Journal List > J Korean Acad Psychiatr Ment Health Nurs > v.22(1) > 1057978

Park, Han, Kang, and Park: Effects of an Exercise Program on Depression Symptom, Self-esteem and Stress in Adolescents: A Systematic Review



This study was done to investigate evidence of exercise programs as interventions to decrease depression, anxiety symptoms and stress as well as to improve physical status and self-esteem in adolescents.


A search of electronic bibliographic database of Medline Ovid, Embase, KoreaMed and NDSL etc. was carried out to identify studies of randomized controlled trials that included exercise programs for adolescent. Of 679 publications identified, 10 studies met inclusion and exclusion criteria, and all studies were used in the meta-analysis. For Quality assessment of studies, Cochrane's Risk of Bias was used.


The effectiveness of exercise therapy in adolescents showed that depression symptoms and stress decreased significantly, -0.50 (95% CI: -0.73~-0.27), -1.65 (95% CI: -3.19~-0.12) respectively, but there were some heterogeneity. Self-esteem increased 0.19 (95% CI: -0.22~0.60) due to exercise therapy but theses scores were not statistically significant.


Based on these findings, there is evidence that exercise programs in adolescents are effective in improving depression symptoms, stress, and self-esteem. Therefore, the priority task is to develop tailored exercise programs for Korean adolescents and make efficient use of these programs.

Figures and Tables

Figure 1
Flow chart of study selection.
Figure 2
Assessment risk of bias in selected studies.
Figure 3
Comparison outcomes of exercise versus control on psychological effects.
Figure 4
Funnel plot of selected studies for effect size extraction.
Table 1
Characteristics of Selected Studies

Exp.=experimental group; Cont.=control group; CES-D=the center for epidemiological studies-depression scale; KINDL=Serbian KINDL questionnaire; PSS=perceived stress scale; SMFQ-C=the short mood and feelings questionnaire-child version; RSQ=responses to stress questionnaire; CDI=children's depressive inventory; RSES=rosenberg self-esteem scale; BDI=beck depression inventory; LES=life experiences survey; SD=self-development; RCDS=reynolds child depression scale; SPPC=the self-perception profile for children; Self-development=this scale was developed for this study by authors (Cronbach's α=.71); STAI=Spielberg's trait anxiety inventory.


This research was supported by General Research program through the National Research Foundation of Korea(NRF) funded by the Ministry of Education Science and Technology (2011-0012616).


1. Committee on Sports Medicine. Risks in distance running for children. Pediatrics. 1990. 86:799–800.
2. Archibald AB, Graber JA, Brooks-Gunn J. Associations among parent-adolescent relationships, pubertal growth, dieting, and body image in young adolescent girls: A short-term longitudinal study. J Res Adolesc. 1999. 9:395–415.
3. Beets MW, Mitchell E. Effects of yoga on stress, depression, and health-related quality of life in a nonclinical, bi-ethnic sample of adolescents: A pilot study. Hisp Health Care Int. 2010. 8:47–53.
4. Biddle S. Children, exercise and mental health. Int J Sport Psychol. 1993. 24:200–216.
5. Bidwell S, Jensen MF. Topfer LA, Auston I, editors. Chapter 3: Using a search protocol to identify sources of information: The COSI model. A Text on Health Technology Assessment (HTA) Information Resources. 2004. Bethesda, MD: National Information Center on Health Services Research and Health Care Technology (NICHSR), US National Library of Medicine.
6. Calfas K, Taylor W. Effects of physical activity on psychological variables in adolescents. Pediatr Exerc Sci. 1994. 6:406–423.
7. Cho YH, Rho BI. The effect of geriatric health exercise on depression with special reference to Naegong gymnastics. Korean J Care Work. 2009. 12:5–12.
8. Chung MS, Ko KH, Kim YO. The effect of an obesity control program for children in pediatric and adolescent psychiatric hospital. J Korean Acad Psychiatr Ment Health Nurs. 2011. 20:71–80.
9. Crawford MJ, McGuire H, Moncrieff J, Martinsen EW. Exercise therapy for depression and other neurotic disorders (Protocol for a Cochrane review). Cochrane Library. 2002. (4):
10. Crews DJ, Lochbaum MR, Landers DM, Crews DJ, Lochbaum MR, Landers DM. Aerobic physical activity effects on psychological well-being in low-income Hispanic children. Percept Mot Skills. 2004. 98:319–324.
11. Crocker PR, Grozelle C. Reducing induced state anxiety: Effects of acute aerobic exercise and autogenic relaxation. J Sports Med Phys Fitness. 1991. 31:277–282.
12. Dechamps A, Diolez P, Thiaudiere E, Tulon A, Onifade C, Vuong T, et al. Effects of exercise programs to prevent decline in health-related quality of life in highly deconditioned institutionalized elderly persons: A randomized controlled trial. Arch Intern Med. 2010. 170:162–169.
13. Herman-Tofler LR, Tuckman BW. The effects of aerobic training on children's creativity, self-perception, and aerobic power. Child Adolesc Psychiatr Clin N Am. 1998. 7:773–790.
14. Higgins J, Green S, editors. Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration. 2011. Retrieved March 30, 2011. from
15. Kim OH, Park JK. The effects of participation in exercise and nutrition education program on physical fitness, dietary habits and nutrition intake status for adolescents. Korean J Obes. 2012. 21:158–165.
16. Kim TS. The effect of stage based exercise program on obesity index, blood components, health-related physical fitness and self-esteem in obese adolescents. 2007. Nonsan: Konyang University;Unpublished master's thesis.
17. Larun L, Nordheim LV, Ekeland E, Hagen KB, Heian F. Exercise in prevention and treatment of anxiety and depression among children and young people. Cochrane Database Syst Rev. 2006. (3):CD004691.
18. Lee HG. The influence of walking intervention on severity of depressive symptoms in adolescents. 2008. Daegu: Keimyung University;Unpublished master's thesis.
19. Lee HS. Relation of the self differentiation, self-esteem and mental health in adolescents. J Korean Acad Psychiatr Ment Health Nurs. 2011. 20:199–207.
20. MacMahon JR, Gross RT. Physical and psychological effects of aerobic exercise in delinquent adolescent males. Am J Dis Child. 1988. 142:1361–1366.
21. Melnyk BM, Small L, Morrison-Beedy D, Strasser A, Spath L, Kreipe R, et al. Mental health correlates of healthy lifestyle attitudes, beliefs, choices, and behaviors in overweight adolescents. J Pediatr Health Care. 2006. 20:401–406.
22. Mendelson T, Greenberg MT, Dariotis JK, Gould LF, Rhoades BL, Leaf PJ, et al. Feasibility and preliminary outcomes of a school-based mindfulness intervention for urban youth. J Abnorm Child Psychol. 2010. 38:985–994.
23. Petty KH, Davis CL, Tkacz J, Young-Hyman D, Waller JL, Petty KH, et al. Exercise effects on depressive symptoms and self-worth in overweight children: A randomized controlled trial. J Pediatr Psychol. 2009. 34:929–939.
24. Rethorst CD, Landers DM, Nagoshi CT, Ross JT, Rethorst CD, Landers DM, et al. Efficacy of exercise in reducing depressive symptoms across 5-HTTLPR genotypes. Med Sci Sports Exerc. 2010. 42:2141–2147.
25. Robinson TN, Matheson DM, Kraemer HC, Wilson DM, Obarzanek E, Thompson NS, et al. A randomized controlled trial of culturally tailored dance and reducing screen time to prevent weight gain in low-income African American girls: Stanford GEMS. Arch Pediatr Adolesc Med. 2010. 164:995–1004.
26. Scully D, Kremer J, Meade MM, Graham R, Dudgeon K. Physical exercise and psychological well being: A critical review. Br J Sports Med. 1998. 32:111–120.
27. Seo EH. Effects of the Behas exercise program on physical strength, depression and life satisfaction in the institutionalized elderly. 2011. Gwangju: Chonnam University;Unpublished doctoral dissertation.
28. Terjestam Y, Jouper J, Johansson C. Effects of scheduled qigong exercise on pupils' well-being, self-image, distress, and stress. J Altern Complement Med. 2010. 16:939–944.
29. Timonen L, Rantanen T, Timonen TE, Sulkava R, Timonen L, Rantanen T, et al. Effects of a group-based exercise program on the mood state of frail older women after discharge from hospital. Int J Geriatr Psychiatry. 2002. 17:1106–1111.
30. Weintraub DL, Tirumalai EC, Haydel KF, Fujimoto M, Fulton JE, Robinson TN, et al. Team sports for overweight children: The Stanford Sports to Prevent Obesity Randomized Trial (SPORT). Arch Pediatr Adolesc Med. 2008. 162:232–237.
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