Effects of Aerobic Exercise on Depressive Symptoms in People with Parkinson’s Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objectives: The objective of this study was to assess the effect of aerobic exercise on depressive symptoms and to determine the optimal exercise prescription for Parkinson’s disease (PD) patients. Methods: A comprehensive search was conducted across PubMed, Web of Science, Cochrane, Scopus, and Embase databases. A meta-analysis was conducted to determine the standardized mean difference (SMD) and 95% confidence interval. Results: Aerobic exercise significantly alleviated depressive symptoms in PD patients (SMD, −0.68, p = 0.002). Subgroup analyses revealed that moderate intensity aerobic exercise (SMD, −0.72, p = 0.0006), interventions conducted for ≥12 weeks (SMD, −0.85, p = 0.04), ≥3 times per week (SMD, −0.68, p = 0.002), ≥60 min per session (SMD, −0.57, p < 0.0001), and ≥180 min per week (SMD, −0.87, p = 0.0002) were more effective in improving depressive symptoms in PD patients, especially in PD patients with a disease duration of ≤6 years (SMD, −1.00, p = 0.04). Conclusions: Integrating the available data, it is clear that aerobic exercise is a proven method for alleviating depressive symptoms in PD patients. This meta-analysis provides empirical support for clinicians to recommend that PD patients engage in aerobic exercise regimens of no less than 12 weeks’ duration, performed at a minimum frequency of three sessions per week, with each session lasting in excess of 60 min and a cumulative weekly duration of at least 180 min, to effectively attenuate depressive symptomatology. Earlier implementation of aerobic exercise interventions is recommended, as PD patients in the early stages of the disease (up to 6 years post-diagnosis) may derive the greatest benefit in terms of depression symptom improvement from such programs.