Skip to main content Accessibility help
×
×
Home

Cardiorespiratory fitness and response to exercise treatment in depression

  • Md Shafiqur Rahman (a1), Björg Helgadóttir (a2), Mats Hallgren (a3), Yvonne Forsell (a4), Brendon Stubbs (a5), Davy Vancampfort (a6) and Örjan Ekblom (a7)...
Abstract
Background

Exercise improves cardiorespiratory fitness (CRF) and reduces depressive symptoms in people with depression. It is unclear if changes in CRF are a predictor of the antidepressant effect of exercise in people with depression.

Aims

To investigate whether an increase in CRF is a predictor of depression severity reduction after 12 weeks of exercise (trial registration: DRKS study ID, DRKS00008745).

Method

The present study includes participants who took part in vigorous (n = 33), moderate (n = 38) and light (n = 39) intensity exercise and had CRF information (as predicted maximal oxygen uptake, O2max) collected before and after the intervention. Depression severity was measured with the Montgomery–Åsberg Depression Rating Scale (MADRS). O2max (L/min) was assessed with the Åstrand–Rhyming submaximal cycle ergometry test. The main analysis was conducted pooling all exercise intensity groups together.

Results

All exercise intensities improved O2max in people with depression. Regardless of frequency and intensity of exercise, an increase in post-treatment O2max was significantly associated with reduced depression severity at follow-up (B = −3.52, 95% CI −6.08 to −0.96); adjusting for intensity of exercise, age and body mass index made the association stronger (B = −3.89, 95% CI −6.53 to −1.26). Similarly, increased O2max was associated with higher odds (odds ratio = 3.73, 95% CI 1.22–11.43) of exercise treatment response (≥50% reduction in MADRS score) at follow-up.

Conclusions

Our data suggest that improvements in O2max predict a greater reduction in depression severity among individuals who were clinically depressed. This finding indicates that improvements in O2max may be a marker for the underpinning biological pathways for the antidepressant effect of exercise.

Declaration of interest

None.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Cardiorespiratory fitness and response to exercise treatment in depression
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Cardiorespiratory fitness and response to exercise treatment in depression
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Cardiorespiratory fitness and response to exercise treatment in depression
      Available formats
      ×
Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Corresponding author
Correspondence: Örjan Ekblom, Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Box 5626, Lidingovagen 1, 114 86 Stockholm, Sweden. Email: orjan.ekblom@gih.se
References
Hide All
1Garber, CE, Blissmer, B, Deschenes, MR, Franklin, BA, Lamonte, MJ, Lee, I, et al. ACSM's Guidelines for Exercise Testing and Prescription. Med Sci Sports Exerc 2011; 43: 1334–59.
2Schuch, FB, Vasconcelos-Moreno, MP, Borowsky, C, Fleck, MP. Exercise and severe depression: preliminary results of an add-on study. J Affect Disord 2011; 133: 615–8.
3Cooney, G. Exercise for depression. J Evid Based Med 2013; 6: 307–8.
4Krogh, J, Nordentoft, M, Sterne, JAC, Lawlor, DA. The effect of exercise in clinically depressed adults: systematic review and meta-analysis of randomized controlled trials. J Clin Psychiatry 2011; 72: 529–38.
5Stubbs, B, Rosenbaum, S, Vancampfort, D, Ward, PB, Schuch, FB. Exercise improves cardiorespiratory fitness in people with depression: a meta-analysis of randomized control trials. J Affect Disord 2016; 190: 249–53.
6Schuch, FB, Vancampfort, D, Sui, X, Rosenbaum, S, Firth, J, Richards, J, et al. Are lower levels of cardiorespiratory fitness associated with incident depression? A systematic review of prospective cohort studies. Prev Med 2016; 93: 159–65.
7Lee, D, Artero, EG, Sui, X, Blair, SN. Mortality trends in the general population: the importance of cardiorespiratory fitness. J Psychopharmacol 2010; 24 (4 suppl): 2735.
8Dishman, RK, Sui, X, Church, TS, Hand, GA, Trivedi, MH, Blair, SN. Decline in cardiorespiratory fitness and odds of incident depression. Am J Prev Med 2012; 43: 361–8.
9Papasavvas, T, Bonow, RO, Alhashemi, M, Micklewright, D. Depression symptom severity and cardiorespiratory fitness in healthy and depressed adults: a systematic review and meta-analysis. Sports Med 2016; 46: 219–30.
10Hallgren, M, Helgadottir, B, Herring, MP, Zeebari, Z, Lindefors, N, Kaldo, V, et al. Exercise and internet-based cognitive-behavioural therapy for depression: multicentre randomised controlled trial with 12-month follow-up. Br J Psychiatry 2016; 209: 414–20.
11Hallgren, M, Kraepelien, M, Ojehagen, A, Lindefors, N, Zeebari, Z, Kaldo, V, et al. Physical exercise and internet-based cognitive-behavioural therapy in the treatment of depression: randomised controlled trial. Br J Psychiatry 2015; 207: 227–34.
12Kroenke, K, Spitzer, RL, Williams, JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16: 606–13.
13Helgadóttir, B, Hallgren, M, Ekblom, Ö, Forsell, Y. Training fast or slow? Exercise for depression: a randomized controlled trial. Prev Med 2016; 91: 123–31.
14Astrand, I. Aerobic work capacity in men and women with special reference to age. Acta Physiol Scand Suppl 1960; 49: 192.
15Astrand, PO, Ryhming, I. A nomogram for calculation of aerobic capacity (physical fitness) from pulse rate during sub-maximal work. J Appl Physiol 1954; 7: 218–21.
16Ekblom, B, Engström, L-M, Ekblom, O. Secular trends of physical fitness in Swedish adults. Scand J Med Sci Sports 2007; 17: 267–73.
17Nordgren, B, Fridén, C, Jansson, E, Österlund, T, Grooten, WJ, Opava, CH, et al. Criterion validation of two submaximal aerobic fitness tests, the self-monitoring Fox-walk test and the Åstrand cycle test in people with rheumatoid arthritis. BMC Musculoskelet Disord 2014; 15: 305.
18Montgomery, SA, Åsberg, M. A new depression scale designed to be sensitive to change. Br J Psychiatry 1979; 134: 382–9.
19Hallgren, M, Nakitanda, OA, Ekblom, Ö, Herring, MP, Owen, N, Dunstan, D, et al. Habitual physical activity levels predict treatment outcomes in depressed adults: a prospective cohort study. Prev Med 2016; 88: 53–8.
20Martinsen, EW, Medhus, A, Sandvik, L. Effects of aerobic exercise on depression: a controlled study. Br Med J (Clin Res Ed) 1985; 291: 109.
21Kerling, A, von Bohlen, A, Kück, M, Tegtbur, U, Grams, L, Haufe, S, et al. Exercise therapy improves aerobic capacity of inpatients with major depressive disorder. Brain Behav 2016; 6: e00469.
22Siqueira, CC, Valiengo, LL, Carvalho, AF, Santos-Silva, PR, Missio, G, de Sousa, RT, et al. Antidepressant efficacy of adjunctive aerobic activity and associated biomarkers in major depression: a 4-week, randomized, single-blind, controlled clinical trial. PLoS ONE 2016; 11: e0154195.
23Kolb, EM, Kelly, SA, Middleton, KM, Sermsakdi, LS, Chappell, MA, Garland, T. Erythropoietin elevates but not voluntary wheel running in mice. J Exp Biol 2010; 213: 510–9.
24Ekblom, B. Blood doping and erythropoietin. The effects of variation in hemoglobin concentration and other related factors on physical performance. Am J Sports Med 1996; 24 (6 suppl): S40–2.
25Berglund, B, Ekblom, B. Effect of recombinant human erythropoietin treatment on blood pressure and some haematological parameters in healthy men. J Intern Med 1991; 229: 125–30.
26Miskowiak, KW, Rush, AJ, Gerds, TA, Vinberg, M, Kessing, LV. Targeting treatments to improve cognitive function in mood disorder: suggestions from trials using erythropoietin. J Clin Psychiatry 2016; 77: e163946.
27Cooney, G, Dwan, K, Mead, G. Exercise for depression. JAMA 2014; 311: 2432–3.
28Schuch, FB, Vancampfort, D, Richards, J, Rosenbaum, S, Ward, PB, Stubbs, B. Exercise as a treatment for depression: a meta-analysis adjusting for publication bias. J Psychiatr Res 2016; 77: 4251.
29Stubbs, B, Vancampfort, D, Rosenbaum, S, Ward, PB, Richards, J, Soundy, A, et al. Dropout from exercise randomized controlled trials among people with depression: a meta-analysis and meta regression. J Affect Disord 2016; 190: 457–66.
30Rethorst, CD, Wipfli, BM, Landers, DM. The antidepressive effects of exercise: a meta-analysis of randomized trials. Sport Med 2009; 39: 491511.
31Correll, CU, Solmi, M, Veronese, N, Bortolato, B, Rosson, S, Santonastaso, P, et al. Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: a large-scale meta-analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry 2017; 16: 163–80.
32Naci, H, Ioannidis, JPA. Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study. BMJ 2013; 347: f5577.
33Olsson, SJG. Studies of Physical Activity in the Swedish Population. Gymnastik- och idrottshögskolan, 2016.
34Blair, SN, Kohl, HW, Paffenbarger, RS, Clark, DG, Cooper, KH, Gibbons, LW. Physical fitness and all-cause mortality. A prospective study of healthy men and women. JAMA 1989; 262: 2395–401.
35Ekblom-Bak, E, Björkman, F, Hellenius, M-L, Ekblom, B. A new submaximal cycle ergometer test for prediction of VO2max. Scand J Med Sci Sports 2014; 24: 319–26.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Open
  • ISSN: -
  • EISSN: 2056-4724
  • URL: /core/journals/bjpsych-open
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Type Description Title
WORD
Supplementary materials

Rahman et al. supplementary material
Figure S1

 Word (57 KB)
57 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Cardiorespiratory fitness and response to exercise treatment in depression

  • Md Shafiqur Rahman (a1), Björg Helgadóttir (a2), Mats Hallgren (a3), Yvonne Forsell (a4), Brendon Stubbs (a5), Davy Vancampfort (a6) and Örjan Ekblom (a7)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *