Effect of Adapted Physical Activity on Emotion Regulation in People With Depressive Disorders (REAPAD)

Comparador Ativo: Classical Adapted Physical Activity

Comportamental: Classical Adapted Physical Activity Program

Participants received an individualized, moderate-intensity adapted physical activity program consisting of 8 sessions over 6 weeks, with at least one session per week. The program included aerobic training (step-based exercises, lateral stepping and locomotor circuit tasks), lower-limb resistance training (chair stands, step-ups, lateral stepping and lunges), and agility and coordination exercises (agility ladder drills and motor circuit tasks). Session duration progressively increased from 25 minutes for sessions 1 and 8 to 30, 35 and 40 minutes for the intermediate sessions. Each session included a 5-minute warm-up and muscular flexibility period and a 10-minute cool-down period.

Experimental: Combined Adapted Physical Activity Program

Comportamental: Adapted Physical Activity Program

Participants received an individualized, moderate-intensity adapted physical activity program consisting of 8 sessions over 6 weeks, with at least one session per week. The program included aerobic training, lower-limb resistance training, and agility and coordination exercises. In addition, cognitive and emotional training tasks were integrated into the physical activity sessions. Cognitive tasks included short-term memory activities, verbal fluency dual tasks and cognitive flexibility exercises. Emotional tasks included identifying, recognizing and expressing emotions using images and photographs of facial expressions. These cognitive and emotional tasks were incorporated during exercises and rest periods throughout the program.

Change in emotion regulation strategies assessed by the Cognitive Emotion Regulation Questionnaire (CERQ

Emotion regulation strategies are assessed using the Cognitive Emotion Regulation Questionnaire (CERQ), a 36-item self-administered questionnaire comprising nine subscales. Items are rated from 1 (almost never) to 5 (almost always), providing scores for adaptive and maladaptive cognitive emotion regulation strategies

Change in Depressive Symptom Severity Assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS

Depressive symptom severity is assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS). The scale consists of 10 items assessing depressive symptoms, each rated from 0 to 6. The total score ranges from 0 to 60, with higher scores indicating greater severity of depressive symptoms.

Change in Cognitive Flexibility Assessed by the Trail Making Test (TMT)

Cognitive functioning is assessed using the Trail Making Test (TMT). The test includes Part A and Part B. Performance is assessed using the time required to complete each part, with longer completion times indicating poorer performance.

Change in Subjective Vitality Assessed by the Subjective Vitality Scale

Subjective vitality is assessed using the Subjective Vitality Scale. The scale consists of 5 items rated from 1 to 7 and assesses the participant's subjective experience of physical and psychological energy and vitality. Higher scores indicate greater subjective vitality

Change in Mood States Assessed by the Profile of Mood States (POMS-F)

Mood states are assessed using the French version of the Profile of Mood States (POMS-F), a 65-item self-administered questionnaire. The questionnaire assesses seven transient and fluctuating mood dimensions: tension-anxiety, anger-hostility, confusion-bewilderment, depression-dejection, fatigue-inertia, vigor-activity, and interpersonal relations. Items are rated on a 5-point Likert scale. An overall psychological distress score is calculated by summing the tension-anxiety, anger-hostility, confusion-bewilderment, depression-dejection, and fatigue-inertia scores and subtracting the vigor-activity score. Higher psychological distress scores indicate greater mood disturbance. Mood state is assessed using the French version of the Profile of Mood States (POMS-F). The POMS-F consists of 65 items rated from 0 (not at all) to 4 (extremely). The Global Score is calculated as the sum of Anxiety-Tension, Anger-Hostility, Confusion-Bewilderment, Depression-Dejection, and Fatigue-Inertia scores