Exercise and Depression in Adults with Arthritis: An IPD Meta-Analysis

描述(申请人提供)：与健康对照相比，抑郁症状在患有关节炎和其他风湿病(AORD)的成年人中更为普遍。改善成人AORD抑郁症状的一种潜在的非药物方法是运动，这种干预通常对大多数AORD类型的人是安全和合适的。然而，社区锻炼对成人AORD抑郁症的整体治疗效果以及治疗-协变量的相互作用从未在荟萃分析水平上得到阐明。这是有问题的，因为它阻止卫生专业人员就绝大多数普通公众可获得的低成本、容易获得的非药物干预提供基于证据的建议。这个拟议的项目旨在使用黄金标准的个人参与者数据(IPD)元分析方法来填补这些空白，这个由研究人员发起的为期两年的R01应用程序的总体目标是检查大约30年期间的随机对照试验文献，以确定 社区递送运动(有氧运动、力量运动或两者兼而有之)治疗患有骨性关节炎、类风湿性关节炎和纤维肌痛的成年人的抑郁症，这三种类型的AORD拥有最多的随机对照运动干预试验。该项目的具体目标是(1)确定社区递送运动(有氧、力量或两者)对患有骨性关节炎、类风湿性关节炎和纤维肌痛的成年人抑郁症状的总体影响，(2)确定与社区递送运动(有氧、力量或两者)对患有骨关节炎、类风湿性关节炎和纤维肌痛的成年人抑郁症状的影响相关的异质性结果的那些因素。这是有史以来第一个由一组经验丰富的研究人员领导的项目，他们在类似项目上有持续的成功合作历史，将就社区递送运动对患有骨性关节炎、类风湿性关节炎和纤维肌痛的成年人抑郁的影响提供循证建议。这将是关于在社区一级治疗患有选定类型关节炎的成年人的新的和重要的信息，这种方法有可能最大限度地实现NIAMS的部分使命，即“治疗关节炎以及肌肉骨骼和皮肤病”。 公共卫生相关性：抑郁症是成人关节炎患者的主要公共卫生问题。这项拟议的项目旨在确定运动(有氧运动、强度运动或两者兼有)对患有关节炎的成年人抑郁的影响。

DESCRIPTION (provided by applicant): When compared to healthy controls, depressive symptoms are more prevalent among adults with arthritis and other rheumatic diseases (AORD). One potential non-pharmacologic approach for improving depressive symptoms in adults with AORD is exercise, an intervention that is generally safe and appropriate for most persons with various types of AORD. However, the overall treatment effect as well as treatment-covariate interactions from different studies addressing the effects of community-based exercise on depression in adults with AORD has never been elucidated at the meta-analytic level. This is problematic because it prevents health professionals from providing evidence-based recommendations regarding a low-cost, readily available, nonpharmacologic intervention that is available to the vast majority of the general public. This proposed project aims to fill these gaps Using the gold standard individual participant data (IPD) meta- analytic approach, the overall objective of this two-year investigator-initiated R01 application is to examine the randomized controlled trial literature over an approximate 30 year period in order to determine the effects of community-deliverable exercise (aerobic, strength, or both) on depression in adults with osteoarthritis, rheumatoid arthritis and fibromyalgia, the three types of AORD in which the largest number of randomized controlled exercise intervention trials are available. The specific aims of this project are to (1) determine the overall effects of community-deliverable exercise (aerobic, strength, or both) on symptoms of depression in adults with osteoarthritis, rheumatoid arthritis and fibromyalgia, (2) identify those factors responsible for heterogeneous results in relation to the effects of community-deliverable exercise (aerobic, strength, or both) on symptoms of depression in adults with osteoarthritis, rheumatoid arthritis and fibromyalgia. The results of this first-ever project, conducted by a team of experienced investigators who have an on- going history of successful collaboration on similar projects, will provide evidence-based recommendations regarding the effects of community-deliverable exercise on depression in adults with osteoarthritis, rheumatoid arthritis and fibromyalgia. This will be new and important information regarding the treatment of adults with selected types of arthritis at the community level, an approach that has the potential for the greatest reach in fulfilling part of the mission f NIAMS, that is, the "treatment of arthritis and musculoskeletal and skin diseases". PUBLIC HEALTH RELEVANCE: Depression is a major public health problem in adults with arthritis. This proposed project is aimed at determining the effects of exercise (aerobic, strength or both) on depression in adults with arthritis.