BACKGROUND: Depression is a common and important cause of morbidity and mortality worldwide. Depression is commonly treated with antidepressants and/or psychological therapy, but some people may prefer alternative approaches such as exercise. There are a number of theoretical reasons why exercise may improve depression. This is an update of an earlier review first published in 2009. OBJECTIVES: To determine the effectiveness of exercise in the treatment of depression in adults compared with no treatment or a comparator intervention. SEARCH METHODS: We searched the Cochrane Depression, Anxiety and Neurosis Review Group's Controlled Trials Register (CCDANCTR) to 13 July 2012. This register includes relevant randomised controlled trials from the following bibliographic databases: The Cochrane Library (all years); MEDLINE (1950 to date); EMBASE (1974 to date) and PsycINFO (1967 to date). We also searched www.controlled-trials.com, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. No date or language restrictions were applied to the search.We conducted an additional search of the CCDANCTR up to 1st March 2013 and any potentially eligible trials not already included are listed as 'awaiting classification.' SELECTION CRITERIA: Randomised controlled trials in which exercise (defined according to American College of Sports Medicine criteria) was compared to standard treatment, no treatment or a placebo treatment, pharmacological treatment, psychological treatment or other active treatment in adults (aged 18 and over) with depression, as defined by trial authors. We included cluster trials and those that randomised individuals. We excluded trials of postnatal depression. DATA COLLECTION AND ANALYSIS: Two review authors extracted data on primary and secondary outcomes at the end of the trial and end of follow-up (if available). We calculated effect sizes for each trial using Hedges' g method and a standardised mean difference (SMD) for the overall pooled effect, using a random-effects model risk ratio for dichotomous data. Where trials used a number of different tools to assess depression, we included the main outcome measure only in the meta-analysis. Where trials provided several 'doses' of exercise, we used data from the biggest 'dose' of exercise, and performed sensitivity analyses using the lower 'dose'. We performed subgroup analyses to explore the influence of method of diagnosis of depression (diagnostic interview or cut-off point on scale), intensity of exercise and the number of sessions of exercise on effect sizes. Two authors performed the 'Risk of bias' assessments. Our sensitivity analyses explored the influence of study quality on outcome. MAIN RESULTS: Thirty-nine trials (2326 participants) fulfilled our inclusion criteria, of which 37 provided data for meta-analyses. There were multiple sources of bias in many of the trials; randomisation was adequately concealed in 14 studies, 15 used intention-to-treat analyses and 12 used blinded outcome assessors.For the 35 trials (1356 participants) comparing exercise with no treatment or a control intervention, the pooled SMD for the primary outcome of depression at the end of treatment was -0.62 (95% confidence interval (CI) -0.81 to -0.42), indicating a moderate clinical effect. There was moderate heterogeneity (I² = 63%).When we included only the six trials (464 participants) with adequate allocation concealment, intention-to-treat analysis and blinded outcome assessment, the pooled SMD for this outcome was not statistically significant (-0.18, 95% CI -0.47 to 0.11). Pooled data from the eight trials (377 participants) providing long-term follow-up data on mood found a small effect in favour of exercise (SMD -0.33, 95% CI -0.63 to -0.03).Twenty-nine trials reported acceptability of treatment, three trials reported quality of life, none reported cost, and six reported adverse events.For acceptability of treatment (assessed by number of drop-outs during the intervention), the risk ratio was 1.00 (95% CI 0.97 to 1.04).Seven trials compared exercise with psychological therapy (189 participants), and found no significant difference (SMD -0.03, 95% CI -0.32 to 0.26). Four trials (n = 300) compared exercise with pharmacological treatment and found no significant difference (SMD -0.11, -0.34, 0.12). One trial (n = 18) reported that exercise was more effective than bright light therapy (MD -6.40, 95% CI -10.20 to -2.60).For each trial that was included, two authors independently assessed for sources of bias in accordance with the Cochrane Collaboration 'Risk of bias' tool. In exercise trials, there are inherent difficulties in blinding both those receiving the intervention and those delivering the intervention. Many trials used participant self-report rating scales as a method for post-intervention analysis, which also has the potential to bias findings. AUTHORS' CONCLUSIONS: Exercise is moderately more effective than a control intervention for reducing symptoms of depression, but analysis of methodologically robust trials only shows a smaller effect in favour of exercise. When compared to psychological or pharmacological therapies, exercise appears to be no more effective, though this conclusion is based on a few small trials. Language: en

/pdf/exercise-for-depression-20ts27iwem.pdf

Exercise for depression

We examined the topographic organization of corticospinal neurons in the primary motor cortex and in the two premotor areas on the lateral surface of the hemisphere [i.e., the dorsal premotor area (PMd) and the ventral premotor area (PMv)]. In two macaques, we labeled corticospinal neurons that project beyond T7 or S2 by placing crystals of HRP into the dorsolateral funiculus at these segmental levels. In another seven macaques, we labeled corticospinal neurons that project to specific segmental levels of the spinal cord by injecting the fluorescent tracers fast blue and diamidino yellow into the gray matter of the cervical and lumbosacral segments. In one set of experiments (n = 2), we defined the representations of the arm and leg in each cortical motor area by injecting one of the two fluorescent tracers into lower cervical segments (C7-T1) and the other fluorescent tracer into lower lumbosacral segments (L6-S1) of the same animal. In another set of experiments (n = 5), we defined the representations of distal and proximal parts of the forelimb in each cortical motor area by injecting one of the two fluorescent tracers into lower cervical segments (C7-T1) and the other tracer into upper cervical segments (C2-C4) of the same animal. In the primary motor cortex and the PMd, cortical regions that project to lower cervical segments were largely separate from those that project to lower lumbosacral segments. In the PMv, few neurons were labeled after tracer injections into lower cervical segments or lower lumbosacral segments. However, corticospinal neurons were labeled in the PMv after tracer injections into upper cervical segments and after HRP placement in the dorsolateral funiculus at T7. The region of the PMv that projects to upper cervical segments was separate from that which projects below T7. Cortical regions that project to upper and lower cervical segments of the spinal cord overlapped considerably in the primary motor cortex and in the PMd. Despite this overlap, we found that the regions of the primary motor cortex and PMd that project most densely to upper cervical segments were largely separate from those that project most densely to lower cervical segments. Furthermore, we found two separate regions within area 4 that send corticospinal projections primarily to the lower cervical segments. One of these regions was located within the classical "hand" area of the primary motor cortex. The other was located at the medial edge of arm representation in the primary motor cortex.(ABSTRACT TRUNCATED AT 400 WORDS)

Topographic organization of corticospinal projections from the frontal lobe: motor areas on the lateral surface of the hemisphere.

A significant body of research has investigated the effects of physical activity on sleep, yet this research has not been systematically aggregated in over a decade. As a result, the magnitude and moderators of these effects are unclear. This meta-analytical review examines the effects of acute and regular exercise on sleep, incorporating a range of outcome and moderator variables. PubMed and PsycINFO were used to identify 66 studies for inclusion in the analysis that were published through May 2013. Analyses reveal that acute exercise has small beneficial effects on total sleep time, sleep onset latency, sleep efficiency, stage 1 sleep, and slow wave sleep, a moderate beneficial effect on wake time after sleep onset, and a small effect on rapid eye movement sleep. Regular exercise has small beneficial effects on total sleep time and sleep efficiency, small-to-medium beneficial effects on sleep onset latency, and moderate beneficial effects on sleep quality. Effects were moderated by sex, age, baseline physical activity level of participants, as well as exercise type, time of day, duration, and adherence. Significant moderation was not found for exercise intensity, aerobic/anaerobic classification, or publication date. Results were discussed with regards to future avenues of research and clinical application to the treatment of insomnia.

The effects of physical activity on sleep: a meta-analytic review

Effects of repetitive motor training on movement representations in adult squirrel monkeys: role of use versus learning.

Background 
New effective interventions to attenuate age-related cognitive decline are a global priority. Computerized cognitive training (CCT) is believed to be safe and can be inexpensive, but neither its efficacy in enhancing cognitive performance in healthy older adults nor the impact of design factors on such efficacy has been systematically analyzed. Our aim therefore was to quantitatively assess whether CCT programs can enhance cognition in healthy older adults, discriminate responsive from nonresponsive cognitive domains, and identify the most salient design factors.


Methods and Findings 
We systematically searched Medline, Embase, and PsycINFO for relevant studies from the databases' inception to 9 July 2014. Eligible studies were randomized controlled trials investigating the effects of ≥4 h of CCT on performance in neuropsychological tests in older adults without dementia or other cognitive impairment. Fifty-two studies encompassing 4,885 participants were eligible. Intervention designs varied considerably, but after removal of one outlier, heterogeneity across studies was small (I2 = 29.92%). There was no systematic evidence of publication bias. The overall effect size (Hedges' g, random effects model) for CCT versus control was small and statistically significant, g = 0.22 (95% CI 0.15 to 0.29). Small to moderate effect sizes were found for nonverbal memory, g = 0.24 (95% CI 0.09 to 0.38); verbal memory, g = 0.08 (95% CI 0.01 to 0.15); working memory (WM), g = 0.22 (95% CI 0.09 to 0.35); processing speed, g = 0.31 (95% CI 0.11 to 0.50); and visuospatial skills, g = 0.30 (95% CI 0.07 to 0.54). No significant effects were found for executive functions and attention. Moderator analyses revealed that home-based administration was ineffective compared to group-based training, and that more than three training sessions per week was ineffective versus three or fewer. There was no evidence for the effectiveness of WM training, and only weak evidence for sessions less than 30 min. These results are limited to healthy older adults, and do not address the durability of training effects.


Conclusions 
CCT is modestly effective at improving cognitive performance in healthy older adults, but efficacy varies across cognitive domains and is largely determined by design choices. Unsupervised at-home training and training more than three times per week are specifically ineffective. Further research is required to enhance efficacy of the intervention.

Please see later in the article for the Editors' Summary

https://minerva-access.unimelb.edu.au/bitstream/handle/11343/256006/PMC4236015.pdf

Computerized cognitive training in cognitively healthy older adults: a systematic review and meta-analysis of effect modifiers.

Sensori-motor development and performance of daily living skills (DLS) remain little explored in children with autism spectrum disorders (ASD). The objective of this study was to determine the impact of sensori-motor skills on the performance of DLS in preschool children with ASD. Thirty-five children, 3–4 years of age, were recruited and assessed with a battery of diagnostic and clinical tests. Children showed atypical sensory responses, very poor motor and DLS. Sensory avoiding, an excessive reaction to sensory stimuli, and fine motor skills were highly correlated with DLS, even when cognitive performance was taken into account. Sensori-motor deficits have an impact on the autonomy of children with ASD and interventions should aim at improving and supporting the development of sensori-motor skills.

Sensori-motor and Daily Living Skills of Preschool Children with Autism Spectrum Disorders

Background. There is growing evidence of the involvement of executive control in the maintenance of balance in old age. We examined whether healthy older adults who completed five sessions of nonmotor cognitive dual-task training would show significant improvements on measures of dual-task standing balance and mobility, compared with an un trained control group. Methods. T wenty healthy older adults were assigned to either training or control groups. In the pre- and post-training sessions, all participants performed tests of cognition, balance, and mobility (single-support balance, dynamic posturography, sit-to-stand, 40-foot walk) under single- and dual-task conditions. The training group completed five sessions of cognitive dual-task training spaced at least 2 days apart. The two tasks involved making two-choice decisions to visually presented stimuli. Participants completed multiple blocks of single-task (task A or B, blockwise) and mixed (A, B, or A + B) trials in each training session. Results. The training group showed significant improvements in body sway during single-support balance and center of gravity alignment during double-support dynamic balance. The control group showed no appreciable improvements.

/pdf/benefits-of-cognitive-dual-task-training-on-balance-308s0mgwj5.pdf

Benefits of Cognitive Dual-Task Training on Balance Performance in Healthy Older Adults

When adults reach to grasp stationary targets, movement kinematics (endpoint trajectories, interjoint coordination) are highly stereotyped and stable. The emergence of an optimal coordination for reaching involves mastering the redundant number of degrees of freedom while the body grows. Reaching has been well studied in healthy children under the age of 3 years. We characterised the development of coordination during reaching in children over the age of 3 years and identified age ranges in which stable patterns emerge. A random sample of 38 healthy children aged 4-11 years and nine adults participated in the study. They reached from the seated position with the dominant arm and grasped a cone placed at three distances in the forward sagittal plane in front of the body. Kinematic data from markers placed on the arm, head and trunk were recorded at 100 Hz (Optotrak Motion Analysis System). Immature patterns of reaching were characterised by increased variability in younger compared to older children. Hand trajectories became smoother and less variable with age. Interjoint coordination became more consistent, while trunk displacement and variability decreased with age. Only children between 8 and 10 years old had variability similar to adults. Our data suggest that different aspects of movement kinematics mature at different rates. However, our data do not support the idea of a sequential maturation of different biomechanical variables.

The development of coordination for reach-to-grasp movements in children

https://www.youtwocantango.com/uploads/1/3/2/4/13241074/argentine_tango_for_depression.pdf

Argentine tango dance compared to mindfulness meditation and a waiting-list control: A randomised trial for treating depression

A motor performance which involves multijoint coordination and belongs to the natural repertoire of motor behavior has been studied. Displacements have been related to EMG in the lower limb when taking off and landing from a jump down (45 cm) onto two surfaces of differing compliance in two populations of teenage girls: skilled and unskilled. To evaluate the performance, an index was defined taking into account: 1) the time required for reaching stability (1 body weight) after landing, and 2) the amount of sway during the stabilization time. Despite the apparent intra and inter subject similarities in performing the jump-down, slight differences were observed in both the kinematics and electromyogram patterns. During takeoff, two strategies were identified that were not related to either skill or landing surface compliance. The most common strategy, "Push Off", is characterized by almost full joint extension when departing from the jump platform and includes a swing period during flight. The other strategy, "Roll Off", is characterized by joint flexion at departure and continual extension during midflight. While the ankle dorsiflexor, tibialis anterior, is active in preparation for the takeoff phase in both strategies, it is followed by activation of the ankle plantarflexors, lateral gastrocnemious and soleus and the hip/knee musculature, rectus femoris, biceps femoris, and vastus lateralis, only in the push off strategy. The roll off strategy is characterized by a lack of other muscle activation prior to takeoff. At landing, regardless of the strategy used in takeoff, onset of muscles followed the same sequence for both landing surfaces; ankle musculature activity began first followed by activity in the knee and hip musculature. The onset of the musculature occurred closer to landing when landing on the more compliant surface. Skilled subjects were characterized by adjustments in amount of ankle extension present at landing and concomitant flexion post-landing with respect to landing surface. When landing on the rigid surface, the ankle was more plantarflexed and onset of the dorsiflexor occurred after that of the plantarflexors; on foam, dorsiflexor activity was coincident with the plantarflexors. Ankle joint range of motion post-landing was subsequently larger when landing on the rigid surface. In contrast, unskilled individuals used a default strategy for landing on both surfaces where the ankle position and movement was between that seen for the two conditions in the skilled individual. It is suggested the landing and takeoff phases are programmed independently in both skilled and unskilled subjects.(ABSTRACT TRUNCATED AT 400 WORDS)

Patricia McKinley

Papers

Sensori-motor and Daily Living Skills of Preschool Children with Autism Spectrum Disorders

Benefits of Cognitive Dual-Task Training on Balance Performance in Healthy Older Adults

The development of coordination for reach-to-grasp movements in children

Argentine tango dance compared to mindfulness meditation and a waiting-list control: A randomised trial for treating depression

Motor strategies in landing from a jump: the role of skill in task execution.