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多种运动方式对儿童青少年抑郁和焦虑干预效果的网状Meta分析

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目的 采用网状Meta分析法比较有氧运动、抗阻运动、有氧联合抗阻运动、常规护理和无干预对儿童青少年抑郁和焦虑的干预效果.方法 计算机检索CNKI、WanFang Data、VIP、CBM、Web of Science、EBSCO、PubMed、Cochrane Library和Embase数据库,搜集运动干预儿童青少年抑郁和焦虑相关的随机对照试验,检索时限均从建库至2023年4月.由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 14.0和RevMan 5.3软件进行统计分析.结果 最终纳入27个随机对照试验,涵盖3 210名儿童青少年.网状Meta分析结果显示:在改善抑郁方面,抗阻运动[SMD=-0.37,95%CI(-0.64,-0.10),P<0.05]、有氧运动[SMD=-0.19,95%CI(-0.34,-0.04),P<0.01]显著优于无干预组;在缓解焦虑方面,有氧运动[SMD=-0.29,95%CI(-0.54,-0.03),P<0.05]显著优于无干预组.在提升自我价值方面,有氧联合抗阻运动[SMD=0.26,95%CI(0.01,0.52),P<0.05]与无干预相比,具有统计学差异.累积概率图曲线下面积排序结果显示:在降低抑郁方面,抗阻运动(95.0%)>有氧运动(64.4%)>有氧联合抗阻运动(60.7%)>常规护理(22.9%)>无干预(7.0%);在缓解焦虑症状方面,有氧运动(72.4%)>常规护理(69.0%)>有氧联合抗阻运动(55.3%)>无干预(3.4%);在改善自我价值方面,有氧联合抗阻运动(94.0%)>抗阻运动(67.3%)>有氧运动(35.1%)>无干预(32.7%)>常规护理(21.0%).结论 有限证据表明,抗阻运动对改善儿童青少年抑郁,有氧运动对缓解儿童青少年焦虑,有氧联合抗阻运动对改善儿童青少年自我价值,各具优势.受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证.
Intervention effects of multiple exercise methods on depression and anxiety in children and adolescents:a network meta-analysis
Objective To compare the effects of aerobic exercise,resistance exercise,aerobic combined with resistance exercise,routine nursing and no intervention on depression and anxiety in adolescents by means of network meta-analysis.Methods A computer search was conducted in CNKI,WanFang Data,VIP,CBM,Web of Science,EBSCO,PubMed,Cochrane Library and Embase to collect randomized controlled trials(RCTs)related to exercise intervention for depression and anxiety in children and adolescents from inception to April 2023.After two researchers independently screened the literature,extracted data and evaluated the methodological quality of the included studies,Stata 14.0 and RevMan 5.3 software were used for statistical analysis.Results Finally 27 RCTs were included,covering 3210 children and adolescents.The results of the network meta-analysis showed that in terms of improving depression resistance exercise(SMD=-0.37,95%CI-0.64 to-0.10,P<0.05)and aerobic exercise(SMD=-0.19,95%CI-0.34 to-0.04,P<0.01)were significantly better than the no intervention group;in relieving anxiety,aerobic exercise(SMD=-0.29,95%CI-0.54 to-0.03,P<0.05)was significantly better than the no intervention group.In improving self-worth,aerobic combined with resistance exercise(SMD=0.26,95%CI 0.01 to 0.52,P<0.05)was statistically different from the no intervention group.The results of SUCRA probability sequence showed that in reducing depression,resistance exercise(95.0%)>aerobic exercise(64.4%)>aerobic combined with resistance exercise(60.7%)>routine nursing(22.9%)>no intervention(7.0%).In relieving anxiety,aerobic exercise(72.4%)>routine nursing(69.0%)>aerobic combined with resistance exercise(55.3%)>no intervention(3.4%).In improving self-worth,aerobic combined with resistance exercise(94.0%)>resistance exercise(67.3%)>aerobic exercise(35.1%)>no intervention(32.7%)>routine nursing(21.0%).Conclusion Limited evidence suggests that resistance exercise has advantages in improving depression in children and adolescents,aerobic exercise has advantages in relieving anxiety in children and adolescents,and aerobic combined with resistance exercise has advantages in improving self-worth in children and adolescents.Due to the limitation of the number and quality of included studies,more high-quality studies are needed to verify the above conclusions.

ExerciseChildren and adolescentsDepressionAnxietyNetwork meta-analysis

刘松、柳鸣毅、敬艳

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武汉体育学院中国青少年体育与体教融合公共政策研究中心(武汉 430079)

武汉体育学院运动训练学院(武汉 430079)

运动方式 儿童青少年 抑郁 焦虑 网状Meta分析

国家社会科学基金湖北省优势特色学科(群)项目(十四五)

21BTY029鄂教研[2021]5号

2024

中国循证医学杂志
四川大学

中国循证医学杂志

CSTPCD北大核心
影响因子:1.761
ISSN:1672-2531
年,卷(期):2024.24(8)