Background: Patients with schizophrenia have a high risk of cardiovascular disease (CVD). High aerobic intensity training (HIT) improve peak oxygen uptake (VO2peak), net mechanical efficiency of walking and risk factors for CVD but has not been investigated in patients with schizophrenia. Aims: To investigate effects from HIT on VO2peak, net mechanical efficiency of walking and risk factors for CVD in patients with schizophrenia. Methods: 25 inpatients (F20-29, ICD-10) were allocated to either HIT or playing computer games (CG), 3 days per week for 8 weeks. HIT consisted of 4 × 4-min intervals with 3-min break periods, at 85-95% and 70% of peak heart rate, respectively. Results: 12 and seven patients completed HIT and CG, respectively. The baseline VO2peak in both groups combined (n = 19) was 36.8 ± 8.2 ml/kg/min and 3.12 ± 0.55 1/min. The HIT group improved VO2peak by 12% from 3.17 ± 0.59 to 3.56 ± 0.68 1/min (P < 0.001), more than the CG group (P = 0.014). Net mechanical efficiency of walking improved by 12% in the HIT group from 19.8 ± 3.0% to 22.2 ± 4.5% (P = 0.005), more than the CG group (P = 0.031). The psychiatric symptoms, expressed as the Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS), did not improve in either group. Conclusions: VO2peak and net mechanical efficiency of walking improved significantly by 8 weeks of HIT. HIT should be included in rehabilitation in order to improve physical capacity and contribute risk reduction of CVD.

BackgroundPatients with schizophrenia frequently have disabling gait deficits. The net mechanical efficiency of walking (ϵnet) is an accurate measure often used to evaluate walking performance. Patients with gait deficits have a reduced ϵnet with excessive energy expenditure during sub-maximal walking. Maximal strength training (MST) improves ϵnet in healthy individuals and is associated with reduced risk of mortality. The aim of this study was to investigate whether MST improves ϵnet in patients with schizophrenia.MethodsPatients (ICD-10 schizophrenia, schizotypal or delusional disorders (F20-F29)) were included in a non-randomized trial. Patients were assigned to one of two groups: 1) MST consisting of 4x4 repetitions at 85-90% one repetition maximum (1RM) performed in a leg press apparatus or 2) playing computer games (CG). Both groups carried out their activity three days per week for eight weeks. 1RM, ϵnet at 60 watt walking, peak oxygen uptake (VO2peak), the Positive and Negative Syndrome Scale (PANSS) and the 36-items short form (SF-36) were measured pre and post intervention.ResultsThe baseline ϵnet was 17.3 ± 1.2% and 19.4 ± 3.0% in the MST (n = 6) and CG groups (n = 7), respectively, which is categorized as mechanical inefficiency. The MST group improved 1RM by 79 kg (p = 0.006) and ϵnet by 3.4% (p = 0.046) more than the CG group. The MST group improved 1RM and ϵnet, by a mean of 83 kg (p = 0.028) and 3.4% (p = 0.028), respectively. VO2peak at baseline was 34.2 ± 10.2 and 38.3 ± 9.8 ml·kg-1·min-1 in the MST and CG groups, respectively, and did not change (p > 0.05). No change was observed in PANSS or SF-36 (p > 0.05).ConclusionsMST improves 1RM and ϵnet in patients with schizophrenia. MST could be used as a therapeutic intervention for patients with schizophrenia to normalize their reduced ϵnet.

BackgroundPeak oxygen uptake (VO2peak) is a strong predictor of cardiovascular disease (CVD) and all-cause mortality, but is inadequately described in patients with schizophrenia. The aim of this study was to evaluate treadmill VO2peak, CVD risk factors and quality of life (QOL) in patients with schizophrenia (ICD-10, F20-29).Methods33 patients, 22 men (33.7 ± 10.4 years) and 11 women (35.9 ± 11.5 years), were included. Patients VO2peak were compared with normative VO2peak in healthy individuals from the Nord-Trøndelag Health Study (HUNT). Risk factors were compared above and below the VO2peak thresholds; 44.2 and 35.1 ml·kg-1·min-1 in men and women, respectively.ResultsVO2peak was 37.1 ± 9.2 ml·kg-1·min-1 in men with schizophrenia; 74 ± 19% of normative healthy men (p < 0.001). VO2peak was 35.6 ± 10.7 ml·kg-1·min-1 in women with schizophrenia; 89 ± 25% of normative healthy women (n.s.). Based on odds ratio patients were 28.3 (95% CI = 1.6-505.6) times more likely to have one or more CVD risk factors if they were below the VO2peak thresholds. VO2peak correlated with the SF-36 physical functioning (r = 0.58), general health (r = 0.53), vitality (r = 0.47), social function (r = 0.41) and physical component score (r = 0.51).ConclusionMen with schizophrenia have lower VO2peak than the general population. Patients with the lowest VO2peak have higher odds of having one or more risk factors for cardiovascular disease. VO2peak should be regarded as least as important as the conventional risk factors for CVD and evaluation of VO2peak should be incorporated in clinical practice.