Physical activity in the treatment-resistant depression and non-remitted depression: a systematic review of randomized controlled trials.

BACKGROUND: The objective of this systematic review was to analyze the effects of physical activity (PA) intervention as an adjuvant strategy to pharmacological treatment in people with treatment-resistant depression (TRD) and non-remitted depression (NRD). METHODS: A search strategy was conducted from five databases: PubMed, Cochrane Central Register of Controlled Trials, Scopus, SPORTDiscus, and Web of Science. The Physiotherapy Evidence Database and Oxford's Evidence Levels were used to classify the quality appraisal. RESULTS: Of the 10777 records, 11 randomized controlled studies met the inclusion criteria. The main outcome for this analysis was the effect of physical activity (PA) or exercise on depressive symptoms in people with TRD and NRD diagnosis. According to the FITT (Frequency, Intensity, Time, and Type) principle, there was some variability in the PA intervention. However, except for one article, all were classified as excellent in terms of quality description. CONCLUSIONS: This review highlights the potential of PA intervention as an adjuvant program to improve various traits in TRD and NRD. The remission of depression seems to be higher after PA intervention, showing improvements in quality of life, sleep quality, executive function, and vitality.