Ask an answerable question (PICO)：
Central Health Insurance Administration (2021) stated nearly 640,000 people were diagnosed with depression in Taiwan. Among those aged 15-24 and over 65, 88.2% and 63.7% overgrew. Because intervention in medicine and psychotherapy is limited in improving depressive symptoms, the current study suggests that any planned, repetitive exercise can alleviate symptoms of depression. Therefore, this study uses an empirical approach to explore whether designed and repetitive training can improve depressive symptoms.
The Method and Analysis of Literature Review：
According to empirical health care 5A, the three previous steps (asking, acquiring, appraisal), form the PICO problem. Using MeSH (Medical Subject Heights) term, natural language, synonyms to set keywords, P: patient with depression, I: exercise, O: depressive symptoms. The article types are restricted to the SR (systematic review) and RCT (randomized controlled experimental study) by suing the Boolean logic OR link and the AND intersection between PICOs. It was set to search 136 Pub Med articles, 4 CINAHL articles, and 337 Cochrane Library articles from 2018 to 2022. A total of 477 documents were searched. Duplicates and literatures that did not discuss the effect of exercise intervention on depression symptoms of patients with depression were deleted and the selected publication date was the latest. Finally, three papers were reviewed.
Critical Appraisal：
The quality evaluation of this paper is based on the 2020 edition of the Critical Appraisal Skill Program (CASP) for Randomized Controlled Trials Checklist. First article is a randomized controlled trial of multimodal exercise intervention for severely depressed adolescents with one-hour and three times per week intervention for12 weeks. It shows beneficial clinical therapeutic effects. Second article is a randomized controlled trial of aerobic exercise intervention for depressive adults 3 days per week for 8 weeks at 35 minutes intervention per week, with cost-effective results. Third article is a randomized controlled trial in which patients with severe depression participate in standardized guided exercise therapy for six weeks at three 50-minute intervals per week. The results support that standardized guided exercise therapy benefits patients with severe depression. None of the three empirical studies observed adverse reactions to exercise intervention. The three RCT documents are 1.c by Joanna Briggs Institute (JBI) levels of evidence (2014), suggesting strength A.
Results, Conclusions and Recommendations：
The comprehensive empirical literature review shows that the use of exercise intervention can effectively improve the depressive symptoms of patients with depression, and the use of exercise intervention will not have adverse effects on patients with depression, which can provide a clinical reference basis.
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