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Efficacy of guidelines-based resistance exercise training for depressive symptoms among young adults with and without analogue generalized anxiety disorder
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Date
2026-02
Abstract
This programme of research investigated the efficacy of resistance exercise training (RET) for depressive symptoms, including among at-risk young adults with and without subclinical, or analogue, Generalized Anxiety Disorder (AGAD). Meta-analytic evidence supports the antidepressant efficacy of RET compared to inactive controls; however, to improve behavioural treatment precision and success, direct comparative efficacy of interventions should be considered. A novel meta-analysis of 80 randomized controlled trials (RCTs) was conducted, and found a significant, moderate-magnitude (Δ=0.54 [95% Confidence Interval (95%CI): 0.39 to 0.68]) antidepressant effect of RET compared to inactive comparisons, and, importantly, a significant, small-magnitude (Δ=0.21 [95%CI: 0.14 to 0.27]) antidepressant effect compared to active comparisons. Documentation of RET designs, post-intervention follow-ups, and examinations of the efficacy of RET for depressive symptoms in samples with AGAD, were limited. Therefore, secondary analyses of existing RCT data quantified the efficacy of progressive, moderate-to-high-intensity, World Health Organisation (WHO) and American College of Sports Medicine (ACSM) guidelines-based RET (PRET) compared to a waitlist control for depressive symptoms, and a single bout of resistance exercise (RE) compared to quiet-rest for depressed mood state, among at-risk young adults with and without AGAD and/or highly comorbid subclinical, or analogue, Major Depressive Disorder (AMDD). Single bouts of RE (SMD=0.25 [95%CI: -0.29 to 0.79]) and quiet-rest (SMD=0.27 [95%CI: -0.21 to 0.75]) induced similar, small-magnitude acute reductions in depressed mood state; however, RE induced large-magnitude (SMD=0.85 to 1.71) reductions among participants with elevated pre-condition symptoms. Across the larger RCT, PRET induced a large-magnitude reduction in depressive symptoms compared to the waitlist control (d=1.01 [95%CI: 0.44 to 1.57]). Thereafter, novel RCTs replicated and rigorously expanded on these promising findings by (1) comparing PRET to a low-intensity sham RET attention-control (SHAM), (2) examining a potential minimal effective dose threshold for meaningful improvement, (3) examining understudied persistence of effects post-intervention, and (4) focusing on at-risk young adult women with AGAD. Both moderate-to-high-intensity RE (SMD=0.43 [95%CI: -0.05 to 0.90]) and a single bout of the SHAM (SMD=0.50 [95%CI: -0.01 to 1.01]) significantly reduced depressed mood state. Across the larger RCT, PRET (SMD=1.53 [95%CI: 0.92 to 2.13]) and the SHAM (SMD=1.04 [95%CI: 0.49 to 1.60]) induced large-magnitude reductions in depressive symptoms that persisted at one-month follow-up (SMD: PRET: 1.64 [95%CI: 1.02 to 2.26]; SHAM: 1.15 [95%CI: 0.59 to 1.72]). Though not significantly different between groups, PRET induced larger within-condition effects. These findings critically expand knowledge by demonstrating superior antidepressant effects of RET compared to active comparisons; that antidepressant effects of PRET extend beyond potential social and psychological benefits of engagement, that both PRET and a potential minimal effective dose of low-intensity RET can induce large antidepressant effects that persist post-intervention, and that acute post-bout reductions in depressed mood state can occur. Collectively, these novel findings warrant the addition of PRET to behavioural treatment recommendations for depressive symptoms.
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Peer-reviewed
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University of Limerick
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Sustainable Development Goals
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Attribution-NonCommercial-ShareAlike 4.0 International