Fifty-four studies (6,253 participants) were included in the review. Quality assessment scores ranged from 4 to 8 points.
Exercise programmes (10 RCTs): Exercise interventions significantly reduced depression immediately after the intervention compared with usual care (SMD -2.03, 95% CI -3.22 to -0.85, Ι²=21%; two RCTs, 137 participants). There was insufficient evidence to support exercise interventions for increasing participation, HRQoL or for longer term outcomes in depression.
Community interventions to enhance leisure pursuits (five RCTs): There was moderate evidence of effect for improving participation and HRQoL and insufficient evidence for depressive symptoms.
Single discipline community-based rehabilitation (10 RCTs): Studies reported limited evidence of effect for increasing participation at the end of the intervention and insufficient evidence at follow-up assessments. Insufficient evidence of effect was found for reduction in depressive symptoms and HRQoL.
Comprehensive rehabilitation (nine RCTs): Studies reported strong evidence for improving HRQoL but only limited evidence of effect for a reduction in depressive symptoms and improvement in participation.
There was insufficient evidence to support the use of care-co-ordination, psychosocial and inter-disciplinary management (nine RCTs), gait and balance programmes (five RCTs), self-management programmes (three RCTs), information provision (two RCTs) and continence programme (one RCT).