Purpose: To identify the most effective aerobic exercise regimen and explore the dose-response relationship for improving depressive symptoms.
Methods: A systematic search was conducted in PubMed, MEDLINE, Embase, CENTRAL, and Web of Science, covering studies up to September 2024. Randomized controlled trials (RCTs) evaluating the impact of aerobic exercise on depressive symptoms in children and adolescents (6-19 years) were included. Subgroup analyses were performed based on age, depression status, and exercise characteristics. Outcome measures were standardized mean differences (SMD) with 95 % confidence intervals (CI).
Results: Eighteen RCTs with 1540 participants were included. Aerobic exercise significantly reduced depressive symptoms post-intervention (SMD: -0.37, 95 % CI: -0.59 to -0.15) and during follow-up (SMD: - 0.51, 95 % CI: -0.85 to -0.18). Effects were stronger in adolescents and those with clinically diagnosed depression. Moderate intensity exercise (4.0-5.9 METs), 30-45 min per session, 3-4 times per week, over 6-10 weeks was most effective. Dose-response analysis found an optimal dose of 590 METs-min/week (SMD: -0.46, 95 % CrI: -0.78 to -0.10), with an effective range of 360-780 METs-min/week.
Conclusion: Aerobic exercise significantly reduces depressive symptoms in adolescents, particularly in those with diagnosed depression. Moderate-intensity exercise (4.0-5.9 METs), 30-45 min per session, 3-4 times per week, over 6-10 weeks, is most effective. The optimal dose is 590 METs-min/week. These findings offer practical insights for designing targeted interventions.
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