1. Patient Clinical Profile
Baseline Assessment
16 (Moderate-Severe)
85%
2. Exercise Dosing Parameters (FITT)
Active Tuning
4 sessions/wk
35 min
5 (Moderate)
Very Light (1-2)
Moderate (4-6)
Vigorous (7-8)
Max (9-10)
Weekly Dose
11.67
MET-hours / week
Effect Size
-0.62
Hedges' g (Moderate-Large)
PHQ-9 Reduction
5.4 pts
Est. Final PHQ-9: 10.6
Therapeutic Zone
Optimal Window
10–17.5 MET-hrs target
Meta-Analytic Dose-Response & Trajectory Curve
Non-linear therapeutic window mapping MET-hrs/wk against antidepressant efficacy
Current Rx
Target Window
Current Operating Dose: 11.67 MET-hrs/wk yields -0.62 Hedges' g (PHQ-9 trajectory: 16.0 → 10.6 points over 12 weeks).
Standardized FITT Exercise Prescription
Formal Psychiatric Clinical Note Fragment & Patient Care Plan
FITT Protocol Specification
Frequency: 4 days / week
Intensity: RPE 5 / 10 (Moderate Aerobic Target)
Time (Duration): 35 mins / session (140 mins/wk)
Type (Modality): Aerobic Brisk Walking / Cycling
Clinical Efficacy & Progression
Weekly Target Volume: 11.67 MET-hours / week
Anticipated Efficacy: Hedges' g = -0.62 (-5.40 PHQ-9 pts)
Micro-Dosing Progression: Week 1–2: Start 20 mins @ RPE 4. Build 5 mins/wk to reach target.
Safety Screening & Contraindications
Screen for acute suicidal ideation, unmanaged cardiovascular symptoms, or severe orthopedic pain. Adjust intensity if active fatigue spikes.
Primary Literature Citations
1. Noetel et al. (BMJ 2024): Effect of exercise for depression (g = -0.62 for walking/jogging).
2. Schuch et al. (AJP 2018): Exercise as treatment for depression: Meta-analysis of RCTs.