Physical exercise improves quality of life, depressive symptoms, and cognition across chronic brain disorders: a transdiagnostic systematic review and meta-analysis of randomized controlled trials

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Abstract
We performed a meta-analysis to synthesize evidence on the efficacy and safety of physical exercise as an add-on therapeutic intervention for quality of life (QoL), depressive symptoms and cognition across six chronic brain disorders: Alzheimer’s disease, Huntington’s disease, multiple sclerosis, Parkinson’s disease, schizophrenia and unipolar depression. 122 studies ( = k) (n = 7231) were included. Exercise was superior to treatment as usual in improving QoL (k = 64,n = 4334, ES = 0.40,p < 0.0001), depressive symptoms (k = 60,n = 2909, ES = 0.78,p < 0.0001), the cognitive domains attention and working memory (k = 21,n = 1313, ES = 0.24,p < 0.009), executive functioning (k = 14,n = 977, ES = 0.15,p = 0.013), memory (k = 12,n = 994, ES = 0.12,p = 0.038) and psychomotor speed (k = 16,n = 896, ES = 0.23,p = 0.003). Meta-regression showed a dose–response effect for exercise time (min/week) on depressive symptoms (β = 0.007,p = 0.012). 69% of the studies that reported on safety, found no complications. Exercise is an efficacious and safe add-on therapeutic intervention showing a medium-sized effect on QoL and a large effect on mood in patients with chronic brain disorders, with a positive dose–response correlation. Exercise also improved several cognitive domains with small but significant effects.
Funding Information
  • ZonMw (40-00812-98-13009)