Exercise interventions significantly improved overall health-related quality of life immediately after treatment (SMD 0.31) in adults with major depressive disorder compared to control conditions.
Meta-Analysis (n=637)
Do physical activity/exercise interventions improve health-related quality of life in adults with major depressive disorder?
Exercise interventions significantly improve short-term health-related quality of life, particularly in physical and psychological domains, in adults with major depressive disorder.
Effect estimate: SMD 0.31 (95% CI 0.16, 0.46)
Background Major Depressive Disorder (MDD) causes global disability and economic burden. Standard treatments often yield incomplete recovery with impaired health-related quality of life (HR-QoL). This meta-analysis evaluates exercise interventions’ effects on HR-QoL in adults with clinically diagnosed MDD. Methods Following PRISMA 2020 guidelines, randomized controlled trials (RCTs) of adults (≥18 years) with MDD were included if they evaluated physical activity/exercise interventions (e.g., aerobic, resistance, yoga, Tai Chi) versus active or non-active controls with HR-QoL outcomes. Comprehensively the main four databases and grey literature searches were conducted. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane RoB-2 tool. Statistical analysis performed by STAT-17. Results Finally, 11 RCTs were included (mean age about 48.9 years; majority female participants (68%)). The meta-analysis showed that exercise interventions significantly improved overall HR-QoL immediately after treatment (SMD = 0.31 0.16, 0.46, I² = 0.00%). At follow-up, exercise was also associated with a significant improvement in HR-QoL (SMD = 0.41 0.13, 0.70, I² = 34.42%). Domain-level analyses indicated significant improvements favoring exercise in overall (SMD = 0.25 0.05, 0.45, I² = 0%), physical (SMD = 0.50 0.10, 0.91, I² = 48.18%), psychological (SMD = 0.58 0.24, 0.92, I² = 0%), and emotional (SMD = 0.51 0.11, 0.91, I² = 21.03%) domains, while the social domain showed no significant difference (SMD = 0.11 –0.34, 0.57, I² = 0%). Conclusion Exercise interventions, primarily structured and supervised, may improve short-term HR-QoL in adults with major depressive disorder, particularly in the physical and psychological domains. However, long-term effects remain uncertain, and current evidence does not support the superiority of any specific exercise modality. Given the limited number of studies, heterogeneity in control conditions, and variability in HR-QoL measures, further high-quality randomized controlled trials with longer follow-up are needed.
Peng et al. (2026) conducted a meta-analysis in Major Depressive Disorder (MDD) (n=637). Exercise interventions (e.g., aerobic, resistance, yoga, Tai Chi) vs. Active or non-active controls was evaluated on Overall health-related quality of life (HR-QoL) immediately after treatment (SMD 0.31, 95% CI 0.16, 0.46). Exercise interventions significantly improved overall health-related quality of life immediately after treatment (SMD 0.31) in adults with major depressive disorder compared to control conditions.
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