SYSTEMATIC REVIEW article
Front. Psychol.
Sec. Movement Science
This article is part of the Research TopicTowards a Psychophysiological Approach in Physical Activity, Exercise, and Sports-Volume VView all 31 articles
Optimal Exercise Modality and Dose for Alleviating Depressive Symptoms in Postmenopausal Women: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials
Provisionally accepted
- 1Shandong University, Jinan, China
- 2Shandong University of Finance and Economics, Jinan, China
- 3University of Jinan, Jinan, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: Although physical exercise is widely recognized as an effective non-pharmacological intervention for depressive symptoms, the relative efficacy of different exercise modalities and the optimal dose for postmenopausal women remain unclear. This study aimed to determine the optimal exercise modality and dose for alleviating depressive symptoms in postmenopausal women through a systematic review and network meta-analysis (NMA), incorporating a model-based network meta-analysis (MBNMA) for dose-response relationships. Methods: Five major electronic databases (Web of Science, Cochrane Library, PubMed, EBSCO, and Embase) were searched for randomized controlled trials (RCTs) investigating the effects of exercise interventions on depressive symptoms in postmenopausal women. The risk of bias in included studies was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. The NMA and dose-response MBNMA were conducted using R software. Results: A total of 33 RCTs involving 2,607 participants were included. The NMA results showed that all four exercise modalities—resistance exercise (RE), mind-body exercise (MBE), aerobic exercise (AE), and combined exercise (CBE)—significantly alleviated depressive symptoms compared to the control group: RE (SMD = -0.90, 95% CI: -1.61 to -0.20), MBE (SMD = -0.75, 95% CI: -1.07 to -0.43), AE (SMD = -0.67, 95% CI: -0.93 to -0.42), and CBE (SMD = -0.63, 95% CI: - 1.19 to -0.06). P-score rankings suggested that RE (P=0.774) and MBE (P=0.662) had the greatest therapeutic potential. The dose-response analysis revealed a significant U-shaped relationship, with a minimum effective dose of 183 METs-min/week and an optimal dose around 750 METs-min/week. The therapeutic effect tended to diminish beyond 1,130 METs-min/week. Among the modalities, MBE had the lowest effective dose threshold (164 METs-min/week). Conclusion: Physical exercise is a highly effective intervention for alleviating depressive symptoms in postmenopausal women, with resistance and mind-body exercises demonstrating the greatest therapeutic potential. The antidepressant effect of exercise follows a U-shaped dose-response relationship, with an optimal dose of approximately 750 METs-min/week. These findings provide robust evidence for clinicians to move beyond generic recommendations and to develop precise, individualized exercise prescriptions tailored to the specific needs and conditions of their patients.
Keywords: Exercise, Depression, postmenopausal women, dose-response, Model-based network 8meta-analysis, rct
Received: 11 Nov 2025; Accepted: 30 Nov 2025.
Copyright: © 2025 Xu, Guo, Yang and Ding. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Junkai Ding
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.