Effects of Combined Music and Exercise Therapy on Depression: A Systematic Review and Meta-Analysis

Background: Depression is a common psychiatric disorder that impacts millions globally. Non-pharmacological treatments, such as combining music and exercise therapy, have shown potential as alternatives to medication. This meta-analysis evaluates the impact of integrating music with exercise on depressive symptoms. Methods: A comprehensive literature search was conducted across multiple databases. Randomized controlled trials of combined music and exercise therapy for patients with mild, moderate, or severe depression were included. Interventions included any exercise paired with music therapy, such as Tai Chi or aerobics. They were compared with the standard of care, a waitlist control group, medication, and monotherapy. A meta-analysis was performed using random-effects models in RevMan 5.4. The standardized mean difference (SMD) was used as a summative measure. The effects of age, type of exercise, and duration of intervention on depression were explored in the subgroup analysis. Results: Seven randomized controlled trials involving 640 patients with depression were analyzed. Results indicated significant improvement in depressive symptoms (SMD = −0.49, 95% CI: −0.93 to −0.06, p = 0.03). Subgroup analyses showed that music combined with Tai Chi (SMD = −0.96, 95% CI: −1.90 to −0.02, p = 0.04) or aerobic exercise (SMD = −0.60, 95% CI: −0.98 to −0.23, p = 0.001) over 12 weeks (SMD = −0.29, 95% confidence interval (CI): −0.50 to −0.08, p = 0.008) significantly reduced symptoms, especially in patients older than 60 years (SMD = −0.31, 95% CI: −0.61 to −0.01, p = 0.04). It can be suggested that patients with depression better tolerate music combined with exercise therapy. Two studies reported transient fatigue, and no withdrawals occurred due to adverse events. Conclusions: This meta-analysis suggests that combining music and exercise therapy is effective in reducing depressive symptoms. Combining music with aerobic exercise and tai chi is particularly beneficial for patients over 60 years of age. The quality of the evidence was limited by the heterogeneity and varying risk of bias of the included studies, and caution is warranted.