Effects of Different Physical Activity Interventions on Symptoms of Anxiety and Depression in Children and Adolescents ：A Network Meta-Analysis of Randomized Controlled Trials

Abstract Background: Anxiety and depression are widespread mental health conditions worldwide, with significant negative impacts on patients. These conditions are especially prevalent among adolescents. Recently, exercise therapy has gained popularity as a supplementary approach to managing anxiety and depression. Numerous studies have started investigating the relationship between physical activity and anxiety and depressive symptoms in adolescents. Nonetheless, systematic evidence to guide the optimal choice of physical activities remains insufficient. This study aims to compare and rank various physical activity interventions to determine the most effective ones for treating adolescent anxiety and depression, ultimately providing valuable insights for clinical practice. Methods: A thorough search was performed in PubMed, Embase, Web of Science, and the Cochrane Library to identify randomized controlled trials evaluating the impact of physical activity interventions on children with anxiety and depression. The search encompassed all available records from the inception of each database up to April 2024. Literature screening, data extraction, and quality evaluation were managed independently by two reviewers. Subsequently, Stata version 15.1 was employed to conduct a network meta-analysis. Results: A total of 25 studies were included in the analysis. The findings demonstrate that High-intensity interval training is the most effective intervention for preventing and reducing depression and anxiety in children(SUCRA = 85.4%), followed by REC (SUCRA = 82.2%). Additionally, Mind-body exercise and Moderate-to-vigorous exercise were identified as relatively effective strategies, with SUCRA scores of 70.9% and 67.1%, respectively. Conclusions: Our study shows that High-intensity interval training and Resistance training are the most effective interventions overall. Selecting the optimal exercise type should be individualized based on each child’s unique needs while encouraging consistent participation in physical activity. PROSPERO: CRD42024563543 DATE: July 10, 2024 retrospectively registered