22 Recent Meta-Analyses of the Effects of Exercise

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Exercise's Effects on Psychological Health, Well-being, Disorders, Cognition, & Quality of Life:

22 Meta-Analyses Published in 2017-present

Kenneth S. Pope, Ph.D., ABPP

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This site includes 3 related sections on recent meta-analyses:

I searched out meta-analytic studies of exercise's psychological effects on cognition, psychological disorders, psychological health, and quality of life, to help clinicians, expert witnesses, researchers, and others to stay abreast of the evolving research in this area. 

I focused on recent studies (i.e., published in 2017-present), and included both the citation and a brief excerpt for each study.

  1. Álvarez-Bueno, C., et al. (2017). "The effect of physical activity interventions on children's cognition and metacognition: A systematic review and meta-analysis." Journal of the American Academy of Child & Adolescent Psychiatry 56(9): 729-738.

    EXCERPT: " Pooled ES estimations were as follows: nonexecutive cognitive functions 0.23 (95% CI = 0.09−0.37); core executive functions 0.20 (95% CI = 0.10−0.30), including working memory (0.14 [95% CI = 0.00−0.27]), selective attention−inhibition (0.26 [95% CI = 0.10−0.41]), and cognitive flexibility (0.11 [95% CI = −0.10 to 0.32]); and metacognition 0.23 (95% CI = 0.13−0.32), including higher-level executive functions (0.19 [95% CI = 0.06−0.31]) and cognitive life skills (0.30 [95% CI = 0.15−0.45]). … PA benefits several domains of cognition and metacognition in youth. Curricular physical education interventions and programs aimed at increasing daily PA seem to be the most effective."

  2. Bailey, A. P., et al. (2017). "Treating depression with physical activity in adolescents and young adults: A systematic review and meta-analysis of randomised controlled trials." Psychological Medicine.

    EXCERPT: "Seventeen trials were eligible and 16 provided data from 771 participants showing a large effect of physical activity on depression symptoms compared to controls (SMD = −0.82, 95% CI = −1.02 to −0.61, p < 0.05, I 2 = 38%). The effect remained robust in trials with clinical samples (k = 5, SMD = −0.72, 95% CI = −1.15 to −0.30), and in trials using attention/activity placebo controls (k = 7, SMD = −0.82, 95% CI = −1.05 to −0.59).… However, the quality of RCT-level evidence contributing to the primary analysis was downgraded two levels to LOW (trial-level risk of bias, suspected publication bias), suggesting uncertainty in the size of effect and caution in its interpretation. While physical activity appears to be a promising and acceptable intervention for adolescents and young adults experiencing depression, robust clinical effectiveness trials that minimise risk of bias are required to increase confidence in the current finding. The specific intervention characteristics required to improve depression remain unclear, however best candidates given current evidence may include, but are not limited to, supervised, aerobic-based activity of moderate-to-vigorous intensity, engaged in multiple times per week over eight or more weeks. Further research is needed."

  3. Biazus-Sehn, L. F., et al. (2020). "Effects of physical exercise on cognitive function of older adults with mild cognitive impairment: A systematic review and meta-analysis." Archives of Gerontology and Geriatrics 89.

    EXCERPT: "PE improves global cognitive function (SMD = 0.348 [95 % CI 0.166 to 0.529]; p = 0.0001), executive function (SMD = 0.213 [95 % CI 0.026 to 0.400]; p = 0.026) and delayed recall (SMD = 0.180 [95 % CI 0.002 to 0.358]; p = 0.047). A trend towards beneficial effects of PE on verbal fluency (SMD = 0.270 [95 %, CI -0.021 to 0.561]; p = 0.069) and attention (SMD = 0.170 [CI -0.016 to 0.357]; p = 0.073) were also observed. Subgroup analyses showed a relationship between modality and intensity of physical exercise and changes observed in global cognitive function, executive function, delayed recall, verbal fluency and working memory.... PE can ameliorate cognitive deficts of older adults with MCI. The most pronounced effects appear to arise from other types of exercise that included mind-body exercises and moderate intensity."

  4. Healy, S., et al. (2018). "The effect of physical activity interventions on youth with autism spectrum disorder: A meta-analysis." Autism Research.

    EXCERT: "Results of the meta-analysis…showed physical activity interventions to have a moderate or large effect on a variety of outcomes, including for the development of manipulative skills, locomotor skills, skill-related fitness, social functioning, and muscular strength and endurance."

  5. Jacquart, J., et al. (2018). "The effects of exercise on transdiagnostic treatment targets: A meta-analytic review." Behaviour Research and Therapy.

    EXCERPT: "Exercise interventions had a large effect on reducing AS …, a medium effect on increasing GSE… ), and a small effect on reducing SR."

  6. Ji, L., et al. (2021). "Effects of physical exercise on the aging brain across imaging modalities: A meta-analysis of neuroimaging studies in randomized controlled trials." International Journal of Geriatric Psychiatry: published online.

    EXCERPT: "Overall, physical exercise consistently results in structural and functional changes in the hippocampus/parahippocampusl area and a cluster within the cerebellum. Although changes of medial/superior prefrontal cortex did not pass the stringent threshold, they were associated with cognitive changes....  This study highlights the effectiveness of physical exercise in inducing hippocampus plasticity, which may be crucially relevant for maintaining memory function in older adults."

  7. Landrigan, J.-F., et al. (2019). "Lifting cognition: A meta-analysis of effects of resistance exercise on cognition." Psychological Research.

    EXCERPT: "Results revealed positive effects of resistance training on composite cognitive scores (SMD 0.71, 95% CI 0.30–1.12), screening measures of cognitive impairment (SMD 1.28, 95% CI 0.39–2.18), and executive functions (SMD 0.39, 95% CI 0.04–0.74), but no effect on measures of working memory (SMD 0.151, 95% CI − 0.21 to 0.51). High heterogeneity was observed in all analyses."

  8. Leng, M., et al. (2018). "Effects of physical exercise on depressive symptoms in patients with cognitive impairment: A systematic review and meta-analysis." Journal of Nervous and Mental Disease 206(10): 809-823

    .EXCERPT: The meta-analysis showed that physical exercise significantly ameliorated depressive symptoms (standardized mean difference [SMD] = −0.23; 95% confidence interval [CI], −0.39 to −0.07; p = 0.004). In addition, beneficial improvements in neuropsychiatric symptoms (mean difference, −4.62; 95% CI, −9.07 to −0.16, p = 0.04), quality of life (SMD = 0.23; 95% CI, 0.01–0.46; p = 0.04), and activities of daily living (SMD = 0.27; 95% CI, 0.12–0.43; p = 0.0005) were observed in our study. No significant improvements were found in anxiety or apathy."

  9. Mercier, J., et al. (2017). "Exercise interventions to improve sleep in cancer patients: A systematic review and meta-analysis." Sleep Medicine Reviews 36: 43-56.

    EXCERPT: "The review looked at twenty one trials, including 17 randomized controlled trials. Most interventions were home-based aerobic walking programs and breast cancer patients were the subgroup most represented. Sleep variables were most commonly used as secondary outcomes in the reviewed studies. Studies were highly heterogeneous in terms of methodology. The qualitative review of available evidence suggested a beneficial effect of exercise interventions on sleep in several studies (48%). However, the meta-analysis conducted on RCTs revealed no significant effect either on subjective or on objective sleep measures. This lack of significant effect could be due, at least in part, to a floor effect."

  10. Morres, I. D., et al. (2018). "Aerobic exercise for adult patients with major depressive disorder in mental health services: A systematic review and meta-analysis." Depression and Anxiety.

    EXCERPT: "Across 11 eligible trials (13 comparisons) involving 455 patients, AE was delivered on average for 45 min, at moderate intensity, three times/week, for 9.2 weeks and showed a significantly large overall antidepressant effect (g = –0.79, 95% confidence interval = –1.01, –0.57, P < 0.00) with low and nonstatistically significant heterogeneity (I2 = 21%). No publication bias was found. Sensitivity analyses revealed large or moderate to large antidepressant effects for AE (I2 ≤ 30%) among trials with lower risk of bias, trials with short-term interventions (up to 4 weeks), and trials involving individual preferences for exercise. Subgroup analyses revealed comparable effects for AE across various settings and delivery formats, and in both outpatients and inpatients regardless symptom severity."

  11. Pérez-López, F. R., et al. (2017). "Effects of programmed exercise on depressive symptoms in midlife and older women: A meta-analysis of randomized controlled trials." Maturitas 106: 38-47.

    EXCERPT: "We assessed randomized controlled trials (RCTs) that compared the effect of exercise for at least 6 weeks versus no intervention on DSs as the outcome (as defined by trial authors). Exercise was classified according to duration as "mid-term exercise intervention" (MTEI; lasting for 12 weeks to 4 months), and "long-term exercise intervention" (LTEI; lasting for 6–12 months). Mean changes (± standard deviations) in DSs, as assessed with different questionnaires, were extracted to calculate Hedges' g and then used as the effect size for meta-analysis. Standardized mean differences (SMDs) of DSs after intervention were pooled using a random-effects model. Results: Eleven publications were included for analysis related to 1943 midlife and older women (age range 44–55 years minimum to 65.5 ± 4.0 maximum), none of whom was using a hormone therapy. Seven MTEIs were associated with a significant reduction in DSs (SMD = −0.44; 95% CI −0.69, −0.18; p = 0.0008) compared with controls. The reduction in DSs was also significant in six LTEIs (SMD = − 0.29; 95% CI −0.49; −0.09; p = 0.005). Heterogeneity of effects among studies was moderate to high. Less perceived stress and insomnia (after exercise) were also found as secondary outcomes…. Exercise of low to moderate intensity reduces depressive symptoms in midlife and older women."

  12. Perry, S. A., et al. (2020). "The effectiveness of physical exercise as an intervention to reduce depressive symptoms following traumatic brain injury: A meta-analysis and systematic review." Neuropsychological Rehabilitation 30: 564-578.

    EXCERPT: "Consistent with research in non-brain injury populations, the current meta-analysis identified a small to medium effect size of physical exercise on reducing depressive symptoms in people with a TBI."

  13. Poyatos-León, R., et al. (2017). "Effects of exercise-based interventions on postpartum depression: A meta-analysis of randomized controlled trials." Birth: Issues in Perinatal Care 44(3): 200-208.

    EXCERPT: "Effect size for the relationship between physical activity interventions during pregnancy and the postpartum period on postpartum depressive symptoms was 0.41 (95% CI 0.28-0.54). Heterogeneity was I² = 33.1% (P = .117). When subgroup analyses were done, pooled effect sizes were 0.67 (95% CI 0.44-0.90) for mothers who met postpartum depressive symptoms criteria at baseline based on specific scales, and 0.29 (95% CI 0.14-0.45) for mothers who did not meet those depressive symptoms criteria at baseline…. Physical exercise during pregnancy and the postpartum period is a safe strategy to achieve better psychological well-being and to reduce postpartum depressive symptoms."

  14. Raafs, B. M., et al. (2020). "Physical exercise training improves quality of life in healthy older adults: A meta-analysis." Journal of Aging and Physical Activity 28: 81-93.

    EXCERPT:  "In total, 16 randomized controlled trials were included. The primary analysis showed a medium effect of physical exercise training on QoL in healthy older adults (standard mean difference [SMD] = 0.38, confidence interval, CI, [0.18, 0.59], p p p p = .17). These findings warrant implementation efforts pertaining to exercise training for older adults to improve the QoL in our aging societies."

  15. Rossi, P. G., et al. (2021). "Effects of physical exercise on the cognition of older adults with frailty syndrome: A systematic review and meta-analysis of randomized trials." Archives of Gerontology and Geriatrics 93.

  16. EXCERPT: "The data from the meta-analysis showed that physical exercise improves Global Cognition (Mean Difference = 2.26; 95% CI, 0.42—4.09; P = 0.02) and mental flexibility (Trail Making Test B) (Mean Difference = -30.45; 95% CI; -47.72—-13.19; P = 0.0005).... Interventions with physical exercise promote benefits in global cognition and mental flexibility of older adults with frailty syndrome."

  17. Ruiz-González, D., et al. (2021). "Effects of physical exercise on plasma brain-derived neurotrophic factor in neurodegenerative disorders: A systematic review and meta-analysis of randomized controlled trials." Neuroscience and Biobehavioral Reviews 128: 394-405.

    EXCERPT: " Neurodegenerative disorders are associated with reduced levels of brain-derived neurotrophic factor (BDNF). We aimed to assess the effect of exercise interventions on plasma BDNF levels in individuals with neurodegenerative disorders. Eighteen randomized controlled trials (RCT) assessing the effects of exercise interventions versus no exercise on plasma BDNF levels in individuals with neurodegenerative disorders (i.e., multiple sclerosis, Parkinson’s disease, mild cognitive impairment [MCI] and Alzheimer’s disease) were included. Overall, exercise interventions induced a significant increase in plasma BDNF levels (SMD = 2.22, 95% CI = 1.33–3.12, p p p = 0.009; 3 studies), with a non-significant trend also observed for MCI (SMD= 1.07, 95% CI = -0.14–2.28, p = 0.080; 4 studies). BDNF levels significantly increased regardless of exercise type (p, p = 0.003 and p = 0.020 for combined, aerobic and resistance exercise, respectively), weekly exercise volume (p p < 0.001 for both interventions of ≥ 12 and < 12 weeks)."

  18. Song, D., et al. (2018). "The effectiveness of physical exercise on cognitive and psychological outcomes in individuals with mild cognitive impairment: A systematic review and meta-analysis." International Journal of Nursing Studies 79: 155-164.

    EXCERPT: "The exercise interventions can be classified into three types: (a) aerobic exercise, (b) resistance exercise, and (c) multi-modal exercise. Results showed that physical exercise had beneficial effects for global cognition [standard mean difference (SMD) = 0.30, 95% confidence interval (CI): 0.10–0.49, p = 0.002]. Further subgroup analysis demonstrated that aerobic exercise programmes are consistently associated with medium effect size (SMD: 0.54–0.58). However, the effects of physical exercise on domain-specific cognitive function and psychological outcomes in MCI patients remain inconclusive."

  19. Sun, M., et al. (2018). "Exercise for cognitive symptoms in depression: A systematic review of interventional studies." The Canadian Journal of Psychiatry / La Revue canadienne de psychiatrie 63(2): 115-128.

    EXCERPT: "No significant effect of exercise was found on global cognition (Hedges' g = 0.08, P = 0.33, I² = 0%) or on individual cognitive domains. Meta-regression analyses failed to find significant relationships among participant age, baseline cognition, number of exercise sessions per wk, duration of exercise per wk, total duration of exercise during the intervention, or improvement in global cognition. Interventions combining physical with cognitive activity significantly improved global cognition (P = 0.048), whereas low-intensity interventions were also positive (P = 0.048)…. No impact of physical exercise was found on cognition in MDD overall. However, we found that interventions combining physical and cognitive activities had a positive impact, and that lower-intensity interventions, where adherence was improved, also impacted positively. There remains a lack of high-quality data in this population."

  20. Teh, E. J., et al. (2022). "Effects of physical exercise interventions on stereotyped motor behaviours in children with ASD: A meta-analysis." Journal of Autism and Developmental Disorders 52: 2934-2957.

    EXCERPT: "The present systematic review and meta-analysis included 22 studies, involving 274 children with ASD, to quantify the effect of exercise on SMB and its potential moderators. Multi-level modelling revealed a large overall effect, Hedges’ g = 1.16, with significant heterogeneity across participant, treatment, and study levels. Further, a more appropriate model using between-case estimation for within-subject effects to improve comparability between single-case and group-design studies, yielded a smaller but still significant effect, g = 0.51. Lastly, higher exercise intensity, but not age, exercise duration or settings, reliably predicted treatment effectiveness. Implications for clinical practice and research are discussed."

  21. Vysniauske, R., et al. (2020). "The effects of physical exercise on functional outcomes in the treatment of ADHD: A meta-analysis." Journal of Attention Disorders 24: 644-654.

    EXCERPT: "There was a significant effect of exercise on ADHD functional outcomes (g = 0.627). Longer exercise intervention duration was consistently associated with larger effect sizes. Effect sizes were not related to exercise intensity, mean age of participants, or gender distribution....  Results suggest that exercise has a modest positive impact on ADHD functional outcomes, such as executive functions and motor skills, with longer interventions yielding better results."

  22. Xiong, J., et al. (2021). "Effects of physical exercise on executive function in cognitively healthy older adults: A systematic review and meta-analysis of randomized controlled trials: Physical exercise for executive function." International Journal of Nursing Studies 114.

    EXCERPT: "Compared to a no-exercise intervention, physical exercise had positive effect on working memory (Hedge's g=0.127, p<0.01, I²= 0%), cognitive flexibility (Hedge's g=0.511; p=0.007, I²=89.08%), and inhibitory control (Hedge's g=0.136; p=0.001, I²=0%) in cognitively healthy older adults. The moderator analysis indicated that more than 13 weeks of aerobic exercise significantly improved working memory and cognitive flexibility, and intervention lasting more than 26 weeks significantly improved inhibition; mind-body exercise significantly improved working memory. No significant effect on planning or semantic verbal fluency (SVF) was found....  Regular physical exercise training, especially aerobic exercise and mind-body exercise, had positive benefit for improving working memory, cognitive flexibility and inhibitory control of executive function in cognively healthy older adults."


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