Abstract: Backround Working memory impairment is a core cognitive feature of depression. Physical exercise may improve working memory through neuroplastic mechanisms, yet existing meta-analyses have yielded inconsistent conclusions and lack in-depth exploration of key moderators such as intervention dosage and age. Objective To systematically evaluate the effects of physical exercise on working memory in patients with depression and provide evidence for developing clinical exercise interventions for working memory impairment. Methods Searched PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP, and WanFang Data for RCTs on exercise interventions for working memory in depression patients. Search period: database inception to December 2024. Independently screened and coded studies. Assessed RCT quality using the PEDro scale. Conducted meta-analysis with RevMan 5.3 and Stata 17. Results Twenty eligible studies (total sample: n=1 433) with 31 effect sizes were included. Physical exercise significantly improved working memory in depressed patients (SMD=0.18, 95%CI=0.03-0.32, P=0.02).Subgroup analyses revealed: optimal modalities: Tai Chi (SMD=0.95, 95%CI=0.49-1.40，P<0.001) and Baduanjin (SMD=0.95,95%CI=0.49-1.40，P<0.001) ;Optimal frequency: ≥ 5 week (SMD=0.30, 95%CI=0.18-0.71, P=0.005) ;Optimal duration: 60 minutes (SMD=0.46, 95%CI=0.25-0.68, P<0.001). Conclusion Physical exercise effectively improves working memory in depression, with efficacy moderated by exercise modality, frequency, and duration. Tai Chi and Baduanjin are recommended as primary mind-body interventions. While current evidence shows no moderating effect of age, elderly populations warrant further investigation.

Key words: Depression, Exercise, Working memory, Meta-analysis, Root cause analysis

摘要： 背景 工作记忆缺陷是抑郁症的核心认知特征，而体育锻炼可能通过神经可塑性机制对其进行改善。然而，现有相关元分析结论存在矛盾，且缺乏对干预剂量（如强度、周期）及年龄等关键调节因素的深入探讨。目的 系统评价体育锻炼对抑郁症患者工作记忆的干预效果及影响因素，为临床抑郁症患者工作记忆损伤的体育锻炼方案制订提供参考。方法 检索PubMed、Embase、Cochrane Library、Web of Science、中国知网（CNKI）、维普网、万方数据知识服务平台等中、英文数据库中与体育锻炼对抑郁症患者工作记忆干预相关的随机对照试验（RCT），检索时限为建库至2024年12月。由研究者独立筛选文献并进行编码，采用PEDro量表对RCT进行质量评价。采用Rev Man 5.3和Stata 17软件进行Meta分析。结果 纳入有效文献20篇，样本共计1 433例。研究共纳入31个效应量，Meta分析结果显示，体育锻炼对抑郁症患者的工作记忆改善具有显著疗效（SMD=0.18，95%CI=0 .03~0 .32，P=0.02）。亚组分析结果显示，太极和八段锦（SMD=0.95，95%CI=0 .49~1 .40，P<0.001）是最有效的锻炼形式，每周锻炼5次以上（SMD=0.30，95%CI=0 .18~0 .71，P=0.005）、每次锻炼60 min（SMD=0.46，95%CI=0 .25~0 .68，P<0.001）的干预效果最好。结论 体育锻炼能够有效改善抑郁症患者的工作记忆，干预效果与锻炼形式、锻炼频率和持续时间有关。制订体育锻炼方案时，尽量以太极、八段锦等慢节奏身心运动形式为主。尽管当前证据不支持年龄对体育锻炼改善抑郁症患者工作记忆的效果具有调节作用，但老年群体可能是一个值得深入研究的亚群体。

关键词: 抑郁症, 运动, 工作记忆, Meta 分析, 影响因素分析