A systematic review and meta-analysis of the effects of mind-body exercise on depressed and anxious individuals.

Background: This systematic review evaluates the effectiveness of mind-body exercise in alleviating symptoms of depression and anxiety. It further compares the effects of different types of mind-body exercise and examines whether intervention cycle, session length, or frequency exhibit dose-response relationships. Methods: This study adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and systematically searched seven prominent databases-Web of Science, PubMed, Cochrane Library, Embase, CNKI, WANFANG DATA, and the VIP database-from their inception through July 6, 2024. Only randomized controlled trials (RCTs) examining the impact of mind-body exercise interventions on depression and anxiety were included in the analysis. All experimental groups engaged only in mind-body exercise, and control groups received no intervention. Meta-analysis, subgroup analysis, sensitivity analysis, and assessment of publication bias were performed using Stata 17.0 software. Evidence quality was assessed using the GRADE tool. Results: A total of 15 studies that encompassed 1,351 participants were included in this review. The meta-analysis demonstrated that mind-body exercise significantly alleviated symptoms of depression (Hedges' g = -0.86, 95% CI [-1.24 to -0.48], P < 0.001) and anxiety (Hedges' g = -0.38, 95% CI [-0.53 to -0.23], P < 0.001). Five subgroup variables were examined in this study: exercise type, session duration (minutes), intervention period (weeks), frequency (sessions per week), and baseline depression severity. In the analysis of depression outcomes, exercise type, session duration, frequency, and baseline depression severity were identified as significant moderators. The most effective intervention characteristics for reducing depressive symptoms were: Qigong as the exercise type, sessions lasting 31-60 min, a frequency of three sessions per week, an intervention period of 9-12 weeks, and high baseline levels of depression. In contrast, none of these variables were found to be significant moderators in the analysis of anxiety outcomes. However, the most effective intervention characteristics for alleviating anxiety symptoms were tai chi as the exercise type, sessions lasting 31-60 min, a frequency of four or more sessions per week, an intervention period of 8 weeks or less, and normal baseline anxiety levels. Discussion: There was robust evidence that mind-body exercise significantly reduces symptoms of depression and anxiety. Other: This study adhered to PRISMA guidelines to ensure rigorous transparency and methodological accuracy. Furthermore, it was formally registered on the PROSPERO international systematic review platform (https://www.crd.york.ac.uk/prospero/) under registration number CRD42024613769.