The Effect of Walking on Depressive and Anxiety Symptoms: Systematic Review and Meta-Analysis

Summary & key facts

This systematic review pooled 75 randomized trials with 8,636 people to see if walking changes symptoms of depression and anxiety. In adults, walking reduced depressive symptoms (SMD −0.591, 95% CI −0.778 to −0.403, P<.001) and anxiety symptoms (SMD −0.446, 95% CI −0.628 to −0.265, P<.001) compared with inactive controls. The benefit was seen across many types of walking (indoor/outdoor, group/individual, different frequencies and durations). Results were similar when walking was compared with active controls. The authors note substantial variation between studies and say more evidence is needed on low-intensity walking.

Key facts:

• The review included 75 randomized controlled trials with a total of 8,636 participants.
• Compared with inactive controls, walking reduced depressive symptoms in adults (44 RCTs; standardized mean difference [SMD] −0.591; 95% CI −0.778 to −0.403; P<.001).
• Compared with inactive controls, walking reduced anxiety symptoms in adults (26 RCTs; SMD −0.446; 95% CI −0.628 to −0.265; P<.001).
• There was high statistical heterogeneity in the pooled results (depression I2=84.8%; anxiety I2=81.1%), indicating substantial variation between study results.
• Adults who were clinically depressed showed larger effects for depressive symptoms (5 RCTs; SMD −1.863; 95% CI −2.764 to −0.962) than adults who were not depressed (39 RCTs; SMD −0.442; 95% CI −0.604 to −0.280); the difference between these
• When walking was compared with active controls (for example, other forms of activity), there was no significant difference in reducing depressive symptoms (17 RCTs; SMD −0.126; 95% CI −0.343 to 0.092; P=.26) or anxiety symptoms (14 RCTs; SM
• Most subgroup analyses (different frequency, duration, indoor vs outdoor, group vs individual) showed significant reductions in depressive or anxiety symptoms (all reported P values <.05).
• The authors reported that participants could not be blinded to walking vs control and that more research is needed specifically on low-intensity walking.

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Anxiety CINAHL Confidence interval Depression (economics) Economics Internal medicine Law Macroeconomics Medicine MEDLINE Meta-analysis Physical therapy Political science Psychiatry Psychological intervention PsycINFO Randomized controlled trial Relative risk Strictly standardized mean difference Systematic review

Conditions & symptoms

Anxiety Depression Anxiety or worry Lack of energy or motivation Sadness or low mood