Role of Exercise in Improving Mental Health: A Systematic Literature Review

This systematic literature review examines the current literature that exists on the subject of exercise and mental health and the manner by which exercises can bring about a significant improvement in the mental conditions of patients who suffer from depression and related disorders.

Running head: SYSTEMATIC LITERATURE REVIEW
Systematic Literature Review
Name of the Student
Name of the University
Author Note

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Table of Contents
Introduction......................................................................................................................................2
1. Literature Review.....................................................................................................................2
1.1. Purpose of the Literature Review......................................................................................2
1.2. Methods.............................................................................................................................3
1.2.1. Literature Search and Strategy......................................................................................3
1.3. Eligibility Criteria.............................................................................................................3
1.3.1. Interventions..................................................................................................................3
1.3.2. Study Type....................................................................................................................4
1.3.3. Results...........................................................................................................................4
1.4. Detailed Literature Review...............................................................................................4
2. Gaps in the Literature Review..............................................................................................8
References........................................................................................................................................9

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Introduction
Exercise is not merely about muscle size and aerobic capacity. While exercise certainly
plays an active role in improving physical health and in enabling a person to trim the waistline
and enhance the physique, it is not what motivates majority of the people worldwide to stay
active. People who engage in regular physical exercise are seen to do so because the activity of
physical exercise provides them with a fantastic sense of wellbeing. Exercise helps people to
gain the energy that they need in order to remain happy and active for the most part of the day,
enjoy better sleep in the night, have a sharper memory and also have a more positive outlook and
approach to themselves, their families and their lives in general. Recently it has been discovered,
that exercise has a positive influence on mental health issues and conditions such as depression
and anxiety. Regular exercise can improve memory, relieve stress, help a person to sleep better
and boost a person’s mood overall. This assignment reviews key literature on the role that
exercise has to play in the improvement of mental health. The aim of this literature review is to
discover what scholars have to say on the matter of exercise and in doing so, come up with
techniques and methods by which exercise can be successfully used in order to combat the
problem of depression.
1. Literature Review
1.1. Purpose of the Literature Review
The primary purpose of the literature review is to examine the current literature that
exists on the subject of exercise and mental health and the manner by which exercises can bring
about a significant improvement in the mental conditions of patients who suffer from depression

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and related disorders. The literature review will specifically study the contribution that is being
made by the literature that is examined to the subject of mental health and exercise and the forms
of exercise and other physical interventions that can be put in place to help patients of mental
health issues to recover constructively and conclusively.
1.2. Methods
1.2.1. Literature Search and Strategy
A number of well-known platforms and databases were searched intensively in order to come
across relevant peer reviewed journal articles, edited books and volumes that could be selected
for the literature review. Some of the databases and platforms that were explored for this purpose
include the Pro-Quest library online, Sage Journals online, ERIC, Cochrane and Google Scholar.
Some of the important keywords that were used to conduct the search for relevant articles and
books are exercise and mental health, positive impact of exercise on mental health, depression
and exercise, and role of exercise in curing depression and anxiety.
1.3. Eligibility Criteria
1.3.1. Interventions
The interventions that were studied were those that aimed at understanding specifically
how the act of physical exercise could lead to improvement and proper treatment of mental
conditions such as depression, anxiety and even psychiatric disorders. The intervention had to
offer positive recommendations or suggestions by which exercise could be incorporated in the
psychotherapy and other forms of treatment to which patients of mental disorders are subjected.

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1.3.2. Study Type
Research that adopted both qualitative and quantitative research methods, that included
randomized and controlled trials and other clinical procedures, were reviewed as part of this
literature survey.
1.3.3. Results
As many as fifty different articles were detected in the first phase of the search for
relevant literature on the subject matter. This list was scrutinized and the list was ultimately
brought down to six of the most relevant articles on the subject of exercise and the effect that this
can have in improving the mental health of a person, the details of which have been outlined
below.
1.4. Detailed Literature Review
Firth et al. (2015) have conducted a meta-analysis and a systematic review of
interventions of exercise with regard to patients who suffer from schizophrenia. The authors
compiled 1581 cases or references for the research and finally, this list was narrowed down to 20
eligible studies of the mental and physical effects that the intervention of exercise can have on
patients suffering from non-affective psychotic conditions or disorders. The aim of the research
undertaken by Firth et al. (2015), is to arrive at an understanding of how interventions are
capable of reducing cardio-metabolic risk, cognitive deficits and negative symptoms as several
aspects of mental illness are often seen to be neglected or go untreated because of the fact that
interventions do not take place on time. It was found upon conducting the research that exercise
interventions do not have any significant role to play in impacting the body mass index of an
individual. However, exercise does have a role to play in improving physical fitness, and in
doing so, it reduces the risk that is associated with cardio-metabolism. It was found through this

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research study that psychiatric symptoms in patients could be significantly reduced with the help
of interventions such as exercise with the exercise in question being of ninety minutes duration,
and which needs to be carried out in a moderate to vigorous manner over a period of one week.
Mikkelsen et al. (2017) have conducted in-depth and detailed research on the co-relation
that exists between exercise and mental health. In the view of Mikkelsen et al. (2017) exercise is
a physical activity that can be seen to bring about an improvement in a wide range of mental
conditions such as anxiety, depression and trauma among others. According to the researchers
exercise plays an active role in the reduction of inflammation, and it also improves a variety of
psychological, immunological and physical functions in the human body. Mikkelsen et al. (2017)
state at the outset of the research that the positive effects associated with exercise are now being
increasingly recognized in every part of the world including the positive impact that exercise is
seen to have on the reduction of mental health conditions like depression and anxiety. It is stated
by Mikkelsen et al. (2017) that the reduction in inflammation that is brought about by exercise
for important tissues in the body such as adipose tissue and toll receptors leads to a significant
improvement being generated in people who suffer from mood related disorders.
Knapen et al. (2014) argue that exercise can bring about vast improvements in physical as
well as mental health in people who suffer from severe depression. The purpose of the research
is to develop a number of clinical guidelines that can be used for conducting exercise therapy in
patients who suffer from depression, as is derived from recently conducted meta-analysis. Four
meta-analyses were conducted on the type of effects that physical exercise can have on physical
and mental ailments that are brought about by depression and which were then analyzed. The
results of the research reveal that for people suffering from moderate depression to mild
depression, the act of exercise is likely to have the same impact that psychotherapy or the use of

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anti-depressant medication can. For patients who are suffering from severe cases of depression,
exercise can serve as a type of therapy that is complementary to many of the traditional methods
that are used in order to combat depression. It is the concluding argument of Knapen et al. (2014)
that exercise can serve as a powerful instrument for preventing as well as treating mental illness
in every sense of the term.
Firth et al. (2016) have undertaken research on the barriers and the motivating factors
associated with exercise in the cure of patients who suffer from mental illness. It is argued by
Firth et al. (2016) that exercise is something that can most definitely improve clinical outcomes
in patients who are suffering from mental disorders but that this is a population that engages in
very minimal physical activity and does not easily adhere to the physical intervention of exercise
for the cure of depression. The researchers made use of quantitative methods to conduct their
investigation with major electronic databases of patients suffering from depression being studied
for this purpose. It was found as a result of the study that most of the patients who do engage in
physical exercise do so in order to improve their health. However, it was also found that the
positive or desirable effects that physical activity can have on mental health are inversely
connected to the negative view that depressed patients have of physical activity, largely because
of the stress and the fatigue that is induced as a result of engaging in physical exercise. The
researchers conclude that professional support needs to be made available to such patients if they
are to identify and then achieve their exercise related goals in the manner desired.
Goldstein et al. (2018) have studied in detail, the role that exercise and mental health
have to play on perceived stress and mental health. The procedure of a randomized and
controlled trial has been used for the purpose of investigation. The research investigates the
impact that exercise training and mindfulness can have on the indicators of stress and mental

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health and this is done through an examination of the shared mediators of what may be termed as
program effects. As a part of the study, community recruited adults were placed in a randomized
manner, in one out of three important clinical conditions, namely, moderate intensity exercise,
stress reduction based on mindfulness and wait list control. What the results of the research
happened to reveal is the fact that self-efficacy based on mindfulness is something that fulfills a
vital role in the mediation of meditation as well as exercise program effects. What the findings of
the research happen to reveal is that exercise training and mindfulness are processes that share a
number of similar mechanisms, which in turn can bring about improvements in mental health at
the global level, that includes adaptive responses to situations of stress. In other words, patients
who suffer from moderate to severe depression can be subjected to mindfulness programs and to
physical exercise in order to witness a significant improvement in their mental conditions in
particular and mental health in general.
Yet another investigation has been conducted by Firth et al. (2016) on how
exercise can be used as a form of intervention for patients who suffer from what is termed as a
first episode psychosis condition. A feasibility methodology was used in order to carry out this
research. It is the argument of the researchers that exercise is something that can bring about a
significant improvement in psychiatric symptoms of patients who suffer from mental conditions
such as depression. It can also bring about an improvement in neurocognitive functioning as well
as in physical health in people suffering specifically from schizophrenia. What this study is
particularly aimed at, is to arrive at an understanding of the feasibility of exercise intervention
for patients who are undergoing the stage of early psychosis with the purpose of determining
whether this is connected with changes in mental and physical health. As many as thirty one
patients suffering from the condition of first episode psychosis were selected as a sample

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research population for this study. They were recruited from the places where they receive early
intervention services and they were subjected to an exercise intervention process that lasted for
as long as ten weeks. Individualized training programs formed an important part of the ten week
long intervention process. The results of the research reveal that the retention rate and the
consent rate for the exercise group were 81 percent and 94 percent respectively. It is the
conclusion of the researchers that individual exercise training could serve as an important and
feasible treatment option in order to bring about improvements in the metabolic, neurocognitive
and symptomatic outcomes for patients who suffer from first episode psychosis enabling them to
recover from their situation in a far more constructive way than other forms of treatment that are
used for the same.
2. Gaps in the Literature Review
The literature that has been reviewed above does a good job of pointing out that exercise can
have a role to play in improving physical and mental health of individuals. It however does little
to mention the specific forms of exercise that can be adopted in order to cure mental issues such
as depression and anxiety. More research needs to be carried out how the specific types and
forms of exercise that can be deployed to improve the mental health of a person by a
considerable degree.

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References
Mikkelsen, K., Stojanovska, L., Polenakovic, M., Bosevski, M., & Apostolopoulos, V. (2017).
Exercise and mental health. Maturitas, 106, 48-56
Knapen, J., Vancampfort, D., Moriën, Y. and Marchal, Y., 2015. Exercise therapy improves both
mental and physical health in patients with major depression. Disability and
rehabilitation, 37(16), pp.1490-1495.
Firth, J., Rosenbaum, S., Stubbs, B., Gorczynski, P., Yung, A. R., & Vancampfort,
D. (2016). Motivating factors and barriers towards exercise in severe mental illness: a
systematic review and meta-analysis. Psychological medicine, 46(14), 2869-2881.
Firth, J., Cotter, J., Elliott, R., French, P., & Yung, A. R. (2015). A systematic review and meta-
analysis of exercise interventions in schizophrenia patients. Psychological
medicine, 45(7), 1343-1361.
Firth, J., Carney, R., Elliott, R., French, P., Parker, S., McIntyre, R., ... & Yung, A. R. (2018).
Exercise as an intervention for first‐episode psychosis: a feasibility study. Early
intervention in psychiatry, 12(3), 307-315.