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

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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".