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NEW YORK – Postural exercises that take only a few minutes but are performed several times a day produced large reductions in symptoms of depression and increased the rate of remission at 12 weeks, according to results of a randomized study presented at the annual meeting of the American Psychiatric Association.
“These were very marked symptom improvements seen at the end of 12 weeks in those randomized to the exercises when compared to the controls who received antidepressants alone,” reported Martin Furman, MD, a researcher in psychiatry at the University of Maimónides, Buenos Aires.
The patients in this study all continued on their baseline SSRI dose but were randomized to start postural exercises or to remain on an SSRI alone. The two sets of exercises, which took only a couple of minutes, were repeated four to six times per day with at least 2 hours of separation.
The equilibrium exercises involved raised arms with flexing of first one lower limb then the other. Each flex was maintained for 15 seconds. In a separate exercise, patients were instructed to hold a pencil between the teeth and smile for 1 minute, a technique that activates facial skin afferents, according to Dr. Furman.
“In previous studies, posture and balance have been linked to a reduction in anxiety and moderate depression,” Dr. Furman explained. “Feedback of the muscular and facial skin afferents has been associated with modulation of neural activity within the central circuit of emotions.”
Much of this work was pioneered by Tomás Ortiz Alonso, MD, PhD, director of the department of psychiatry at Universidad Complutense de Madrid, according to Dr. Furman. While working to complete his PhD, Dr. Furman is collaborating with Dr. Ortiz Alonso.
Patients participating in the study were evaluated with the Beck Depression Inventory (BDI) and the 17-item Hamilton Depression Rating Scale (HDRS-17) at baseline and the end of 12 weeks. Response for both scales was defined as at least a 50% score reduction from baseline. Remission of depression was defined as HDRS-17 score of less than 7.
At 12 weeks, 86% of those in the experimental arm versus 28.5% of those in the control arm achieved a response on the HDRS-17 tool. For the BDI tool, the response rates were 71.5% and 19%, respectively. The remission rates as defined by HDRS-17 score of less than 7 were 66.6% and 19%. All differences were statistically significant (P less than .05).
“The exercises are simple and take very little time,” said Dr. Furman, who reported that compliance was good in the study arm according to patient self-report.
There are numerous published studies suggesting that exercise improves mood in a variety of circumstances, including the treatment of depression, and Dr. Furman said these exercises are not physically demanding. If larger studies validate the results of this initial trial, this might prove to be a highly cost-effective tool for depression treatment.
“Further studies are needed to determine whether these exercises are most effective as adjunctive treatment to pharmacotherapy or can be used alone without medications,” he said.
In addition to larger efficacy studies, Dr. Furman reported that efforts to understand the mechanism of benefit are being considered, such as studies with functional MRI or EEG to evaluate the effect of the exercises on brain activity.
“We are excited about these results. ,” he said.
Dr. Furman reports no potential conflicts of interest related to this topic.
NEW YORK – Postural exercises that take only a few minutes but are performed several times a day produced large reductions in symptoms of depression and increased the rate of remission at 12 weeks, according to results of a randomized study presented at the annual meeting of the American Psychiatric Association.
“These were very marked symptom improvements seen at the end of 12 weeks in those randomized to the exercises when compared to the controls who received antidepressants alone,” reported Martin Furman, MD, a researcher in psychiatry at the University of Maimónides, Buenos Aires.
The patients in this study all continued on their baseline SSRI dose but were randomized to start postural exercises or to remain on an SSRI alone. The two sets of exercises, which took only a couple of minutes, were repeated four to six times per day with at least 2 hours of separation.
The equilibrium exercises involved raised arms with flexing of first one lower limb then the other. Each flex was maintained for 15 seconds. In a separate exercise, patients were instructed to hold a pencil between the teeth and smile for 1 minute, a technique that activates facial skin afferents, according to Dr. Furman.
“In previous studies, posture and balance have been linked to a reduction in anxiety and moderate depression,” Dr. Furman explained. “Feedback of the muscular and facial skin afferents has been associated with modulation of neural activity within the central circuit of emotions.”
Much of this work was pioneered by Tomás Ortiz Alonso, MD, PhD, director of the department of psychiatry at Universidad Complutense de Madrid, according to Dr. Furman. While working to complete his PhD, Dr. Furman is collaborating with Dr. Ortiz Alonso.
Patients participating in the study were evaluated with the Beck Depression Inventory (BDI) and the 17-item Hamilton Depression Rating Scale (HDRS-17) at baseline and the end of 12 weeks. Response for both scales was defined as at least a 50% score reduction from baseline. Remission of depression was defined as HDRS-17 score of less than 7.
At 12 weeks, 86% of those in the experimental arm versus 28.5% of those in the control arm achieved a response on the HDRS-17 tool. For the BDI tool, the response rates were 71.5% and 19%, respectively. The remission rates as defined by HDRS-17 score of less than 7 were 66.6% and 19%. All differences were statistically significant (P less than .05).
“The exercises are simple and take very little time,” said Dr. Furman, who reported that compliance was good in the study arm according to patient self-report.
There are numerous published studies suggesting that exercise improves mood in a variety of circumstances, including the treatment of depression, and Dr. Furman said these exercises are not physically demanding. If larger studies validate the results of this initial trial, this might prove to be a highly cost-effective tool for depression treatment.
“Further studies are needed to determine whether these exercises are most effective as adjunctive treatment to pharmacotherapy or can be used alone without medications,” he said.
In addition to larger efficacy studies, Dr. Furman reported that efforts to understand the mechanism of benefit are being considered, such as studies with functional MRI or EEG to evaluate the effect of the exercises on brain activity.
“We are excited about these results. ,” he said.
Dr. Furman reports no potential conflicts of interest related to this topic.
NEW YORK – Postural exercises that take only a few minutes but are performed several times a day produced large reductions in symptoms of depression and increased the rate of remission at 12 weeks, according to results of a randomized study presented at the annual meeting of the American Psychiatric Association.
“These were very marked symptom improvements seen at the end of 12 weeks in those randomized to the exercises when compared to the controls who received antidepressants alone,” reported Martin Furman, MD, a researcher in psychiatry at the University of Maimónides, Buenos Aires.
The patients in this study all continued on their baseline SSRI dose but were randomized to start postural exercises or to remain on an SSRI alone. The two sets of exercises, which took only a couple of minutes, were repeated four to six times per day with at least 2 hours of separation.
The equilibrium exercises involved raised arms with flexing of first one lower limb then the other. Each flex was maintained for 15 seconds. In a separate exercise, patients were instructed to hold a pencil between the teeth and smile for 1 minute, a technique that activates facial skin afferents, according to Dr. Furman.
“In previous studies, posture and balance have been linked to a reduction in anxiety and moderate depression,” Dr. Furman explained. “Feedback of the muscular and facial skin afferents has been associated with modulation of neural activity within the central circuit of emotions.”
Much of this work was pioneered by Tomás Ortiz Alonso, MD, PhD, director of the department of psychiatry at Universidad Complutense de Madrid, according to Dr. Furman. While working to complete his PhD, Dr. Furman is collaborating with Dr. Ortiz Alonso.
Patients participating in the study were evaluated with the Beck Depression Inventory (BDI) and the 17-item Hamilton Depression Rating Scale (HDRS-17) at baseline and the end of 12 weeks. Response for both scales was defined as at least a 50% score reduction from baseline. Remission of depression was defined as HDRS-17 score of less than 7.
At 12 weeks, 86% of those in the experimental arm versus 28.5% of those in the control arm achieved a response on the HDRS-17 tool. For the BDI tool, the response rates were 71.5% and 19%, respectively. The remission rates as defined by HDRS-17 score of less than 7 were 66.6% and 19%. All differences were statistically significant (P less than .05).
“The exercises are simple and take very little time,” said Dr. Furman, who reported that compliance was good in the study arm according to patient self-report.
There are numerous published studies suggesting that exercise improves mood in a variety of circumstances, including the treatment of depression, and Dr. Furman said these exercises are not physically demanding. If larger studies validate the results of this initial trial, this might prove to be a highly cost-effective tool for depression treatment.
“Further studies are needed to determine whether these exercises are most effective as adjunctive treatment to pharmacotherapy or can be used alone without medications,” he said.
In addition to larger efficacy studies, Dr. Furman reported that efforts to understand the mechanism of benefit are being considered, such as studies with functional MRI or EEG to evaluate the effect of the exercises on brain activity.
“We are excited about these results. ,” he said.
Dr. Furman reports no potential conflicts of interest related to this topic.
REPORTING FROM APA
Key clinical point: In patients with major depression, a simple set of daily postural exercises appears effective for improving symptom control.
Major finding: After 12 weeks, 67% of those performing exercises versus 19% of controls (P less than .05) met criteria for depression remission.
Study details: Randomized, controlled trial of 42 patients who met DSM-5 criteria for major depressive disorder.
Disclosures: Dr. Furman reports no potential conflicts of interest related to this topic.