Such a multidisciplinary squad may include a psychiatrist or clinical psychologist, sports medicine specialist and exercise trainer.

4. Discussion

Although contempo findings have shown that practice tin subtract depressive symptoms, there are still many questions and limitations to wider application of exercise in low. For example, there are deficiencies in methodological planning such as uncontrolled nonrandomized trials, small sample sizes, inadequate allotment concealment, lack of intention-to-treat analyses, non-blinded outcome assessments, and inclusion of subjects without clinical diagnosis that limit the interpretability of research outcomes (53). It has non appeared as yet which blazon of control group (waiting list, usual care, or placebo) is the almost suitable group to compare the experimental group with. Another of import question is to what extent and how long the exercise programs will influence the low or depressive symptoms. Furthermore, the effects of sedentary state rather than practise behaviour on the human relationship between practice and low have not been explored nevertheless. There are bereft data to support or refute do for treating less common types of depression such as postpartum blues, seasonal, bipolar depression, depression with chronic diseases, and premenstrual depressive symptoms (11). In that location are however many questions on biological effects of exercise grooming on low. Although exercise tin cause the brain and behavioral changes, and several hypotheses link them together, we are not certain about these behavioral changes and respective changes in brain and neuroendocrine. Consequently, to address these questions, a number of recommendations have been provided in Box iv for researchers who program to utilize exercise protocols in low. To engagement, therapeutic effects of exercise on depression take been documented. Choosing the right exercise for the right person besides long-term follow up can help to ensure the do interventions are having the intended furnishings. Future research needs refined models, methodological convergence, and stronger biological links.

Box 4. Recommendations for Future Trials of Exercise Interventions for Depression

Well-Designed Studies Must
Be randomized
Exist controlled
Include blinded result measurement
Include appropriate sample size
Include adequate allotment concealment
Include clear inclusion/ exclusion criteria
Match the definition and assessment of depression
Determine dropout rates and its reasons
Consider both quality and quantity characteristics of practice
Use waiting list control condition
Consider cultural, moral and demographic factors effects
Determine co-interventions (e.g. medication furnishings)
Consider in-task and postal service exercise melancholia responses
Include biological variables (e.1000. neurohormonal, neuroimaging variables)
Measure out sedentary behaviors in addition to physical activity
Consider long term follow upwards
Do sensitivity analyses to show the authentic effect size
Include intention- to-treat assay
Consider cost- effectiveness of different types of exercise
Written report all relevant and irrelevant outcomes
Publish trials with negative outcomes

References

• 1.

  Chapman DP, Perry GS. Depression as a major component of public health for older adults. Prev Chronic Dis. 2008; 5 (1)[PubMed]

• 2.

  Diagnostic and Statistical Manual of Mental Disorders. 2000;

• 3.

  Strohle A. Concrete activity, exercise, depression and feet disorders. J Neural Transm. 2009; 116 (6) : 777 -84 [DOI][PubMed]

• 4.

  Memari AH, Kordi R, Panahi N, Nikookar LR, Abdollahi Thou, Akbarnejad A. Result of ramadan fasting on body composition and physical functioning in female athletes. Asian J Sports Med. 2011; ii (3) : 161 -6

• v.

  Seif-Barghi T, Kordi R, Memari AH, Mansournia MA, Jalali-Ghomi 1000. The effect of an ecological imagery plan on soccer performance of elite players. Asian J Sports Med. 2012; three (2) : 81 -9 [PubMed]

• six.

  Kordi R, Abdollahi 1000, Memari AH, Najafabadi MG. Investigating Two Unlike Training Time Frames during Ramadan Fasting. Asian J Sports Med. 2011; 2 (3) : 205 -10 [PubMed]

• seven.

  Rethorst CD, Wipfli BM, Landers DM. The antidepressive effects of practise: a meta-assay of randomized trials. Sports Med. 2009; 39 (6) : 491 -511 [DOI][PubMed]

• viii.

  Krogh J, Nordentoft M, Sterne JA, Lawlor DA. The issue of exercise in clinically depressed adults: systematic review and meta-analysis of randomized controlled trials. J Clin Psychiatry. 2011; 72 (4) : 529 -38 [DOI][PubMed]

• 9.

  Stathopoulou G, Powers MB, Drupe AC, Smits JAJ, Otto MW. Exercise Interventions for Mental Health: A Quantitative and Qualitative Review. Clin Psychol Sci Prac. 2006; 13 (ii) : 179 -93 [DOI]

• 10.

  Mead GE, Morley W, Campbell P, Greig CA, McMurdo M, Lawlor DA. Practise for depression. Cochrane Libr. 2009; [DOI]

• eleven.

  Rimer J, Dwan K, Lawlor DA, Greig CA, McMurdo M, Morley W, et al. Exercise for depression. Cochrane Database Syst Rev. 2012; eleven [DOI]

• 12.

  Memari AH, Ghanouni P, Shayestehfar M, Ziaee V, Moshayedi P. Effects of visual search vs. auditory tasks on postural control in children with autism spectrum disorder. Gait Posture. 2014; 39 (1) : 229 -34 [DOI][PubMed]

• 13.

  Memari AH, Ghaheri B, Ziaee V, Kordi R, Hafizi S, Moshayedi P. Physical activity in children and adolescents with autism assessed by triaxial accelerometry. Pediatr Obes. 2013; 8 (2) : 150 -viii [DOI][PubMed]

• 14.

  Memari AH, Ziaee V, Beygi S, Moshayedi P, Mirfazeli FS. Overuse of psychotropic medications amongst children and adolescents with autism spectrum disorders: perspective from a developing land. Res Dev Disabil. 2012; 33 (2) : 563 -9 [DOI][PubMed]

• fifteen.

  Memari AH, Ghanouni P, Gharibzadeh S, Eghlidi J, Ziaee V, Moshayedi P. Postural sway patterns in children with autism spectrum disorder compared with typically developing children. Res Autism Spectrum Disord . 2013; vii (2) : 325 -32

• 16.

  Deslandes A, Moraes H, Ferreira C, Veiga H, Silveira H, Mouta R, et al. Exercise and mental health: many reasons to motion. Neuropsychobiology. 2009; 59 (4) : 191 -8 [DOI][PubMed]

• 17.

  Laurin D, Verreault R, Lindsay J, MacPherson K, Rockwood K. Physical action and run a risk of cerebral impairment and dementia in elderly persons. Curvation Neurol. 2001; 58 (3) : 498 -504 [PubMed]

• eighteen.

  Babyak M, Blumenthal JA, Herman S, Khatri P, Doraiswamy K, Moore K, et al. Do treatment for major depression: maintenance of therapeutic benefit at x months. Psychosom Med. 2000; 62 (5) : 633 -8 [PubMed]

• 19.

  Lafrance MN. Constructing a Non-depressed Self: Women's Accounts of Recovery from Depression. Feminism & Psychology. 2006; 16 (3) : 307 -25 [DOI]

• 20.

  Ebmeier KP, Donaghey C, Steele JD. Recent developments and current controversies in low. Lancet. 2006; 367 (9505) : 153 -67 [DOI][PubMed]

• 21.

  Trindade East, Menon D, Topfer LA, Coloma C. Adverse effects associated with selective serotonin reuptake inhibitors and tricyclic antidepressants: a meta-analysis. CMAJ. 1998; 159 (10) : 1245 -52 [PubMed]

• 22.

  Daley A. Exercise and depression: a review of reviews. J Clin Psychol Med Settings. 2008; 15 (two) : 140 -7 [DOI][PubMed]

• 23.

  Carek PJ, Laibstain SE, Carek SM. Exercise for the treatment of depression and anxiety. Int J Psychiatry Med . 2011; 41 : 15 -28 [DOI]

• 24.

  O'Neal HA, Dunn AL, Martinsen EW. Depression and practise. Int J Sport Psychol. 2000; 31 (2) : 110 -35

• 25.

  Ryan MP. Psychocultural differences in physical activeness-based antidepressant furnishings. Ment Wellness Phys Human action. 2010; 3 (1) : 5 -15 [DOI]

• 26.

  Peluso MA, Guerra DE, Andrade LH. The association between exercise and mood. Phys Ment Wellness . 2005;

• 27.

  Evenson KR, Wen F. Measuring physical action amidst pregnant women using a structured one-week call up questionnaire: show for validity and reliability. Int J Behav Nutr Phys Act. 2010; seven : 21 [DOI][PubMed]

• 28.

  Kendler KS, Thornton LM, Gardner CO. Stressful life events and previous episodes in the etiology of major depression in women: an evaluation of the "kindling" hypothesis. Am J Psychiatry. 2000; 157 (8) : 1243 -51

• 29.

  Rosenberg DE, Bombardier CH, Artherholt Due south, Jensen MP, Motl RW. Self-reported depression and physical activity in adults with mobility impairments. Arch Phys Med Rehabil. 2013; 94 (4) : 731 -6 [DOI][PubMed]

• 30.

  Kinser PA, Bourguignon C, Whaley D, Hauenstein Eastward, Taylor AG. Feasibility, acceptability, and effects of gentle Hatha yoga for women with major low: findings from a randomized controlled mixed-methods study. Arch Psychiatr Nurs. 2013; 27 (3) : 137 -47 [DOI][PubMed]

• 31.

  Memari AH, Ziaee V, Shayestehfar M, Ghanouni P, Mansournia MA, Moshayedi P. Cognitive flexibility impairments in children with autism spectrum disorders: links to age, gender and child outcomes. Res Dev Disabil. 2013; 34 (x) : 3218 -25 [PubMed]

• 32.

  Wellness, United States 2011 With Special Characteristic on Socioeconomic Status and Health. 2011;

• 33.

  Mata J, Thompson RJ, Gotlib IH. BDNF genotype moderates the relation betwixt physical activeness and depressive symptoms. Health Psychol. 2010; 29 (2) : 130 -three [DOI][PubMed]

• 34.

  Torres ER, Sampselle CM, Gretebeck KA, Ronis DL, Neighbors HW. Physical activity effects on depressive symptoms in Black adults. J Wellness Dispar Res Pract. 2010; four (2) : seventy

• 35.

  Wise LA, Adams-Campbell LL, Palmer JR, Rosenberg 50. Leisure fourth dimension physical activity in relation to depressive symptoms in the Blackness Women'south Health Study. Ann Behav Med. 2006; 32 (1) : 68 -76 [DOI][PubMed]

• 36.

  Arent Southward, Landers D, Etnier J. The furnishings of exercise on mood in older adults: A meta-analytic review. J Aging Phys Act. 2000; eight (4) : 407 -thirty

• 37.

  Physical Activity Guidelines for Americans. 2008;

• 38.

  Daley AJ, Jolly G, Sharp DJ, Turner KM, Blamey RV, Coleman S, et al. The effectiveness of practise equally a treatment for postnatal depression: study protocol. BMC Pregnancy Childbirth. 2012; 12 : 45 [DOI][PubMed]

• 39.

  Depression in adults: The treatment and management of depression in adults. 2009;

• 40.

  Robertson R, Robertson A, Jepson R, Maxwell K. Walking for depression or depressive symptoms: a systematic review and meta-assay. Ment Health Phys Act. 2012; 5 (1) : 66 -75 [DOI]

• 41.

  Trivedi MH, Greer TL, Church building TS, Carmody TJ, Grannemann BD, Galper DI, et al. Exercise as an augmentation treatment for nonremitted major depressive disorder: a randomized, parallel dose comparison. J Clin Psychiatry. 2011; 72 (five) : 677 -84 [DOI][PubMed]

• 42.

  Mead GE, Morley Due west, Campbell P, Greig CA, McMurdo M, Lawlor DA. Exercise for depression. Cochrane Database Syst Rev. 2009; (3) : CD004366 [DOI][PubMed]

• 43.

  Mota-Pereira J, Silverio J, Carvalho S, Ribeiro JC, Fonte D, Ramos J. Moderate do improves low parameters in treatment-resistant patients with major depressive disorder. J Psychiatr Res. 2011; 45 (8) : 1005 -eleven [DOI][PubMed]

• 44.

  Gore S, Farrell F, Gordon J. Sports Interest as Protection against Depressed Mood. J Res Adolesc. 2001; 11 (ane) : 119 -30 [DOI]

• 45.

  Luyten P, Blatt SJ, Van Houdenhove B, Corveleyn J. Low research and treatment: are we skating to where the puck is going to exist? Clin Psychol Rev. 2006; 26 (viii) : 985 -99 [DOI][PubMed]

• 46.

  Chu IH, Buckworth J, Kirby TE, Emery CF. Effect of exercise intensity on depressive symptoms in women. Men Health Phys Act. 2009; 2 (1) : 37 -43 [DOI]

• 47.

  Dunn AL, Trivedi MH, Kampert JB, Clark CG, Chambliss HO. Do treatment for low: efficacy and dose response. Am J Prev Med. 2005; 28 (ane) : 1 -8 [DOI][PubMed]

• 48.

  Stanton R, Reaburn P. Practise and the handling of depression: a review of the exercise program variables. J Sci Med Sport. 2014; 17 (2) : 177 -82 [DOI][PubMed]

• 49.

  Cotter KA, Lachman ME. No strain, no gain: psychosocial predictors of physical action across the adult lifespan. J Phys Human action Health. 2010; vii (5) : 584 -94 [PubMed]

• 50.

  Whaley DE. Developmental sport and do psychology: A lifespan perspective. 2004;

• 51.

  Vealey RS. Handbook of sport psychology. 2007;

• 52.

  ACSM'due south guidelines for exercise testing and prescription. 2000;

• 53.

  Lawlor DA, Hopker SW. The effectiveness of exercise as an intervention in the direction of depression: systematic review and meta-regression analysis of randomised controlled trials. BMJ. 2001; 322 (7289) : 763 -seven [PubMed]

Copyright © 2015, Sports Medicine Research Eye. This is an open up-access article distributed nether the terms of the Artistic Commons Attribution-NonCommercial iv.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits re-create and redistribute the material just in noncommercial usages, provided the original work is properly cited.

jordanmoseend.blogspot.com

Source: https://brief.land/asjsm/articles/21607.html

Share this post