Effects of exercise on depression in adults with arthritis: a systematic review with meta-analysis of randomized controlled trials

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fibromyalgia 12 rheumatologydiseases
osteoarthritis 9 rheumatologydiseases
rheumatoid arthritis 14 rheumatologydiseases
systemic lupus erythematosus 7 rheumatologydiseases
arthritis 43 rheumatologydiseases

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arthritis 84 Title: Arthritis Research & TherapyEffects of exercise on depression in adults with arthritis : a systematic review with meta-analysis of randomized controlled trialsGeorge A KelleyKristi S KelleyJennifer
arthritis 475 led to conflicting findings regarding the effects of exercise on depressive symptoms in adults with arthritis and other rheumatic conditions (AORC). The purpose of this study was to use the meta-analytic approach
arthritis 804 (aerobic, strength training, or both) ≥4 weeks, (3) comparative control group, (4) adults with osteo arthritis , rheumatoid arthritis, fibromyalgia or systemic lupus erythematosus, (5) published studies in any language
arthritis 826 training, or both) ≥4 weeks, (3) comparative control group, (4) adults with osteoarthritis, rheumatoid arthritis , fibromyalgia or systemic lupus erythematosus, (5) published studies in any language since January 1,
arthritis 3055 among adults in the United States (US). Current US estimates place the prevalence of doctor-diagnosed arthritis at 55.2 million (22.7%) adults [[1]], and is projected to increase to 67 million (25%) adults by the
arthritis 3227 increase to 67 million (25%) adults by the year 2030 [[2]]. Not surprisingly, the costs associated with arthritis and other rheumatic conditions are substantial. In 2003, the total costs associated with arthritis were
arthritis 3326 arthritis and other rheumatic conditions are substantial. In 2003, the total costs associated with arthritis were estimated at $127.8 billion, $80.8 billion in direct costs and $47.0 billion in indirect costs
arthritis 3492 direct costs and $47.0 billion in indirect costs [[3]]. A common mental health problem among adults with arthritis is depression. For example, a recent study of 1,793 US adults 45 years of age and older with arthritis
arthritis 3595 arthritis is depression. For example, a recent study of 1,793 US adults 45 years of age and older with arthritis found that 18% had depression while only 51% sought help for their depression [[4]]. One potential non-pharmacologic
arthritis 3783 [[4]]. One potential non-pharmacologic intervention for reducing depressive symptoms in adults with arthritis is exercise. Unfortunately, the prevalence of exercise in adults with arthritis is low. For example,
arthritis 3863 symptoms in adults with arthritis is exercise. Unfortunately, the prevalence of exercise in adults with arthritis is low. For example, the percentage of adults with doctor-diagnosed arthritis who perform moderate physical
arthritis 3941 exercise in adults with arthritis is low. For example, the percentage of adults with doctor-diagnosed arthritis who perform moderate physical activity for at least 30 minutes per day, three days per week, has been
arthritis 4249 the effects of exercise (aerobic, strength training, or both) on depressive symptoms in adults with arthritis and other rheumatic conditions (AORC) have led to conflicting results [[6]-[34]] with 23 and 36 exercise
arthritis 5937 fibromyalgia [[39]]. However, these latter findings included participants with conditions other than arthritis , for example back pain. In addition, while this previous meta-analysis included an analysis for such
arthritis 6380 focused specifically on the effects of exercise on depressive symptoms in adults with other AORC (osteo arthritis , rheumatoid arthritis, systemic lupus erythematous), met the eligibility criteria. Since the effects
arthritis 6402 the effects of exercise on depressive symptoms in adults with other AORC (osteoarthritis, rheumatoid arthritis , systemic lupus erythematous), met the eligibility criteria. Since the effects of exercise on depressive
arthritis 7527 control, attention control), (5) adults 18-years old and older with one of the following: rheumatoid arthritis , osteoarthritis, or fibromyalgia, (6) studies published in any language between 1 January 1981 and 1
arthritis 7543 attention control), (5) adults 18-years old and older with one of the following: rheumatoid arthritis, osteo arthritis , or fibromyalgia, (6) studies published in any language between 1 January 1981 and 1 January 2013, (7)
arthritis 9565 a preliminary search in PubMed in which the first cited randomized controlled trial on exercise and arthritis in adults was published in 1981 [[44]].Data sourcesStudies were retrieved using the following 10 electronic
arthritis 10180 requirements of the different databases searched, keywords centered on the terms ‘exercise’ , ‘ arthritis ’ and ‘depression’. An example of the search strategy for one database (Scopus) can be found in
arthritis 19977 guidelines were calculated. This was based on an estimated 34.8 million US adults with doctor-diagnosed arthritis , derived by multiplying the number of adults with doctor-diagnosed arthritis (55.2 million) [[1]] by
arthritis 20054 with doctor-diagnosed arthritis, derived by multiplying the number of adults with doctor-diagnosed arthritis (55.2 million) [[1]] by the percentage of adults with arthritis who were not currently meeting physical
arthritis 20118 number of adults with doctor-diagnosed arthritis (55.2 million) [[1]] by the percentage of adults with arthritis who were not currently meeting physical activity guidelines (63%) [[5]]. Practical application was further
arthritis 29259 and BMI [[16]], age and duration of symptoms [[18]], disease status [[8]], diagnosis of rheumatoid arthritis or osteoarthritis [[19]], or score on the Fibromyalgia Impact Questionnaire [[24]]. None of the studies
arthritis 29277 age and duration of symptoms [[18]], disease status [[8]], diagnosis of rheumatoid arthritis or osteo arthritis [[19]], or score on the Fibromyalgia Impact Questionnaire [[24]]. None of the studies used a crossover
arthritis 59381 heart rate reserve; MHI, Mental Health Inventory; MHR, maximum heart rate; min, minute(s); OA, osteo arthritis ; POMS, Profile of Moods States; RA, rheumatoid arthritis; reps, repetitions; RM, repetition maximum;
arthritis 59438 maximum heart rate; min, minute(s); OA, osteoarthritis; POMS, Profile of Moods States; RA, rheumatoid arthritis ; reps, repetitions; RM, repetition maximum; ROM, range of motion; RPE, rate of perceived exertion; sec,
arthritis 63814 participants with fibromyalgia [[6],[7],[9],[10],[12]-[16],[18],[24]-[31],[33],[34]], five with osteo arthritis [[11],[21]-[23],[32]], and two with rheumatoid arthritis [[17],[20]]. One study included participants
arthritis 63871 [[6],[7],[9],[10],[12]-[16],[18],[24]-[31],[33],[34]], five with osteoarthritis [[11],[21]-[23],[32]], and two with rheumatoid arthritis [[17],[20]]. One study included participants with either rheumatoid arthritis or systemic lupus erythematosus
arthritis 63949 and two with rheumatoid arthritis [[17],[20]]. One study included participants with either rheumatoid arthritis or systemic lupus erythematosus [[8]] while another included participants with osteoarthritis or rheumatoid
arthritis 64043 rheumatoid arthritis or systemic lupus erythematosus [[8]] while another included participants with osteo arthritis or rheumatoid arthritis [[19]]. For the 14 exercise (40%) and 13 control (44.8%) groups in which sufficient
arthritis 64067 systemic lupus erythematosus [[8]] while another included participants with osteoarthritis or rheumatoid arthritis [[19]]. For the 14 exercise (40%) and 13 control (44.8%) groups in which sufficient data were provided,
arthritis 79516 men) and type of AORC (reductions in depressive symptoms greater in fibromyalgia versus rheumatoid arthritis participants). However, as can be seen, the results for those groups comprised of those with rheumatoid
arthritis 79630 participants). However, as can be seen, the results for those groups comprised of those with rheumatoid arthritis , osteoarthritis or rheumatoid arthritis and rheumatoid arthritis or systemic lupus erythematosus, were
arthritis 79646 However, as can be seen, the results for those groups comprised of those with rheumatoid arthritis, osteo arthritis or rheumatoid arthritis and rheumatoid arthritis or systemic lupus erythematosus, were limited to three,
arthritis 79670 results for those groups comprised of those with rheumatoid arthritis, osteoarthritis or rheumatoid arthritis and rheumatoid arthritis or systemic lupus erythematosus, were limited to three, two and one results,
arthritis 79695 comprised of those with rheumatoid arthritis, osteoarthritis or rheumatoid arthritis and rheumatoid arthritis or systemic lupus erythematosus, were limited to three, two and one results, respectively.Exploratory
arthritis 88718 (aerobic, strength training or both) on depressive symptoms in adults with AORC: fibromyalgia, osteo arthritis , rheumatoid arthritis and systemic lupus erythematosus. The overall findings suggest that exercise is
arthritis 88740 training or both) on depressive symptoms in adults with AORC: fibromyalgia, osteoarthritis, rheumatoid arthritis and systemic lupus erythematosus. The overall findings suggest that exercise is associated with important
arthritis 99616 [[7],[8],[10]-[12],[16],[17],[19]-[23],[32]-[34]], none were limited to men. Given that the age-adjusted prevalence of doctor-diagnosed arthritis in the US has been reported to be 18.6% in men and that the biology between men and women differs, future
arthritis 99988 participants with systemic lupus erythematosus and only two were limited to adults with rheumatoid arthritis [[17],[20]], future exercise intervention studies may want to focus on these populations. Such a focus
arthritis 105361 general guidelines recommended by the US Centers for Disease Control and Prevention in adults with arthritis may be an appropriate starting point, especially if viewed from a community-based, public health perspective
arthritis 106194 with activity performed over a short duration and at a low intensity, (2) modify one’s activity when arthritis symptoms increase, (3) participate in activities that do not place undue stress on the joints, for example,
fibromyalgia 837 both) ≥4 weeks, (3) comparative control group, (4) adults with osteoarthritis, rheumatoid arthritis, fibromyalgia or systemic lupus erythematosus, (5) published studies in any language since January 1, 1981 and (6)
fibromyalgia 5134 depressive symptoms in adults with AORC [[36]]. Only two previous meta-analyses, limited to adults with fibromyalgia [[37],[38]], met the criteria for inclusion [[36]]. Exercise minus control group reductions in depressive
fibromyalgia 5702 review [[36]] found a SMD reduction of −0.29 (95% CI, −0.16 to −0.43) in depressive symptoms among fibromyalgia participants as well as a reduction of −0.23 (95% CI, −0.11 to −0.34) in participants with chronic
fibromyalgia 5836 as a reduction of −0.23 (95% CI, −0.11 to −0.34) in participants with chronic pain other than fibromyalgia [[39]]. However, these latter findings included participants with conditions other than arthritis, for
fibromyalgia 7557 (5) adults 18-years old and older with one of the following: rheumatoid arthritis, osteoarthritis, or fibromyalgia , (6) studies published in any language between 1 January 1981 and 1 January 2013, (7) depressive symptoms
fibromyalgia 59190 day(s); DASS, Depression, Anxiety and Stress Scale; FIQ, Fibromyalgia Impact Scale for depression; FM, fibromyalgia ; h, hour(s); HAD, Hospital Anxiety and Depression Scale; HR, heart rate; HRR, heart rate reserve; MHI,
fibromyalgia 63731 deviation; yrs, years.For type of AORC, 20 of 29 studies (69.0%) were limited to participants with fibromyalgia [[6],[7],[9],[10],[12]-[16],[18],[24]-[31],[33],[34]], five with osteoarthritis [[11],[21]-[23],[32]],
fibromyalgia 79485 groups (no study was limited to men) and type of AORC (reductions in depressive symptoms greater in fibromyalgia versus rheumatoid arthritis participants). However, as can be seen, the results for those groups comprised
fibromyalgia 88699 effects of exercise (aerobic, strength training or both) on depressive symptoms in adults with AORC: fibromyalgia , osteoarthritis, rheumatoid arthritis and systemic lupus erythematosus. The overall findings suggest
fibromyalgia 93697 −0.12) [[38]] and Herring et al. (SMD, 0.29, 95% CI, −0.16 to −0.43) [[39]] in participants with fibromyalgia . While the overall magnitude of effect varies between all four meta-analyses, the 95% CI for all studies
fibromyalgia 94342 that reported in a previous meta-analysis of pharmacologic interventions limited to participants with fibromyalgia [[73]]. Hauser et al. examined the effects of tricyclic and tetracyclic antidepressants, selective serotonin
fibromyalgia 106805 effects of exercise on depressive symptoms as a primary outcome in adults with AORC beyond those with fibromyalgia [[36]]. Thus, this adds important information as well as direction for future research and practical
osteoarthritis 799 exercise (aerobic, strength training, or both) ≥4 weeks, (3) comparative control group, (4) adults with osteoarthritis , rheumatoid arthritis, fibromyalgia or systemic lupus erythematosus, (5) published studies in any language
osteoarthritis 6375 meta-analysis focused specifically on the effects of exercise on depressive symptoms in adults with other AORC ( osteoarthritis , rheumatoid arthritis, systemic lupus erythematous), met the eligibility criteria. Since the effects
osteoarthritis 7538 attention control), (5) adults 18-years old and older with one of the following: rheumatoid arthritis, osteoarthritis , or fibromyalgia, (6) studies published in any language between 1 January 1981 and 1 January 2013, (7)
osteoarthritis 29272 [[16]], age and duration of symptoms [[18]], disease status [[8]], diagnosis of rheumatoid arthritis or osteoarthritis [[19]], or score on the Fibromyalgia Impact Questionnaire [[24]]. None of the studies used a crossover
osteoarthritis 59376 HRR, heart rate reserve; MHI, Mental Health Inventory; MHR, maximum heart rate; min, minute(s); OA, osteoarthritis ; POMS, Profile of Moods States; RA, rheumatoid arthritis; reps, repetitions; RM, repetition maximum;
osteoarthritis 63809 to participants with fibromyalgia [[6],[7],[9],[10],[12]-[16],[18],[24]-[31],[33],[34]], five with osteoarthritis [[11],[21]-[23],[32]], and two with rheumatoid arthritis [[17],[20]]. One study included participants
osteoarthritis 64038 rheumatoid arthritis or systemic lupus erythematosus [[8]] while another included participants with osteoarthritis or rheumatoid arthritis [[19]]. For the 14 exercise (40%) and 13 control (44.8%) groups in which sufficient
osteoarthritis 79641 However, as can be seen, the results for those groups comprised of those with rheumatoid arthritis, osteoarthritis or rheumatoid arthritis and rheumatoid arthritis or systemic lupus erythematosus, were limited to three,
osteoarthritis 88713 exercise (aerobic, strength training or both) on depressive symptoms in adults with AORC: fibromyalgia, osteoarthritis , rheumatoid arthritis and systemic lupus erythematosus. The overall findings suggest that exercise is
rheumatoid arthritis 815 strength training, or both) ≥4 weeks, (3) comparative control group, (4) adults with osteoarthritis, rheumatoid arthritis , fibromyalgia or systemic lupus erythematosus, (5) published studies in any language since January 1,
rheumatoid arthritis 6391 specifically on the effects of exercise on depressive symptoms in adults with other AORC (osteoarthritis, rheumatoid arthritis , systemic lupus erythematous), met the eligibility criteria. Since the effects of exercise on depressive
rheumatoid arthritis 7516 wait-list control, attention control), (5) adults 18-years old and older with one of the following: rheumatoid arthritis , osteoarthritis, or fibromyalgia, (6) studies published in any language between 1 January 1981 and 1
rheumatoid arthritis 29248 [[21]], age, sex and BMI [[16]], age and duration of symptoms [[18]], disease status [[8]], diagnosis of rheumatoid arthritis or osteoarthritis [[19]], or score on the Fibromyalgia Impact Questionnaire [[24]]. None of the studies
rheumatoid arthritis 59427 Inventory; MHR, maximum heart rate; min, minute(s); OA, osteoarthritis; POMS, Profile of Moods States; RA, rheumatoid arthritis ; reps, repetitions; RM, repetition maximum; ROM, range of motion; RPE, rate of perceived exertion; sec,
rheumatoid arthritis 63860 [[6],[7],[9],[10],[12]-[16],[18],[24]-[31],[33],[34]], five with osteoarthritis [[11],[21]-[23],[32]], and two with rheumatoid arthritis [[17],[20]]. One study included participants with either rheumatoid arthritis or systemic lupus erythematosus
rheumatoid arthritis 63938 [[11],[21]-[23],[32]], and two with rheumatoid arthritis [[17],[20]]. One study included participants with either rheumatoid arthritis or systemic lupus erythematosus [[8]] while another included participants with osteoarthritis or rheumatoid
rheumatoid arthritis 64056 arthritis or systemic lupus erythematosus [[8]] while another included participants with osteoarthritis or rheumatoid arthritis [[19]]. For the 14 exercise (40%) and 13 control (44.8%) groups in which sufficient data were provided,
rheumatoid arthritis 79505 limited to men) and type of AORC (reductions in depressive symptoms greater in fibromyalgia versus rheumatoid arthritis participants). However, as can be seen, the results for those groups comprised of those with rheumatoid
rheumatoid arthritis 79619 arthritis participants). However, as can be seen, the results for those groups comprised of those with rheumatoid arthritis , osteoarthritis or rheumatoid arthritis and rheumatoid arthritis or systemic lupus erythematosus, were
rheumatoid arthritis 79659 seen, the results for those groups comprised of those with rheumatoid arthritis, osteoarthritis or rheumatoid arthritis and rheumatoid arthritis or systemic lupus erythematosus, were limited to three, two and one results,
rheumatoid arthritis 79684 those groups comprised of those with rheumatoid arthritis, osteoarthritis or rheumatoid arthritis and rheumatoid arthritis or systemic lupus erythematosus, were limited to three, two and one results, respectively.Exploratory
rheumatoid arthritis 88729 strength training or both) on depressive symptoms in adults with AORC: fibromyalgia, osteoarthritis, rheumatoid arthritis and systemic lupus erythematosus. The overall findings suggest that exercise is associated with important
rheumatoid arthritis 99977 limited to participants with systemic lupus erythematosus and only two were limited to adults with rheumatoid arthritis [[17],[20]], future exercise intervention studies may want to focus on these populations. Such a focus
systemic lupus erythematosus 853 (3) comparative control group, (4) adults with osteoarthritis, rheumatoid arthritis, fibromyalgia or systemic lupus erythematosus , (5) published studies in any language since January 1, 1981 and (6) depressive symptoms assessed. Studies
systemic lupus erythematosus 7755 depressive symptoms as an outcome. Post hoc, a decision was made to include studies in adults with systemic lupus erythematosus . For this proposed project, community-deliverable exercise interventions were defined as those that
systemic lupus erythematosus 59568 RM, repetition maximum; ROM, range of motion; RPE, rate of perceived exertion; sec, second(s); SLE, systemic lupus erythematosus ; VAS, Visual Analog Scale; wk, week(s); x, times; \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym}
systemic lupus erythematosus 63962 rheumatoid arthritis [[17],[20]]. One study included participants with either rheumatoid arthritis or systemic lupus erythematosus [[8]] while another included participants with osteoarthritis or rheumatoid arthritis [[19]]. For the
systemic lupus erythematosus 79708 those with rheumatoid arthritis, osteoarthritis or rheumatoid arthritis and rheumatoid arthritis or systemic lupus erythematosus , were limited to three, two and one results, respectively.Exploratory meta-regression analyses for changes
systemic lupus erythematosus 88754 on depressive symptoms in adults with AORC: fibromyalgia, osteoarthritis, rheumatoid arthritis and systemic lupus erythematosus . The overall findings suggest that exercise is associated with important reductions in depressive symptoms
systemic lupus erythematosus 99907 partitioned according to sex, seem appropriate.Seventh, since no study was limited to participants with systemic lupus erythematosus and only two were limited to adults with rheumatoid arthritis [[17],[20]], future exercise intervention

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