perinatal depression is a major public health problem , affecting up to a quarter of all pregnant women in rural countries .
it is associated with profound physical and emotional changes and associated risks for the onset or exacerbation of several mental disorders such as depression .
in addition to its effects on the mother 's well - being , perinatal depression is associated with adverse outcomes of pregnancy .
relevant effective interventions are being developed , but their effectiveness in low- and middle - income countries may be limited by various factors .
exercise can provide a viable treatment options for depressed patients , whether as an alternative treatment strategy to conventional treatments or as a supplemental strategy , either in the short - term or long - term .
research to date by low numbers to support the use of exercise in some form as a positive treatment option for individuals suffering from depression .
all married women aged 1740 years with low socioeconomic status in their second trimester of pregnancy , who had depression , were considered .
women with a diagnosed medical condition , pregnancy - related illness , significant physical or intellectual disability , post par tumor other form of psychosis , and severe depressions were excluded . during the pre - intervention assessment ,
both groups were asked to attend post - intervention assessment 4 and 8 weeks following the start of the program to complete the questionnaire .
subjects in this group had 4 weeks exercise program , cycle 4 sessions a week for 4060 min / session .
the exercise in each session were including : 10 min heating with walking , stretching and flexibility , and three sets of moderate intensity cycling in 6 min with 6065% of maximum heart rate .
subjects in the control group were given a patient handout which is in gujarati explaining about the procedures to do as home based program .
the hand out consist of five criteria such as stay active , do something that you think is fun each day , spend time with people who help or support you , relaxing and set simple goals .
inter group analysis was done using wilcoxon - mann  whitney test and intra group analysis was done using one - way anova .
during the pre - intervention assessment , subjects have undergone kuppuswamy 's socioeconomic status scale and the physical health questionnaire-9 .
both groups were asked to attend post - intervention assessment 4 and 8 weeks following the start of the program to complete the questionnaire .
subjects in this group had 4 weeks exercise program , cycle 4 sessions a week for 4060 min / session .
the exercise in each session were including : 10 min heating with walking , stretching and flexibility , and three sets of moderate intensity cycling in 6 min with 6065% of maximum heart rate .
subjects in the control group were given a patient handout which is in gujarati explaining about the procedures to do as home based program .
the hand out consist of five criteria such as stay active , do something that you think is fun each day , spend time with people who help or support you , relaxing and set simple goals .
inter group analysis was done using wilcoxon - mann  whitney test and intra group analysis was done using one - way anova .
of 146 subjects , 80 ( 55% ) met the inclusion criteria and 60 ( 41% ) agreed to enroll .
four subjects were excluded from the analysis in the exercise group ( group 1 ) and 2 subjects were excluded from analysis in the control group ( group 2 ) .
no significance differences between groups were found at baseline on outcome variable such as depression level .
analysis of depression level shows significant changes within and between exercise and control group . at baseline , the mean depression score was 15.96 ( 3.09 ) and 16.23 ( 3.38 ) for the exercise group and the control group , respectively . after the 4-weeks intervention ,
the mean score fell to 6.10 ( 2.44 ) for the exercise group ( 43.54% ) and to 10.60 ( 2.74 ) for the control group ( 21.25% ) .
at the 8 weeks follow - up , the mean score was 1.34 ( 1.09 ) for the exercise group ( 72.81% ) and 5.03 ( 1.50 ) for the control group ( 42.50% ) .
exercise has been shown in a number of studies to prove beneficial in the treatment of depressive symptoms especially in perinatal and post natal conditions .
bartholomew showed that a single incidence of exercise can have a positive effect on mood . maintaining the intensity and frequency of exercise recommended by most public health agencies were sufficient to provide a significant reduction in major depressive disorder ( mdd ) symptoms .
the additional benefits of exercise to individuals suffering from depression include stress reduction , better attitude , improved outlook , self - confidence , and mental well - being .
our intervention , the  physical exercises  was developed to provide a culturally appropriate , feasible , and evidence - based physical therapy intervention for women living in very poor communities in rural india .
these results suggest that supervised physical exercise provides better improvement in depression status in perinatal subjects .
 background : perinatal depression is a major public health problem , affecting up to a quarter of all pregnant women in rural asean countries and often leads to psychologic symptoms , lower quality of life , and higher health care costs . the purpose of this study was to assess the impact of supervised physical exercise on depression level of perinatal subjects.subjects/intervention:60 subjects who fulfill the selection criteria were randomly assigned to exercise ( group-1 , n=30 ) and control group ( group-2 , n=30 ) . 
 participants completed general screening form and physical health questionnaire-9 ( phq-9 ) before their intervention and again 4 weeks and 8 weeks later . 
 group-1 underwent aerobic training with 60 - 65% maximum heart rate and group-2 was prescribed with handouts for 4 weeks.statistics:repeated-measures analysis of variance ( anova ) was use to analyze group differences over time while controlling for baseline differences.results:demographic and the baseline values show homogenous population ( p>0.05 ) . 
 patients in both groups experienced significant reduction in depression level . 
 group a showed reduction of 91.70% ( p=0.00 ) as compared to group b 69.01% ( p=0.00).conclusion : these results suggest that supervised physical exercise provides better improvement in depression status in perinatal subjects than providing handouts alone . 