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Can high-intensity interval training improve mental health outcomes in the general population and those with physical illnesses? A systematic review and meta-analysis
  1. Rebecca Martland1,
  2. Nicole Korman2,3,
  3. Joseph Firth4,5,
  4. Davy Vancampfort6,7,
  5. Trevor Thompson8,
  6. Brendon Stubbs1,9
  1. 1Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
  2. 2Metro South Addiction and Mental Health Services, Brisbane, Queensland, Australia
  3. 3School of Medicine, University of Queensland, Brisbane, Queensland, Australia
  4. 4Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
  5. 5Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
  6. 6University Psychiatric Centre, Katholieke Universiteit Leuven, Leuven, Belgium
  7. 7Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
  8. 8Centre for Chronic Illness and Ageing, University of Greenwich, London, UK
  9. 9South London and Maudsley NHS Foundation Trust, London, UK
  1. Correspondence to Rebecca Martland, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK; rebecca.martland{at}kcl.ac.uk

Abstract

Objective High-intensity interval training (HIIT) is a safe and feasible form of exercise. The aim of this meta-analysis was to investigate the mental health effects of HIIT, in healthy populations and those with physical illnesses, and to compare the mental health effects to non-active controls and other forms of exercise.

Design Random effects meta-analyses were undertaken for randomised controlled trials (RCTs) comparing HIIT with non-active and/or active (exercise) control conditions for the following coprimary outcomes: mental well-being, symptoms of depression, anxiety and psychological stress. Positive and negative affect, distress and sleep outcomes were summarised narratively.

Data sources Medline, PsycINFO, Embase and CENTRAL databases were searched from inception to 7 July 2020.

Eligibility criteria for selecting studies RCTs that investigated HIIT in healthy populations and/or those with physical illnesses and reported change in mental well-being, depression, anxiety, psychological stress, positive/negative affect, distress and/or sleep quality.

Results Fifty-eight RCTs were retrieved. HIIT led to moderate improvements in mental well-being (standardised mean difference (SMD): 0.418; 95% CI: 0.135 to 0.701; n=12 studies), depression severity (SMD: –0.496; 95% CI: −0.973 to −0.020; n=10) and perceived stress (SMD: −0.474; 95% CI: −0.796 to −0.152; n=4) compared with non-active controls, and small improvements in mental well-being compared with active controls (SMD:0.229; 95% CI: 0.054 to 0.403; n=12). There was a suggestion that HIIT may improve sleep and psychological distress compared with non-active controls: however, these findings were based on a small number of RCTs.

Conclusion These findings support the use of HIIT for mental health in the general population.

Level of evidence The quality of evidence was moderate-to-high according to the Grading of Recommendations Assessment, Development and Evaluation) criteria.

PROSPERO registration number CRD42020182643

  • meta-analysis
  • depression
  • anxiety
  • aerobic fitness
  • well-being

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Footnotes

  • Twitter @MartlandRebecca

  • Contributors RM and BS designed the systematic review and meta-analysis and search criteria. RM, NK and BS determined study eligibility. RM and NK assessed study quality. Data extraction was performed by RM and BS conducted statistical analysis; guidance was provided by TT. The paper was drafted by RM and revised by BS. All authors contributed to protocol development and read and approved the final manuscript.

  • Funding RM is supported by a PhD studentship from the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. BS is supported by a Clinical Lectureship (ICA-CL-2017-03-001) jointly funded by Health Education England (HEE) and the National Institute for Health Research (NIHR). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The funding partners had no involvement in the study at any stage, nor did they influence the decision to publish. JF is supported by a University of Manchester Presidential Fellowship (P123958) and a UK Research and Innovation Future Leaders Fellowship (MR/T021780/1).

  • Competing interests BS has received Honoria from ASICS. BS and JF have received Honoria from Parachutebh, for a separate project.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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