Acceptability of exercise as an adjunct to repetitive transcranial magnetic stimulation for treatment-resistant depression: A patient-oriented collaboration study

Abstract

Background: Repetitive transcranial magnetic stimulation (rTMS) and physical exercise may have synergistic benefits for the treatment of depression. As a prelude to a clinical trial, we conducted a study in collaboration with patient partners to assess the acceptability and preferences of a combined exercise and rTMS intervention for patients with depression. Methods: This study employed a cross-sectional design. Patients receiving rTMS treatment completed a web-based survey. Acceptability and preferences for exercise were assessed, along with their perceptions of a hypothetical exercise intervention consisting of 30 -min of moderate-intensity treadmill exercise, 3 times per week, for the duration of an index course of rTMS (6 weeks). Results: 44 patients (70% female, age = 47±14.7) with major depressive disorder completed the web-based survey. The majority of patients reported they would be interested in an exercise program while receiving rTMS (75%), with preferences for exercising for at least 3 days per week (80%), over the entire course of treatment (72%). Participants perceived the hypothetical exercise intervention to be acceptable (84%) and were clear how it would help manage their depression (80%). Conclusion: Patients perceived exercise to be an acceptable adjunct to rTMS treatment. The interpretation of these results, in collaboration with patient partners, have provided valuable information to design a sequential study examining the efficacy of a combined exercise and rTMS intervention for depression. Limitations: Data was self-reported and there was the potential for recall and social desirability biases.

Keywords

• Repetitive transcranial magnetic stimulation
• Exercise
• Depression
• Mental health
• Patient engagement
• Patient-oriented research