Meta-analysis of the Effect of Physical Exercise on Working Memory in Patients with Depression and Its Influencing Factors

doi:10.12114/j.issn.1007-9572.2025.0258

Abstract

Abstract:

Background

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=1 475) 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 showed that the form, frequency and duration of physical exercise intervention moderated the effect of exercise on improving working memory in patients with depression: Baduanjin/Tai Chi yielded the highest effect size (SMD=0.95, 95%CI=0.49-1.40, P<0.001); 7 sessions per week had the strongest effect (SMD=1.31, 95%CI=0.84-1.78, P<0.001), and 5 sessions per week still had a significant effect (SMD=0.30, 95%CI=0.09-0.52, P=0.005); a single 60-min exercise session produced a significant effect (SMD=0.48, 95%CI=0.23-0.73, 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.

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、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RevMan 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1 475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，体育锻炼干预形式、频次、时间均可调节运动改善抑郁症患者工作记忆的效应：八段锦/太极效应量最高（SMD=0.95，95%CI=0.49~1.40，P<0.001）；每周锻炼7次效果最强（SMD=1.31，95%CI=0.84~1.78，P<0.001），每周5次仍存在明显效应（SMD=0.30，95%CI=0.09~0.52，P=0.005）；单次60 min锻炼效应显著（SMD=0.48，95%CI=0.23~0.73，P<0.001）。

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。

关键词: 抑郁症, 运动, 工作记忆, Meta分析, 影响因素分析

CLC Number:

R 749.41

CHI Liaojing,LI Na,LI Yafang. Meta-analysis of the Effect of Physical Exercise on Working Memory in Patients with Depression and Its Influencing Factors[J]. Chinese General Practice, 2026, 29(36): 5428-5441. DOI: 10.12114/j.issn.1007-9572.2025.0258.
池廖婧,李娜,李雅方. 体育锻炼对抑郁症患者工作记忆干预效果及影响因素的Meta分析[J]. 中国全科医学, 2026, 29(36): 5428-5441. DOI: 10.12114/j.issn.1007-9572.2025.0258.

Figures/Tables 10

References 74

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第一作者	年份（年）	国家	年龄（岁）		性别（男/女）		干预措施		疗程（周）	结局指标
第一作者	年份（年）	国家	试验组	对照组	试验组	对照组	试验组	对照组	疗程（周）	结局指标
符泽娟^[27]	2022	中国	15.12±1.83	15.29±1.96	21/24	20/25	药物治疗+有氧运动，5次/周，40~50 min，中等到较大强度	药物治疗	8	①
陈倩倩^[28]	2021	中国	30.3±7.5	32.7±6.5	22/41	20/42	药物治疗+有氧运动，3次/周，30~60 min，中等强度	药物治疗	16	①②
郑天生^[29]	2019	中国	35.17±5.93	37.50±9.12	13/17	14/16	常规综合治疗+有氧运动，5次/周，30 min，中等强度	常规综合治疗	4	③④⑤
Brüchle^[30]	2021	德国	33.3±3.06	40.11±3.63	12/11	11/7	认知训练+身体活动，3次/周，60 min，中等强度	认知训练	3	⑥
Buscher^[31]	2018	德国	47.27±6.84	47.47±8.47	6/9	5/10	药物治疗+有氧运动，2~3次/周，30 min，中等强度	药物治疗+艺术治疗	3~4	①
Halappa^[32]	2018	印度	34.6±8.85	32.84±9.14	38/27	5/14	药物治疗+瑜伽，3次/周，60 min，低强度	药物治疗	12	①
Hoffman^[33]	2008	美国	51.9±7.4	51.2±7.8	26/78	11/38	有氧运动，3次/周，45 min，中度至剧烈强度	安慰剂	16	①
Imboden^[34]	2016	瑞士	37.9±13.1		16	17	住院治疗+有氧运动，3次/周，约45 min，中等强度	住院治疗	6	②
Imboden^[35]	2020	瑞士	41.3±9.2	38.3±13.4	12/10	10/10	住院治疗+有氧运动，3次/周，45 min，中等强度	住院治疗+拉伸运动，45 min,3次/周，低强度	6	②
Khatri^[36]	2001	英国	56.73±6.54		42	42	药物治疗+有氧运动，3次/周，30 min，中度至剧烈强度	药物治疗	16	①
Krogh^[37]	2009	丹麦	38.1±9.0	36.7±8.7	12/43	21/34	药物治疗+有氧运动，2次/周，90 min，中度至剧烈强度	药物治疗+放松训练	16	①
Krogh^[38]	2012	丹麦	39.7±11.3	43.4±11.2	16/40	22/37	有氧运动，3次/周，45 min，中度至剧烈强度	拉伸运动，45 min，低强度	12	①
Lavretsky^[39]	2021	美国	69.1±7.0	72.0±7.4	13/23	15/22	药物治疗+太极拳，3次/周，60 min，低强度	药物治疗+健康教育	12	⑦
Muhammad^[40]	2023	印度尼西亚	28.38±11.08	30.00±8.66	0/8	1/8	药物治疗+有氧运动，5次/周，30 min，中等强度	药物治疗	2	⑧
Olson^[41]	2017	美国	21.0±1.9	21.2±2.2	4/11	2/13	有氧运动，3次/周，45 min，中度强度	拉伸运动，30~45 min，低强度	8	①
Zhang^[42]	2017	中国	31.4±7.2	32.2±7.6	22/0	20/0	药物治疗+有氧运动，3 d/周，3 km约30 min，中等强度	药物治疗	8
Zhang^[43]	2022	中国	47.20±6.99	54.16±6.09	3/17	1/18	太极拳，2次/周，90 min，低强度	等待组维持日常行为	12	⑨
Neviani^[44]	2017	意大利	75.0±6.3	75.6±5.6	25/54	10/32	药物治疗+有氧运动，3次/周，60 min，强度渐进至高强度	药物治疗	24	⑧
李冰^[45]	2024	中国	69.60±5.25	71.72±5.44	19/24	17/26	药物治疗+八段锦，约30 min，低强度	药物治疗	12	⑧
刘聪^[46]	2024	中国	39.02±10.35	40.92±11.35	26/25	25/24	常规综合治疗+有氧运动，3次/周以上，30~60 min，中等强度	常规综合治疗	4	⑧

第一作者	年份（年）	国家	年龄（岁）		性别（男/女）		干预措施		疗程（周）	结局指标
第一作者	年份（年）	国家	试验组	对照组	试验组	对照组	试验组	对照组	疗程（周）	结局指标
符泽娟^[27]	2022	中国	15.12±1.83	15.29±1.96	21/24	20/25	药物治疗+有氧运动，5次/周，40~50 min，中等到较大强度	药物治疗	8	①
陈倩倩^[28]	2021	中国	30.3±7.5	32.7±6.5	22/41	20/42	药物治疗+有氧运动，3次/周，30~60 min，中等强度	药物治疗	16	①②
郑天生^[29]	2019	中国	35.17±5.93	37.50±9.12	13/17	14/16	常规综合治疗+有氧运动，5次/周，30 min，中等强度	常规综合治疗	4	③④⑤
Brüchle^[30]	2021	德国	33.3±3.06	40.11±3.63	12/11	11/7	认知训练+身体活动，3次/周，60 min，中等强度	认知训练	3	⑥
Buscher^[31]	2018	德国	47.27±6.84	47.47±8.47	6/9	5/10	药物治疗+有氧运动，2~3次/周，30 min，中等强度	药物治疗+艺术治疗	3~4	①
Halappa^[32]	2018	印度	34.6±8.85	32.84±9.14	38/27	5/14	药物治疗+瑜伽，3次/周，60 min，低强度	药物治疗	12	①
Hoffman^[33]	2008	美国	51.9±7.4	51.2±7.8	26/78	11/38	有氧运动，3次/周，45 min，中度至剧烈强度	安慰剂	16	①
Imboden^[34]	2016	瑞士	37.9±13.1		16	17	住院治疗+有氧运动，3次/周，约45 min，中等强度	住院治疗	6	②
Imboden^[35]	2020	瑞士	41.3±9.2	38.3±13.4	12/10	10/10	住院治疗+有氧运动，3次/周，45 min，中等强度	住院治疗+拉伸运动，45 min,3次/周，低强度	6	②
Khatri^[36]	2001	英国	56.73±6.54		42	42	药物治疗+有氧运动，3次/周，30 min，中度至剧烈强度	药物治疗	16	①
Krogh^[37]	2009	丹麦	38.1±9.0	36.7±8.7	12/43	21/34	药物治疗+有氧运动，2次/周，90 min，中度至剧烈强度	药物治疗+放松训练	16	①
Krogh^[38]	2012	丹麦	39.7±11.3	43.4±11.2	16/40	22/37	有氧运动，3次/周，45 min，中度至剧烈强度	拉伸运动，45 min，低强度	12	①
Lavretsky^[39]	2021	美国	69.1±7.0	72.0±7.4	13/23	15/22	药物治疗+太极拳，3次/周，60 min，低强度	药物治疗+健康教育	12	⑦
Muhammad^[40]	2023	印度尼西亚	28.38±11.08	30.00±8.66	0/8	1/8	药物治疗+有氧运动，5次/周，30 min，中等强度	药物治疗	2	⑧
Olson^[41]	2017	美国	21.0±1.9	21.2±2.2	4/11	2/13	有氧运动，3次/周，45 min，中度强度	拉伸运动，30~45 min，低强度	8	①
Zhang^[42]	2017	中国	31.4±7.2	32.2±7.6	22/0	20/0	药物治疗+有氧运动，3 d/周，3 km约30 min，中等强度	药物治疗	8
Zhang^[43]	2022	中国	47.20±6.99	54.16±6.09	3/17	1/18	太极拳，2次/周，90 min，低强度	等待组维持日常行为	12	⑨
Neviani^[44]	2017	意大利	75.0±6.3	75.6±5.6	25/54	10/32	药物治疗+有氧运动，3次/周，60 min，强度渐进至高强度	药物治疗	24	⑧
李冰^[45]	2024	中国	69.60±5.25	71.72±5.44	19/24	17/26	药物治疗+八段锦，约30 min，低强度	药物治疗	12	⑧
刘聪^[46]	2024	中国	39.02±10.35	40.92±11.35	26/25	25/24	常规综合治疗+有氧运动，3次/周以上，30~60 min，中等强度	常规综合治疗	4	⑧