As chiropractors, we often see patients who struggle with mental health issues. This week, a gentle reminder of the power of exercise as a treatment for anxiety and depression….

Depression and anxiety disorders are among the most prevalent mental health conditions worldwide, affecting an estimated 7-25% of the global population (1). Contemporary chiropractors likely encounter patients in practice daily with these conditions. Importantly, depression and anxiety are not simply psychological problems – they affect family and social functioning, physical health, and carry substantial economic costs. They can also impact a patient’s prognosis and response to chiropractic care. Youth populations experience almost twice the rate of depression and anxiety of adults, and women are disproportionately affected. While pharmacotherapy and psychotherapy remain the most common treatments, rising prevalence rates suggest these approaches alone are not keeping pace with the burden of mental illness.

Exercise has been studied for years as a promising adjunct or alternative to traditional mental health treatments. The evidence for its neurobiological effects is compelling – exercise stimulates pathways that support cognitive function, emotional regulation, and neuroplasticity. Despite this, uptake of exercise as a formal mental health intervention remains limited in clinical practice, partly because earlier research was fragmented across specific populations, exercise types, and symptom presentations.

This meta-meta-analysis was designed to address that gap comprehensively. Rather than synthesizing individual studies, it synthesizes previously published meta-analyses of randomized controlled trials – a methodological approach known as an umbrella review or meta-meta-analysis. The goal was to generate the most complete and reliable picture yet of how exercise affects depression and anxiety, across all age groups, clinical settings, and exercise formats, while isolating the specific effect of exercise by excluding populations with pre-existing physiological conditions that might confound the results.

Excerpt from the Clinical Application & Conclusions section of the review:

“This paper is a useful one to have in your clinical toolkit. Most chiropractors already understand that exercise matters for mental health, but having a high-quality synthesis like this one, with specific guidance on format, intensity, duration, and population, makes it easier to counsel patients with confidence. The finding that group-based exercise outperforms individual exercise is something I find particularly useful in practice – it supports recommending classes, community programs, or at minimum, exercise with a partner rather than alone. That is a specific, actionable recommendation that patients can implement.“

This week’s Research Review: