# Effects of combined exercise training for adults with resistant major depression: a pilot study from the TRACE-RMD project

## TL;DR

This pilot study found that a 12-week supervised combined exercise program improved clinical symptoms and quality of life in adults with resistant major depression, without significant changes in body composition or fitness.

## Contribution

The study demonstrates the potential of supervised exercise to improve clinical outcomes in individuals with resistant major depression.

## Key findings

- Clinical symptoms, as measured by MADRS, CGI-S, and SDS, significantly decreased after the intervention.
- Quality of life domains like general health, vitality, and social functioning improved significantly.
- No significant changes were observed in body composition, cardiorespiratory fitness, or biochemical profile.

## Abstract

This pilot study analyzed the changes in body composition, cardiorespiratory fitness (CRF), biochemical profile, clinical symptoms, and quality of life (QoL) of adults with resistant major depression (RMD) following 12 weeks of combined exercise training.

Eighteen adults diagnosed with RMD (42.5 ± 9.9 years, 66.7% women) participated in a supervised exercise group (2 days/week). The combined exercise training consisted of low-to-moderate intensity aerobic interval exercise on a bicycle and strength-resistance exercises. All variables were assessed pre- and post-intervention, including clinical symptoms with the Montgomery-Åsberg Depression Rating Scale (MADRS), the Clinical Global Impressions Scale (CGI-S), the Sheehan Disability Scale (SDS), and health-related QoL with the Short Form-36. A symptom-limited cardiopulmonary exercise peak test was performed to evaluate CRF.

The baseline results classified the participants as metabolically unhealthy with overweight/obesity, moderate depression, and low CRF and QoL. Following the intervention, there were no significant changes (P > 0.05) in body composition, the main CRF physiological variables, and the biochemical profile. However, regarding clinical symptoms, the MADRS (mean difference −8.31, 95% confidence interval (CI) [−15.1 to −1.5], P = 0.021), CGI-S (mean difference -1.17, 95% CI [−1.92 to −0.41], P = 0.006), and SDS (mean difference -5.46, 95% CI [−10.8 to −0.12], P = 0.046) scores decreased, and the domains of health-related QoL –general health (mean difference 13.8, 95% CI [2.9–24.8], P = 0.017), vitality (mean difference 10.4, 95% CI [0.26–20.5], P = 0.045), social functioning (mean difference 25.9, 95% CI [8.1–43.7], P = 0.008), and the mental component summary (mean difference 6.9, 95% CI [1.1–12.8], P = 0.024) increased.

A supervised combined exercise program in people with RMD may induce positive and beneficial changes in functionality and clinical and QoL variables, and maintain body composition, CRF, and the biochemical profile. These preliminary results highlight the critical role of supervised exercise, regardless of intensity, in improving clinical symptoms in people with RMD. This study was registered with the International Standard Randomized Controlled Trial Code NCT 05136027.