Resistance Exercise for Depression

(RESIST Trial)

Recruiting at 1 trial location

Overseen By Jeni Lansing

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Wisconsin, Madison

Disqualifiers: Pregnancy, Obesity, Psychosis, Substance use, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 26

Duration: 16 weeks

200 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

You don't have to stop taking your current medications if you have been on a stable mental health medication regimen for the past 8 weeks and are willing to continue it during the study.

What data supports the effectiveness of this treatment for depression?

Research shows that resistance exercise, which involves muscle-strengthening activities, can significantly reduce symptoms of depression. Studies have found that both in-person and online resistance training programs improve mood and decrease depression scores, making it a promising treatment for individuals with mild to moderate depression. ^{1 2 3 4 5}

Is resistance exercise generally safe for humans?

Research shows that resistance exercise is generally safe for adults, with serious adverse events being uncommon. It offers health benefits like improved physical functioning and reduced risk of diseases, and the benefits usually outweigh any potential harms. ^{4 6 7 8 9}

How does resistance exercise training differ from other treatments for depression?

Resistance exercise training is unique because it focuses on physical activity to improve mental health, specifically targeting muscle strength through exercises, which can be done at varying intensities. Unlike traditional treatments like medication or talk therapy, this approach uses physical exercise to potentially reduce depressive symptoms, making it a promising option for those who prefer non-pharmacological interventions. ^{2 3 4 9 10}

What is the purpose of this trial?

Depression is a leading cause of disability worldwide and current treatments are ineffective for many people. This trial will investigate the efficacy of a 16-week high vs low dose resistance exercise training program for the treatment of Major Depressive Disorder (MDD) in 200 adults.

Research Team

Jacob Meyer, PhD

Principal Investigator

University of Wisconsin, Madison

Eligibility Criteria

Adults aged 18-65 with Major Depressive Disorder as confirmed by a clinical interview, who have mild to severe depressive symptoms. Participants should either not be on mental health treatments or be on a stable regimen for at least 8 weeks and willing to maintain it. They must be safe to exercise per doctor's approval and cannot currently meet the resistance exercise recommendations, be pregnant, or have certain other mental health disorders.

Inclusion Criteria

I am not on mental health meds or I've been stable on my current mental health treatment for 8 weeks.

I am currently experiencing mild or more severe depression.

I have been diagnosed with major depression.

Exclusion Criteria

Currently pregnant, nursing, or planning to become pregnant during the trial

Currently meets resistance exercise recommendations (2 days per week) for the last 8 weeks

I have not had a concussion or brain injury in the last 3 months.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo a 16-week resistance exercise training program, with high vs low dose progressive RET in adults with DSM-5 diagnosed MDD.

16 weeks

Twice per week sessions

Follow-up

Participants are monitored for safety and effectiveness after treatment, with assessments of cerebral blood flow, physical activity, and depression symptoms.

36 weeks

Assessments at weeks 26 and 52

Treatment Details

Interventions

• High Dose Resistance Exercise Training
• Low Dose Resistance Exercise Training Group

Trial Overview The trial is testing how effective two different doses of resistance exercise training are in treating depression over a period of 16 weeks. It will compare the outcomes between a group doing low dose exercises against another doing high dose exercises.

Participant Groups

Group I: High Dose Resistance Exercise Training Experimental Treatment 1 Intervention

Participants will complete a 16-week, twice/week progressive program beginning at a moderate intensity. Each session will last \~60 minutes and begin and end with a 5-minute warm-up/cool-down. Training will begin with standard familiarization sessions to introduce participants to the machines, teach correct lifting techniques, and ensure participant safety and comfort with each exercise machine. Participants will perform 3 sets of 8-12 repetitions on 9 different machines (i.e., leg press, hamstring curl, quadriceps extension, chest press, lat pulldown, shoulder press, biceps curl, triceps extension) and one body weight/free-weight abdominal exercise. Workload will begin at 60% of estimated 1-RM and will systematically and progressively increase during the intervention.

Group II: Low Dose Resistance Exercise Training Active Control 1 Intervention

Participants will complete a 16-week, twice/week progressive program beginning at a low intensity. Each session will last \~60 minutes and begin and end with a 5-minute warm-up/cool-down. Training will begin with standard familiarization sessions to introduce participants to the machines, teach correct lifting techniques, and ensure participant safety and comfort with each exercise machine. Participants will perform 3 sets of 8-12 repetitions on 9 different machines (i.e., leg press, hamstring curl, quadriceps extension, chest press, lat pulldown, shoulder press, biceps curl, triceps extension) and one body weight/free-weight abdominal exercise. Workload will begin at 30% of estimated 1-RM and will systematically and progressively increase during the intervention.

Who Is Running the Clinical Trial?

University of Wisconsin, Madison

Lead Sponsor

Trials

1,249

Recruited

3,255,000+

University of Minnesota

Collaborator

Trials

1,459

Recruited

1,623,000+

University of Limerick

Collaborator

Trials

71

Recruited

23,800+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Iowa State University

Collaborator

Trials

63

Recruited

145,000+

Findings from Research

In a 15-year inpatient treatment program for depression, patients who participated in physical fitness training three times a week for six to nine weeks showed significant improvements in fitness levels and reductions in depression scores.

More than half of the patients continued to exercise regularly one year after discharge, and they ranked physical fitness training as one of the most valuable components of their treatment, indicating its long-term benefits and safety with no serious complications reported.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Physical training as a therapeutic method in depression]. Martinsen, EW.[2008]

Depressed patients often have low physical fitness due to inactivity, suggesting that incorporating physical fitness training into treatment for depression could be beneficial.

Exercise, including both aerobic and nonaerobic forms, has been shown to have antidepressant effects in patients with mild to moderate depression, and many patients continue exercising after treatment, leading to lower depression scores.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Benefits of exercise for the treatment of depression. Martinsen, EW.[2022]

In a study of 55 middle-aged volunteers, resistance training significantly reduced depressed mood in individuals with high metabolic risk factors (HiMF), as shown by a decrease of 14.8 points on the Cardiac Depression Scale after 10 weeks of training.

The improvement in mood was correlated with increased muscle strength in the HiMF group, suggesting that resistance training not only enhances physical strength but also has a positive impact on mental health in those at risk for metabolic syndrome.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Resistance training improves depressive symptoms in individuals at high risk for type 2 diabetes. Levinger, I., Selig, S., Goodman, C., et al.[2017]

A study involving 67 participants showed that online home-based resistance training significantly improved depressive symptoms, as measured by the CES-D scale, after eight weeks of training.

The training also enhanced fitness parameters, indicating that low-load resistance exercises can be an effective way to improve mental health and physical fitness, even when conducted online.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Online Home-Based Resistance Exercise Training on Physical Fitness, Depression, Stress, and Well-Being in Middle-Aged Persons: A Pilot Study. Kikuchi, N., Ohta, T., Hashimoto, Y., et al.[2023]

In a study of 165 adults with unipolar depression, strength training significantly improved work capacity, reducing absenteeism by 12.1% compared to relaxation training, while aerobic training showed no significant effect on work absence.

Despite improvements in physical strength and aerobic capacity, neither strength nor aerobic training led to significant reductions in depression severity as measured by the Hamilton Rating Scale for Depression (HAM-D(17)) at 4 or 12 months.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The DEMO trial: a randomized, parallel-group, observer-blinded clinical trial of strength versus aerobic versus relaxation training for patients with mild to moderate depression. Krogh, J., Saltin, B., Gluud, C., et al.[2019]

In a review of 121 trials involving 6700 older adults, most adverse events related to progressive resistance strength training were musculoskeletal issues like muscle strains and joint pain, particularly in participants with pre-existing health conditions or those engaging in high-intensity training.

Adverse events were often underreported, highlighting the need for clearer definitions and consistent reporting in future studies to better inform practitioners about the risks and benefits of strength training in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse events reported in progressive resistance strength training trials in older adults: 2 sides of a coin. Liu, CJ., Latham, N.[2010]

Resistance training has significant health benefits as we age, including improved muscular strength and reduced risk of all-cause mortality, making it comparable to medicine.

Even minimal doses of resistance training (as little as 60 minutes per week, twice a week) can yield substantial physiological and psychological benefits, encouraging more people to participate despite time constraints or perceived difficulty.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A minimal dose approach to resistance training for the older adult; the prophylactic for aging. Fisher, JP., Steele, J., Gentil, P., et al.[2022]

Resistance training (RT) significantly reduces all-cause mortality and the incidence of cardiovascular disease while improving physical functioning in adults, based on an analysis of 11 systematic reviews involving over 382,000 participants.

Although adverse events were not consistently reported, serious adverse events related to RT were uncommon, suggesting that the benefits of resistance training outweigh the potential harms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Resistance training and health in adults: an overview of systematic reviews. El-Kotob, R., Ponzano, M., Chaput, JP., et al.[2021]

In a randomized controlled trial with 55 young adults, eight weeks of resistance exercise training (RET) led to significant reductions in depressive symptoms, with a large effect size of 1.01 overall, indicating its effectiveness as a treatment for mild depression.

The study found even larger reductions in depressive symptoms among participants with Major Depressive Disorder (effect size of 1.71) and Generalized Anxiety Disorder (effect size of 1.39), suggesting that RET can be particularly beneficial for those at risk for elevated depressive symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of resistance exercise training on depressive symptoms among young adults: A randomized controlled trial. O'Sullivan, D., Gordon, BR., Lyons, M., et al.[2023]

A systematic review of supervised resistance training (RT) programs for individuals with depression identified four eligible studies, with mixed results; half showed positive effects on depressive symptoms while the other half did not.

Meta-analysis of the studies indicated significant benefits of RT in improving depressive symptoms in two out of four combinations, with moderate to small effect sizes, but high heterogeneity suggests that more well-designed randomized controlled trials are needed to confirm these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effects of Exclusively Resistance Training-Based Supervised Programs in People with Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Carneiro, L., Afonso, J., Ramirez-Campillo, R., et al.[2020]

References

1. Norway pubmed.ncbi.nlm.nih.gov

[Physical training as a therapeutic method in depression]. [2008]

2. New Zealand pubmed.ncbi.nlm.nih.gov

Benefits of exercise for the treatment of depression. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Resistance training improves depressive symptoms in individuals at high risk for type 2 diabetes. [2017]

4. Switzerland pubmed.ncbi.nlm.nih.gov

Effect of Online Home-Based Resistance Exercise Training on Physical Fitness, Depression, Stress, and Well-Being in Middle-Aged Persons: A Pilot Study. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

The DEMO trial: a randomized, parallel-group, observer-blinded clinical trial of strength versus aerobic versus relaxation training for patients with mild to moderate depression. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

Adverse events reported in progressive resistance strength training trials in older adults: 2 sides of a coin. [2010]

7. England pubmed.ncbi.nlm.nih.gov

A minimal dose approach to resistance training for the older adult; the prophylactic for aging. [2022]

8. Canada pubmed.ncbi.nlm.nih.gov

Resistance training and health in adults: an overview of systematic reviews. [2021]

9. Ireland pubmed.ncbi.nlm.nih.gov

Effects of resistance exercise training on depressive symptoms among young adults: A randomized controlled trial. [2023]

10. Switzerland pubmed.ncbi.nlm.nih.gov

The Effects of Exclusively Resistance Training-Based Supervised Programs in People with Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. [2020]