A systematic review of the benefits of physical therapy within a multidisciplinary care approach for people with schizophrenia: An update

Vera-Garcia, Elisa; Mayoral-Cleries, Fermín; Vancampfort, Davy; Stubbs, Brendon; Cuesta‐Vargas, Antonio

doi:10.1016/j.psychres.2015.07.083

Cited by 51 publications

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“…One of the Chinese studies also reported that there was a positive association between Tai-chi and quality of life in cancer patients in China [29]. A previous study showed that Tai-chi can help patients to improve their cognition through lessons by improving their attention and memory [30], but no study investigated the effectiveness of social skills training plus Tai-chi in outpatients with schizophrenia [31]. …”

Section: Introductionmentioning

confidence: 99%

Effect of Community-Based Social Skills Training and Tai-Chi Exercise on Outcomes in Patients with Chronic Schizophrenia: A Randomized, One-Year Study

Kang

Wu²,

Li³

et al. 2016

Psychopathology

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Background: Antipsychotic drugs are limited in their ability to improve negative symptoms, quality of life, and medication adherence in patients with schizophrenia. The addition of nonpharmacological interventions like social skills training has a positive effect on medication adherence and decreases rehospitalization rates but is limited in improving patients' symptoms, aggressive behaviors, and quality of life. Aerobic exercise, especially Tai-chi, can potentially reduce psychopathological and negative symptoms, decrease aggressive behaviors, and improve quality of life. It is an ideal rehabilitation intervention for patients with schizophrenia. However, no study has investigated the effects of social skills training plus Tai-chi on outcomes among outpatients with schizophrenia. This study analyzes the effect of antipsychotics combined with community-based integrated interventions on outcomes of schizophrenia. Methods: In this study, a 24-session social skills training plus Tai-chi was used in community settings among patients with schizophrenia. A total of 244 patients were randomly assigned to medication treatment alone (MTA group) or community-based integrated intervention (CBII group), which accepted social skills training plus Tai-chi in addition to medication treatment. Generalized linear mixed models were used to evaluate the intervention effect (group effect), intervention effect over time (time effect), and interaction effect (group × time effect). t tests were used to evaluate between-group differences on clinical variables. Multiple linear regression analysis was used to analyze the differences between the intervention at 12 months and baseline for the Positive and Negative Syndrome Scale (PANSS) negative symptoms and quality of life-social domain. Results: Compared with the MTA group, the CBII group had lower scores on PANSS (F = 17.312, p < 0.001) and negative symptoms (F = 44.909, p < 0.001), a lower risk for aggressive behavior (F = 12.382, p < 0.001), and a greater improvement in adherence to medication (F = 12.391, p < 0.001) after 1 year of intervention. The changes in PANSS total scores, negative scores, and social domain of the World Health Organization Quality of Life Scale-Brief version (WHOQOL-BREF) from baseline to 12 months were significant between the two groups (PANSS total score: t = 4.839, p < 0.001; negative symptoms: t = 8.250, p < 0.001, and quality of life-social domain: t = -2.171, p = 0.031). Multiple linear regression analysis also showed that the intervention was significantly effective for changes from baseline to 12 months on PANSS total score (B = 0.804, p < 0.001), negative score (B = 0.709, p < 0.001), and social domain of quality of life (B = -0.673, p = 0.044). Conclusions: This study suggested that the community-based integrated intervention such as social skills training plus Tai-chi should be part of a rehabilitation effort for patients with schizophrenia in order to improve clinical symptoms, quality of life, and medication adherence.

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Section: Introductionmentioning

confidence: 99%

Effect of Community-Based Social Skills Training and Tai-Chi Exercise on Outcomes in Patients with Chronic Schizophrenia: A Randomized, One-Year Study

Kang

Wu²,

Li³

et al. 2016

Psychopathology

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“…It has been previously reported that interventions that include physical activity or education regarding healthy lifestyle are a cost‐efficient way to improve health among persons with SMI . However, many persons with SMI are affected by cognitive impairments, making it particularly difficult to be motivated for the implementation of healthy lifestyle habits .…”

Section: Discussionmentioning

confidence: 99%

“…Clearly, just 30 min of daily moderate to intensive physical activity provide substantial health benefits . Increased physical activity has also been found to reduce the incidence of mental illness, its severity of symptoms, and risk of medical comorbidities, as well as to improve quality of life and cognitive performance . In the light of the fact that the psychiatric professionals have an already established interpersonal relationship with the person with SMI, they are in a key position to motivate, support, and organize lifestyle habits .…”

Section: Introductionmentioning

confidence: 99%

“…20 Increased physical activity has also been found to reduce the incidence of mental illness, its severity of symptoms, and risk of medical comorbidities, as well as to improve quality of life and cognitive performance. [21][22][23] In the light of the fact that the psychiatric professionals have an already established interpersonal relationship with the person with SMI, they are in a key position to motivate, support, and organize lifestyle habits. 5,24,25 Although lifestyle interventions have shown to positively impact lifestyle habits among persons with SMI, [26][27][28][29] there is a need for more information about programs that are integrated in daily nursing care.…”

Section: Introductionmentioning

confidence: 99%

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Perspectives of a tailored lifestyle program for people with severe mental illness receiving housing support

Rönngren

Björk

Haage

et al. 2017

Perspect Psychiatr Care

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“…diet, interpersonal encounter, environmental change) factors, which may, when taken together, help to explain the significant placebo rate in antipsychotic drug trials [1]. Exercise is one factor that has been shown to temporarily enhance treatment effects in schizophrenia [2][3][4][5][6][7][8]. Whether side effects are enhanced or dampened after exercise, however, has not been addressed in these studies.…”

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confidence: 99%

Exercise and Antipsychotic Drugs

Vs¹

2017

J Pat Care

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Both the beneficial and adverse effects of antipsychotic drugs are known to fluctuate over time even after steady state blood levels of the drug are achieved. This suggests that such effects are influenced, at least temporarily, by a number of endogenous (e.g. mood, stress level, circadian cycle) and exogenous (e.g. diet, interpersonal encounter, environmental change) factors, which may, when taken together, help to explain the significant placebo rate in antipsychotic drug trials [1]. Exercise is one factor that has been shown to temporarily enhance treatment effects in schizophrenia [2][3][4][5][6][7][8]. Whether side effects are enhanced or dampened after exercise, however, has not been addressed in these studies. The following case example suggests that physical activity can sometimes increase the side effects of drugs. Case ExampleTed was a young patient diagnosed with schizophrenia and treated for many years with antipsychotic fluphenazine enanthate depot injections administered every three weeks. Periodically and always unexpectedly, he would knock loudly on my office door, demanding to be seen at once. The complaint was always the same -that his muscles were stiff, a parkinsonian side effect of fluphenazine. The timing of these knocks was mysterious. They did not correspond to the time since last injection. They did not appear to correspond to any particular life event or emotional upset. Months would pass without any knocks and then there could be three in the same week.Ted was the one who finally figured it out. The knocks occurred during the months that he played soccer. His injection was in the upper outer quadrant of the buttock, the dorsogluteal muscle, and whenever those muscles were strongly activated as in soccer, blood flow to and from the depot site increased so much that his blood stream was inundated, his brain received more drug, more dopamine receptors were blocked [the mechanism of action of antipsychotic drugs, and, subsequently, his muscles became stiff, an effect of dopamine blockade [9,10]. Clinical experience reinforces the observation that side effects to depot intramuscular antipsychotic injection increase after exercise. This motivated a literature review of exercise effects on side effects of antipsychotic drugs, however administered. Exercise and Antipsychotic DrugsMary V. Seeman* Department of Psychiatry, University of Toronto, Canada Abstract Background: Exercise has been shown to reduce symptoms in patients with schizophrenia.

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A systematic review of the benefits of physical therapy within a multidisciplinary care approach for people with schizophrenia: An update

Cited by 51 publications

References 44 publications

Effect of Community-Based Social Skills Training and Tai-Chi Exercise on Outcomes in Patients with Chronic Schizophrenia: A Randomized, One-Year Study

Effect of Community-Based Social Skills Training and Tai-Chi Exercise on Outcomes in Patients with Chronic Schizophrenia: A Randomized, One-Year Study

Perspectives of a tailored lifestyle program for people with severe mental illness receiving housing support

Exercise and Antipsychotic Drugs

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