Andrey Rocha Rocca
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José Celio da Rocha Lima Filho
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Rafael Barbosa Roque Pesconi
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Déborah Alvim Monteiro Batista Alves
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João Victor Coutinho Pereira
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Abstract
Background: Bipolar disorder (BD) is a severe, recurrent and chronic disorder associated with cognitive impairment, reduction in quality of life and substantially reduction in psychosocial functioning. It presents high rates of comorbidity with cardiovascular and cerebrovascular diseases, diabetes and metabolic syndrome. Individuals with bipolar disorder need to focus their attention and treatment on mental and physical health. Physical exercise is often recommended in bipolar disorder, based on extrapolation from the major depressive disorder literature, theory and clinical expertise. However, studies tend to exclude individuals with BD or make no distinction between diagnostic groups, which leads to heterogeneity and difficulty in generalizing the results. The aim of this review is to evaluate the role of physical exercise as an intervention in bipolar disorder treatment. Method: The study populations must be humans, aged 18 years or older, with a clinical diagnosis of Bipolar Disorder (BD) according to a recognised widely-used diagnostic classification approach, confirmed with a structured interview. We will evaluate two main outcomes (mood symptoms improvement and functioning) and an additional outcome (prevention of relapse/recurrence). The search strategy will be based on the PICOS framework, using medical subject headings, on the following databases: MEDLINE (via Pubmed), EMBASE, CENTRAL, SPORTDiscus (via EBSCO), PsycINFO (via APA) and OpenGrey Repository. Selection and data collection process will be carried out by two authors, independently. Risk of bias and quality of evidence will be graded acording ROB-2 and GRADE. We will present a narrative and quantitative synthesis of the results from the included studies. Regarding quantitative data, we will extract means (M) and standard deviations (SD), when available, to calculate the standardised mean difference (SMD). Effects size will be calculated using SMD and 95% confidence interval and heterogeneity will be assessed. Subgroup analysis will be conducted to explore heterogeneity across studies depending on quality and quantity of the data extracted.Discussion: To date, there wasn't a systematic review with only randomized controlled trials on effects of physical activity on BD. Because of this, we will conduct this systematic review trying to estabilish the effects of exercise on mood, functionality and prevention of relapse.Registration: submitted
The impact of physical exercise on the fatigue symptoms in patients with multiple sclerosis: a systematic review and meta-analysis
