New systematic review on walking and depression

Walking for depression or depressive symptoms: a systematic review and meta-analysis

Authors: Roma Roberston, Ann R.R. Roberston, Ruth Jepson and Margaret Maxwell 

Previously, physical activity has been proven to be a successful intervention for improving symptoms of depression. It is unknown, however, if lower intensity activities such as walking have the same positive effect.  The authors of this paper sought to determine the suitability of walking as an effective method for treating depression in adults.

A systematic approach was used to identify suitable randomised controlled trials for this analysis. Interventions were included if they involved a structured or semi-structured walking treatment. Those which incorporated the completion of a light warm up or cool down alongside a walking intervention, such as a short period of stretching, were also included in the analysis. Trials were excluded from the analysis if participants participated in any other form of physical activity other than walking, for example jogging or weight lifting. Comparison groups included controls such as ‘no treatment’ or ‘usual care’ and to accommodate for the social aspects of walking, comparison groups were often involved in alternative forms of social contact, such as group meetings or gentle stretching/relaxation sessions.

Eight studies met the inclusion criteria for this analysis. Walking interventions were carried out on at least two days a week (average of 3.5 sessions per week) with individual sessions lasting from 20-50 minutes.

Results of the meta-analysis showed walking to be an effective treatment for depression. Its effect size (-0.86) is comparable to meta-analysis of other physical activity interventions as treatment for depression.  In six studies, walking had significant positive effects on depression while one study found a non-significant positive effect. Only one study found controls had a greater reduction in depressive symptoms as compared with the walking group. Overall, this suggests walking has the potential to reduce symptoms of depression in the same way as other forms of physical activity. 

While the authors set out to evaluate three forms of walking (walking outdoors, walking indoors and walking as a group) the small number of studies available make is difficult to offer any evidence of the effectiveness of different settings. Further good quality walking trials are required to determine the added value of walking in a group or outside.

Based on this analysis, walking demonstrated similar improvements to depressive symptoms compared to vigorous physical activity. It is still, however, unknown which form of walking (indoor, outdoor or walking in a group), and how much walking, provides the most effective treatment.

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