{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:03:07Z","timestamp":1790229787716,"version":"4.1.0"},"reference-count":97,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare the effect of combined physical training (PT) and cognitive training (CT) with single-modality interventions, on depression symptoms in adults across clinical populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Scopus, Web of Science, SPORTDiscus, and APA PsycINFO were systematically searched for relevant English-language studies up to December 2025. Search terms focused on combined PT and CT compared with PT or CT alone in adults with depression symptoms. Included samples were predominantly heterogeneous clinical populations, particularly individuals with neurological conditions (e.g., stroke, Parkinson\u2019s disease, multiple sclerosis, dementia, and mild cognitive impairment), as well as chronic somatic conditions (e.g., fibromyalgia), alongside a smaller number of non-clinical (healthy) populations. Data were extracted on training interventions, sample characteristics, and depression symptoms. Between-group standardized mean differences were calculated from post-intervention means and standard deviations using random-effects models to compare combined PT and CT with single-modality interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixteen studies were identified (\n                      <jats:italic>N<\/jats:italic>\n                      =\u202f813). Across the included studies, both combined and single-modality interventions (PT or CT) were associated with reductions in depression symptoms. However, pooled between-group analyses indicated that combined interventions were associated with greater reductions in depression symptoms than single-modality interventions (SMD\u202f=\u202f\u22120.40, 95% CI [\u22120.69, \u22120.11],\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      =\u202f69.7%), although moderate between-study heterogeneity was observed. Most comparisons were conducted against PT alone, with only limited evidence for CT-only comparators. Sensitivity analyses restricted to studies (\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f13) using validated depression-specific scales showed a smaller effect in the same direction that was no longer statistically significant (SMD\u202f=\u202f\u22120.24, 95% CI [\u22120.51, 0.03],\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      =\u202f57.2%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Combined PT and CT may provide greater reductions in depression symptoms than single-modality interventions, particularly PT alone. However, this effect was attenuated and no longer statistically significant when analyses were restricted to depression-specific measures. Given the heterogeneity, variability in outcome measures, limited evidence for CT-only comparisons, and very low certainty of evidence, findings need to be interpreted cautiously.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42024583214<\/jats:ext-link>\n                      , Identifier CRD42024583214.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1741014","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T05:43:25Z","timestamp":1790228605000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Systematic review and meta-analysis of the effects of combined physical and cognitive training on depression symptoms in adults across clinical populations"],"prefix":"10.3389","volume":"17","author":[{"given":"Piesie A. G.","family":"Asuako","sequence":"first","affiliation":[{"name":"Department of Neuromotor Behavior and Exercise, University of M\u00fcnster","place":["M\u00fcnster, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghazal","family":"Naser","sequence":"additional","affiliation":[{"name":"Department of Neuromotor Behavior and Exercise, University of M\u00fcnster","place":["M\u00fcnster, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis K. H.","family":"Holzhauer","sequence":"additional","affiliation":[{"name":"Department of Neuromotor Behavior and Exercise, University of M\u00fcnster","place":["M\u00fcnster, Germany"]},{"name":"Chair of Sport Analytics, Saarland University","place":["Saarbr\u00fccken, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Beblo","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, Medical School and University Medical Center OWL, Bielefeld University, Evangelisches Klinikum Bethel","place":["Bielefeld, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Voelcker-Rehage","sequence":"additional","affiliation":[{"name":"Department of Neuromotor Behavior and Exercise, University of M\u00fcnster","place":["M\u00fcnster, Germany"]},{"name":"Joint Institute for Individualisation in a Changing Environment (JICE), University of M\u00fcnster and Bielefeld University","place":["Bielefeld, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/j.amepre.2011.10.016","article-title":"Exergaming and older adult cognition: a cluster randomized clinical trial","volume":"42","author":"Anderson-Hanley","year":"2012","journal-title":"Am. J. Prev. Med."},{"key":"ref2","doi-asserted-by":"crossref","first-page":"11349","DOI":"10.4088\/JCP.20f13681","article-title":"Mean difference, standardized mean difference (SMD), and their use in meta-analysis: as simple as it gets","volume":"81","author":"Andrade","year":"2020","journal-title":"J. Clin. Psychiatry"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e889","DOI":"10.1016\/s2468-2667(23)00220-7","article-title":"Prevalence and variability of depressive symptoms in Europe: update using representative data from the second and third waves of the European health interview survey (EHIS-2 and EHIS-3)","volume":"8","author":"Arias-de la Torre","year":"2023","journal-title":"Lancet Public Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.1007\/s41999-023-00849-z","article-title":"Comparison of dance and aerobic exercise on cognition and neuropsychiatric symptoms in sedentary older adults with cognitive impairment","volume":"14","author":"Ayari","year":"2023","journal-title":"Euro. Geriatr. Med."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1186\/s12877-024-04942-1","article-title":"Effects of dual-task resistance exercise on cognition, mood, depression, functional fitness, and activities of daily living in older adults with cognitive impairment: a single-blinded, randomized controlled trial","volume":"24","author":"Baek","year":"2024","journal-title":"BMC Geriatr."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1136\/ebmental-2019-300117","article-title":"How to perform a meta-analysis with R: a practical tutorial","volume":"22","author":"Balduzzi","year":"2019","journal-title":"Evid. Based Ment. Health"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1017\/S1041610295002353","article-title":"Antidepressants in geriatric depression: what difference have they made?","volume":"7","author":"Baldwin","year":"1995","journal-title":"Int. Psychogeriatr."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"152","DOI":"10.3389\/fnagi.2015.00152","article-title":"Gains in cognition through combined cognitive and physical training: the role of training dosage and severity of neurocognitive disorder","volume":"7","author":"Bamidis","year":"2015","journal-title":"Front. Aging Neurosci."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"682","DOI":"10.12998\/wjcc.v3.i8.682","article-title":"Depressive symptoms in neurodegenerative diseases","volume":"3","author":"Baquero","year":"2015","journal-title":"World J. Clin. Cases"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1007\/s11065-011-9171-0","article-title":"Specifying the neuropsychology of affective disorders: clinical, demographic and neurobiological factors","volume":"21","author":"Beblo","year":"2011","journal-title":"Neuropsychol. Rev."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e14181","DOI":"10.2196\/14181","article-title":"Adherence reporting in randomized controlled trials examining manualized multisession online interventions: systematic review of practices and proposal for reporting standards","volume":"21","author":"Beintner","year":"2019","journal-title":"J. Med. Internet Res."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"769","DOI":"10.3233\/JAD-190552","article-title":"Comparative cognitive effects of choreographed exercise and multimodal physical therapy in older adults with amnestic mild cognitive impairment: randomized clinical trial","volume":"73","author":"Bisbe","year":"2020","journal-title":"J. Alzheimer's Dis"},{"key":"ref13","doi-asserted-by":"crossref","DOI":"10.1002\/9781119558378","volume-title":"Introduction to Meta-Analysis","author":"Borenstein","year":"2021"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"77","DOI":"10.17886\/RKI-GBE-2017-070","article-title":"Depressive symptoms among adults in Germany","volume":"2","author":"Bretschneider","year":"2017","journal-title":"Journal of Health Monitoring."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"663","DOI":"10.3390\/brainsci12050663","article-title":"Mindfulness-enhanced computerized cognitive training for depression: an integrative review and proposed model targeting the cognitive control and default-mode networks","volume":"12","author":"Bursky","year":"2022","journal-title":"Brain Sci."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2020\/5480315","article-title":"Effects of video-game based therapy on balance, postural control, functionality, and quality of life of patients with subacute stroke: a randomized controlled trial","volume":"2020","author":"Cano-Ma\u00f1as","year":"2020","journal-title":"J. Healthcare Eng."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1089\/g4h.2019.0108","article-title":"Effects of exergames in women with fibromyalgia: a randomized controlled study","volume":"9","author":"Carvalho","year":"2020","journal-title":"Games for Health Journal."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"216","DOI":"10.3389\/fnagi.2019.00216","article-title":"Effects and mechanisms of cognitive, aerobic exercise, and combined training on cognition, health, and brain outcomes in physically inactive older adults: the projecte moviment protocol","volume":"11","author":"Castells-S\u00e1nchez","year":"2019","journal-title":"Front. Aging Neurosci."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"102636","DOI":"10.1016\/j.msksp.2022.102636","article-title":"Virtual reality and motor control exercises to treat chronic neck pain: a randomized controlled trial","volume":"62","author":"Cetin","year":"2022","journal-title":"Musculoskelet. Sci. Pract."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1093\/ageing\/afaa063","article-title":"Cognitive training interventions and depression in mild cognitive impairment and dementia: a systematic review and meta-analysis of randomized controlled trials","volume":"49","author":"Chan","year":"2020","journal-title":"Age Ageing"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1177\/0271678X221148979","article-title":"Depression, stress and regional cerebral blood flow","volume":"43","author":"Chiappelli","year":"2023","journal-title":"J. Cereb. Blood Flow Metab."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"20552076231203633","DOI":"10.1177\/20552076231203633","article-title":"Effects of computer-based cognitive training combined with physical training for older adults with cognitive impairment: a four-arm randomized controlled trial","volume":"9","author":"Chuang","year":"2023","journal-title":"Digital Health."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"ED000142","DOI":"10.1002\/14651858.ED000142","article-title":"Updated guidance for trusted systematic reviews: a new edition of the Cochrane handbook for systematic reviews of interventions","volume":"10","author":"Cumpston","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref24","doi-asserted-by":"crossref","first-page":"pzab051","DOI":"10.1093\/ptj\/pzab051","article-title":"Effect of virtual reality gait training on participation in survivors of subacute stroke: a randomized controlled trial","volume":"101","author":"de Rooij","year":"2021","journal-title":"Phys. Ther."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1016\/j.neubiorev.2021.07.008","article-title":"The effects of combined physical and cognitive training on inhibitory control: a systematic review and meta-analysis","volume":"128","author":"Dhir","year":"2021","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1016\/j.apmr.2017.12.014","article-title":"The effects of functional training, bicycle exercise, and exergaming on walking capacity of elderly patients with Parkinson disease: a pilot randomized controlled single-blinded trial","volume":"99","author":"Ferraz","year":"2018","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1388","DOI":"10.1007\/s00415-022-11469-1","article-title":"Treadmill training with virtual reality to enhance gait and cognitive function among people with multiple sclerosis: a randomized controlled trial","volume":"270","author":"Galperin","year":"2023","journal-title":"J. Neurol."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12966-018-0697-x","article-title":"Physical activity to improve cognition in older adults: can physical activity programs enriched with cognitive challenges enhance the effects? A systematic review and meta-analysis","volume":"15","author":"Gheysen","year":"2018","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"259","DOI":"10.31887\/DCNS.2006.8.2\/mgoodwin","article-title":"Depression and associated physical diseases and symptoms","volume":"8","author":"Goodwin","year":"2006","journal-title":"Dialogues Clin. Neurosci."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.1007\/s11606-011-1704-y","article-title":"Depression and medication adherence in the treatment of chronic diseases in the United States: a meta-analysis","volume":"26","author":"Grenard","year":"2011","journal-title":"J. Gen. Intern. Med."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1186\/s12911-021-01534-6","article-title":"ICD-11: an international classification of diseases for the twenty-first century","volume":"21","author":"Harrison","year":"2021","journal-title":"BMC Med. Inform. Decis. Mak."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1895","DOI":"10.1162\/jocn_a_01164","article-title":"The effects of physical exercise and cognitive training on memory and neurotrophic factors","volume":"29","author":"Heisz","year":"2017","journal-title":"J. Cogn. Neurosci."},{"key":"ref34","first-page":"29","article-title":"A revised tool for assessing risk of bias in randomized trials","volume":"10","author":"Higgins","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"27","DOI":"10.12965\/jer.2244514.257","article-title":"Effects of multimodal cognitive exercise program on cognitive function, bone density, blood lipid, fitness, and depression in old women with mild cognitive impairment","volume":"19","author":"Hong","year":"2023","journal-title":"J. Exerc. Rehab."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"102266","DOI":"10.1016\/j.psychsport.2022.102266","article-title":"Exergame-based exercise training for depressive symptoms in adults: a systematic review and meta-analysis","volume":"63","author":"Huang","year":"2022","journal-title":"Psychol. Sport Exerc."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"6240","DOI":"10.3390\/ijerph18126240","article-title":"Multi-component intervention program on habitual physical activity parameters and cognitive function in patients with mild cognitive impairment: a randomized controlled trial","volume":"18","author":"Jeong","year":"2021","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"2148","DOI":"10.3390\/jcm10102148","article-title":"Evaluation of the impact of virtual reality-enhanced cardiac rehabilitation on depressive and anxiety symptoms in patients with coronary artery disease: a randomised controlled trial","volume":"10","author":"J\u00f3\u017awik","year":"2021","journal-title":"J. Clin. Med."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"9350","DOI":"10.12998\/wjcc.v9.i31.9350","article-title":"Major depressive disorder: validated treatments and future challenges","volume":"9","author":"Karrouri","year":"2021","journal-title":"World J. Clin. Cases"},{"key":"ref40","first-page":"447","article-title":"FITT principle of exercise in the management of lifestyle-related diseases","volume":"26","author":"Katsukawa","year":"2016","journal-title":"Clin. Calcium"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"189","DOI":"10.3389\/fnins.2010.00189","article-title":"Why and how physical activity promotes experience-induced brain plasticity","volume":"4","author":"Kempermann","year":"2010","journal-title":"Front. Neurosci."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"2130","DOI":"10.47391\/JPMA.319","article-title":"Role Wii fit exer-games in improving balance confidence and quality of life in elderly population","volume":"71","author":"Khushnood","year":"2021","journal-title":"J. Pak. Med. Assoc."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1589\/jpts.30.335","article-title":"The effect of exercise combined with a cognitive-enhancement group training program on cognition and depression in the community-dwelling elderly","volume":"30","author":"Kim","year":"2018","journal-title":"J. Phys. Ther. Sci."},{"key":"ref44","doi-asserted-by":"publisher","first-page":"e48912","DOI":"10.2196\/48912","article-title":"Effect of individual virtual reality cognitive training programs on cognitive function and depression in middle-aged women: randomized controlled trial","volume":"10","author":"Kim","year":"2023","journal-title":"JMIR Mental Health."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1080\/13825585.2011.645010","article-title":"Cognitive function, physical activity, and aging: possible biological links and implications for multimodal interventions","volume":"19","author":"Kraft","year":"2012","journal-title":"Aging Neuropsychol. Cognit."},{"key":"ref46","doi-asserted-by":"publisher","first-page":"458","DOI":"10.2174\/1567205019666220627091246","article-title":"Effect of simultaneous dual-task training on regional cerebral blood flow in older adults with amnestic mild cognitive impairment","volume":"19","author":"Kunieda","year":"2022","journal-title":"Curr. Alzheimer Res."},{"key":"ref47","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12877-016-0315-1","article-title":"Influence of combined physical and cognitive training on cognition: a systematic review","volume":"16","author":"Lauenroth","year":"2016","journal-title":"BMC Geriatr."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"3","DOI":"10.2147\/NDT.S19617","article-title":"The increasing burden of depression","volume":"7","author":"L\u00e9pine","year":"2011","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref49","doi-asserted-by":"publisher","first-page":"1440975","DOI":"10.3389\/fnins.2024.1440975","article-title":"Physical exercise for brain plasticity promotion an overview of the underlying oscillatory mechanism","volume":"18","author":"Li","year":"2024","journal-title":"Front. Neurosci."},{"key":"ref50","doi-asserted-by":"publisher","first-page":"1634","DOI":"10.1080\/13607863.2017.1385722","article-title":"Exergames vs. traditional exercise: investigating the influencing mechanism of platform effect on subthreshold depression among older adults","volume":"22","author":"Li","year":"2018","journal-title":"Aging Ment. Health"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1111\/wvn.12429","article-title":"Effectiveness of early rehabilitation combined with virtual reality training on muscle strength, mood state, and functional status in patients with acute stroke: a randomized controlled trial","volume":"17","author":"Lin","year":"2020","journal-title":"Worldviews Evid.-Based Nurs."},{"key":"ref52","doi-asserted-by":"publisher","first-page":"e19002","DOI":"10.2196\/19002","article-title":"Effects of a combination of three-dimensional virtual reality and hands-on horticultural therapy on institutionalized older adults\u2019 physical and mental health: quasi-experimental design","volume":"22","author":"Lin","year":"2020","journal-title":"J. Med. Internet Res."},{"key":"ref53","article-title":"Estimation of the global disease burden of depression and anxiety between 1990 and 2044: an analysis of the global burden of disease study 2019","author":"Liu","year":"2024","journal-title":"Healthcare 1721"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"1785","DOI":"10.1177\/0962280216669183","article-title":"Optimally estimating the sample mean from the sample size, median, mid-range, and\/or mid-quartile range","volume":"27","author":"Luo","year":"2018","journal-title":"Stat. Methods Med. Res."},{"key":"ref55","doi-asserted-by":"publisher","first-page":"e41173","DOI":"10.2196\/41173","article-title":"Effectiveness of an individualized exergame-based motor-cognitive training concept targeted to improve cognitive functioning in older adults with mild neurocognitive disorder: study protocol for a randomized controlled trial","volume":"12","author":"Manser","year":"2023","journal-title":"JMIR Res. Prot."},{"key":"ref56","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1097\/JNN.0000000000000133","article-title":"Memory training plus yoga for older adults","volume":"47","author":"McDougall","year":"2015","journal-title":"J. Neurosci. Nurs."},{"key":"ref57","doi-asserted-by":"publisher","first-page":"1319","DOI":"10.1016\/j.apmr.2015.02.032","article-title":"Effectiveness of conventional versus virtual reality\u2013based balance exercises in vestibular rehabilitation for unilateral peripheral vestibular loss: results of a randomized controlled trial","volume":"96","author":"Meldrum","year":"2015","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref58","doi-asserted-by":"publisher","first-page":"111362","DOI":"10.1016\/j.exger.2021.111362","article-title":"Motoric cognitive risk syndrome, physio-cognitive decline syndrome, cognitive frailty and reversibility with dual-task exercise","volume":"150","author":"Merchant","year":"2021","journal-title":"Exp. Gerontol."},{"key":"ref59","doi-asserted-by":"publisher","first-page":"S418","DOI":"10.1192\/j.eurpsy.2023.901","article-title":"The association between mood, inhibitory control and depressive symptoms: an ecological momentary assessment study","volume":"66","author":"Nahum","year":"2023","journal-title":"Eur. Psychiatry"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1161\/CIRCULATIONAHA.107.185650","article-title":"Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association","volume":"116","author":"Nelson","year":"2007","journal-title":"Circulation"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"4326","DOI":"10.1212\/WNL.96.15_supplement.4326","article-title":"BDNF mediates improvement in cognitive performance after computerized cognitive training","volume":"96","author":"Nicastri","year":"2021","journal-title":"Neurology"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"e075847","DOI":"10.1136\/bmj-2023-075847","article-title":"Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials","volume":"384","author":"Noetel","year":"2024","journal-title":"BMJ"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/j.apnu.2024.10.020","article-title":"Combined mindfulness-based stress reduction and physical activity improved psychological factors and sleep quality in patients with MDD: a randomized controlled trial study","volume":"53","author":"Norouzi","year":"2024","journal-title":"Arch. Psychiatr. Nurs."},{"key":"ref64","doi-asserted-by":"publisher","first-page":"103823","DOI":"10.1016\/j.msard.2022.103823","article-title":"Effects and safety of exergaming in persons with multiple sclerosis during corticosteroid treatment: a pilot study","volume":"63","author":"Ozdogar","year":"2022","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref65","doi-asserted-by":"publisher","first-page":"104480","DOI":"10.1016\/j.msard.2022.104480","article-title":"Effect of exergaming in people with restless legs syndrome with multiple sclerosis: a single-blind randomized controlled trial","volume":"70","author":"Ozdogar","year":"2023","journal-title":"Mult. Scler. Relat. 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