Individualized Web-based Exercise for the Treatment of Depression � a Feasibility Study (Preprint)

BACKGROUND Due to the high prevalence of depressive disorders, it is mandatory to develop therapeutic strategies that provide universal access and require limited financial and human resources. Web-based therapeutic approaches fulfill these claims. OBJECTIVE The purpose of this study was to assess if a supervised, individualized 8-week web-based exercise program in patients with moderate to severe depressive episodes was feasible, accepted and promising to relieve symptoms. METHODS Twenty patients with unipolar depression were recruited and randomly assigned into two groups (1: intervention, exercise program, n=14; 2: control, treatment-as-usual, n=6). At baseline, depressive symptoms were rated via the Quick Inventory of Depressive Symptomatology (QIDS) by the patient him- or herself (QIDS-SR) and a blinded psychiatrist (QIDS-C) and performance diagnostics (lactate analysis, spiroergometry during a treadmill walking test) were conducted. Participants of the intervention group received exercise schedules once weekly with endurance and strength training instructions. Rating of depressive symptoms was repeated after 6-12 days and 8 weeks; performance diagnostics were repeated after 8 weeks, only. RESULTS Severity of depression subsided significantly in the intervention group after 8 weeks (median change of QIDS-SR: -5, IQR: -2 to -10), already evident within the first 6-12 days (median change of QIDS-SR: -6, IQR: -2 to -8). During the intervention, participants conducted on average 75 minutes of endurance training (IQR: 63-98) per week or 16 (IQR: 15-21) of 19 recommended endurance units in total. In addition, 9 (IQR: 4-12) of 10 recommended strength training exercise units were conducted during the 8 weeks. Performance diagnostics revealed a significant increase of maximum output in Watt for the intervention group after 8 weeks. CONCLUSIONS Our individualized web-based exercise intervention in moderate to severe depression was highly accepted and led to a significant and clinically relevant improvement of depressive symptoms. CLINICALTRIAL ClinicalTrials.gov Identifier: NCT02874833