The Efficacy of Different Exercise Intervention Models and Dosages on Post-Stroke Depression: A Systematic Review and...

Post-stroke depression (PSD) is a prevalent psychological complication among stroke survivors. Exercise intervention, as a non-pharmacological therapeutic approach, plays a crucial role in the rehabilitation of PSD. This study aimed to systematically evaluate the efficacy of various exercise intervention models and exercise doses on PSD through a network meta-analysis. The findings are expected to provide personalized exercise recommendations for patients with PSD and further promote the integration of exercise therapy into stroke rehabilitation.

This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant randomized controlled trials (RCTs) published up to April 2025 were retrieved from PubMed, Cochrane, Embase, Ovid, and Web of Science databases. Data analysis was performed using R statistical software.

Exercise interventions lasting less than 8 weeks, performed at least five times per week, and with individual sessions of 30 minutes or less, demonstrated the most significant improvement in PSD symptoms. As the exercise dose increased, the antidepressant effects of mixed aerobic exercise (MAE), combined exercise (CE), resistance training (RT), high-intensity interval training (HIIT), moderate-intensity continuous training (MICT), traditional martial arts (TOMA), and yoga (YOGA) all exhibited a continuous downward trend. Among these, resistance training (RT) showed the most significant decline, with no subsequent rebound effect.

All exercise intervention models effectively alleviate PSD symptoms, with resistance training emerging as the most effective single exercise modality. However, the optimal exercise dose for resistance training remains to be established. Further clinical studies are warranted to clarify the dose-response relationship and optimize exercise dose PSD management.

PROSPERO (CRD420251012962).