Depression can be treated with the help of exercise therapy (1). There is some evidence on the topic (2), but additional research is required as well (1). The proposed study will compare the effectiveness of different types of training in managing the symptoms of depression; the therapy will also be considered from the point of view of its approval by people with moderate depression. The research is significant because according to existing studies (1), there is no sufficient evidence to make conclusive statements about the types of training that should be employed to manage depression.
According to recent meta-analyses and systematic reviews, there is some evidence which indicates positive outcomes of exercise therapy for patients with depression (1-4). The specific results are concerned with the reduction of depressive symptoms and the improvements that are related to comorbidities (1-3). The effect of exercise therapy is typically described as modest (1, 3), but certain approaches are seen to improve it. In particular, it has been found (1) that certain types of training (especially mixed training) may have better outcomes. Still, the evidence on the topic is not very extensive, which makes offering definitive statements difficult.
It should be pointed out that numerous methodological issues were found in some of the existing studies; also, their heterogeneity makes them difficult to meta-analyze (3). In general, the topic is shown to require additional investigation, which explains the need for the proposed research. Furthermore, it is evidenced that different approaches to training can have different outcomes, but more research is required to make specific recommendations (1). Given the problems that are associated with depression and the fact that it is a major health issue (1-4), it is apparent that the proposed study would have notable value due to its contribution of more information on the topic.
Methodology. A Mixed Methods Approach
The proposed research intends to combine the benefits of qualitative and quantitative inquiry for an improved exploration of the topic (5). In particular, quantitative methods will be used to determine the relationships between exercise therapy and depression symptoms while qualitative ones will be employed to gather participants’ feedback related to their experiences and attitudes towards their therapy. Both approaches are explained by the specifics of different methods; a relationship between phenomena can only be proven to exist (or not exist) with the help of quantitative research (6). However, quantitative approaches cannot analyze qualitative data, which the feedback will include (5-6). Thus, both strategies are required to satisfy the needs of the research.
Considering more specific methods, a randomized controlled trial would provide the highest-quality evidence describing the relationship between exercise therapy and health outcomes. It is proposed to have three groups with moderate depression, one of which will have only their regular therapy. The other two groups will be testing two different training approaches in addition to their regular therapy. It would be better to recruit the people who are treated with the same regular therapy (for instance, only pharmacotherapy or psychotherapy). The participants’ depression symptoms will be measured with the help of an established scale (for example, the Hamilton Rating Scale for Depression (7) or another one) before and after the intervention.
After the intervention, a specifically-developed questionnaire will be administered to gather the participants’ feedback. This feedback will include attitudes towards exercise therapy, barriers and facilitators encountered by the participants, their willingness to proceed with the treatment, and other features. The quantitative data will be analyzed statistically (specific tests will be determined depending on the collected data), and the qualitative data will use thematic analysis. This mixed methods approach will help to achieve the aims of the proposed study.
- Pedersen B, Saltin B. Exercise as medicine – evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports. 2015;25: 1-72.
- Knapen J, Vancampfort D, Moriën Y, Marchal Y. Exercise therapy improves both mental and physical health in patients with major depression. Disabil Rehabil. 2014;37(16): 1490-1495.
- Cooney G, Dwan K, Mead G. Exercise for depression. JAMA. 2014;311(23): 2432-2433.
- Stubbs B, Vancampfort D, Rosenbaum S, Ward P, Richards J, Soundy A, et al. Dropout from exercise randomized controlled trials among people with depression: a meta-analysis and meta regression. J Affect Disord. 2016;190: 457-466.
- Creswell J. A concise introduction to mixed methods research. Washington: SAGE Publications; 2014.
- Creswell JW, Creswell JD. Research design. 5th ed. Washington: SAGE Publications; 2017.
- Sharp R. The Hamilton Rating Scale for Depression. Occup Med. 2015;65(4):340-340.