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

描述（由申请人提供）：与健康对照组相比，患有关节炎和其他风湿性疾病（AORD）的成年人中抑郁症状更为普遍。一个潜在的非药物方法，以改善抑郁症状的成年人与AORD是运动，干预，通常是安全和适当的大多数人与各种类型的AORD。然而，从不同的研究，以社区为基础的运动对抑郁症的影响，AORD成人的整体治疗效果以及治疗协变量的相互作用从未阐明在荟萃分析水平。这是有问题的，因为它阻止了卫生专业人员提供关于低成本，容易获得的，非药物干预的循证建议，而这些建议是绝大多数公众可以获得的。本拟议项目旨在填补这些空白。使用金标准个体参与者数据（IPD）Meta分析方法，本研究启动的R01申请的总体目标是检查约30年期间的随机对照试验文献，以确定 社区可交付的运动（有氧，力量，或两者兼而有之）对患有骨关节炎，类风湿性关节炎和纤维肌痛的成年人的抑郁症的影响，这三种类型的AORD中有最多的随机对照运动干预试验。本项目的具体目标是：（1）确定社区交付练习的总体效果（有氧运动、力量运动或两者兼有）对骨关节炎、类风湿性关节炎和纤维肌痛成年患者抑郁症状的影响，（2）确定与社区可交付运动效果相关的异质性结果的相关因素（有氧，力量，或两者兼而有之）对患有骨关节炎，类风湿性关节炎和纤维肌痛的成年人的抑郁症状的影响。这是有史以来第一个项目的结果，由一组经验丰富的研究人员进行，他们在类似项目上有成功的合作历史，将提供关于社区可交付运动对患有骨关节炎，类风湿性关节炎和纤维肌痛的成年人抑郁症的影响的循证建议。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重要信息，这种方法有可能最大限度地实现NIAMS的部分使命，即“治疗关节炎和肌肉骨骼及皮肤疾病”。

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".