Exercise therapy improves mental and physical health in schizophrenia: a randomised controlled trial

Scheewe, Thomas W.; Backx, F. J. G.; Takken, Tim; Jörg, Frederike; Strater, A. C. P. van; Kroes, A. G.; Kahn, René S.; Cahn, Wiepke

doi:10.1111/acps.12029

Cited by 212 publications

(212 citation statements)

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“…The observation that antipsychotic medication use was not associated with a lower aerobic fitness is in accordance with previous research (Scheewe et al, 2013). The current data therefore indicates that the exposure to an unhealthy lifestyle rather than to antipsychotic medication use is associated with a worse performance on aerobic exercise tests.…”

Section: Factors Associated With the Astrand-rhyming Test Performancesupporting

confidence: 92%

“…Associations between negative symptoms and impaired aerobic fitness have been reported before in this population (Scheewe et al, 2013). However in contrast, Strassnig et al (2011) found that aerobic fitness was only associated with the severity of positive symptoms and not with negative symptoms.…”

Section: Factors Associated With the Astrand-rhyming Test Performancementioning

confidence: 47%

“…For this reason, an impaired aerobic fitness is an important indicator for physical activity interventions within the multidisciplinary treatment of patients with schizophrenia (Stubbs et al, 2014;Uwakwe et al, 2014;Vancampfort et al, 2009Vancampfort et al, , 2010. Given that physical activity might be beneficial in the prevention of cardiovascular diseases, support for aerobic exercise programmes in the multidisciplinary treatment of schizophrenia and schizoaffective disorder is growing (Scheewe et al, 2012(Scheewe et al, , 2013Strassnig et al, 2012;Vancampfort et al, 2012a, b).…”

Section: Introductionmentioning

confidence: 99%

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Reliability and clinical correlates of the Astrand–Rhyming sub-maximal exercise test in patients with schizophrenia or schizoaffective disorder

Vancampfort

Guelinckx

Hert

et al. 2014

Psychiatry Research

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Reliability and clinical correlates of the Astrand-Rhyming sub-maximal exercise test in patients with schizophrenia or schizoaffective disorder, Psychiatry Research, http://dx.doi.org/10.1016/j.psychres. 2014.08.049 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. AbstractCardiovascular fitness is reduced in people with schizophrenia and is related to an increased morbidity and mortality. There is mounting interest in the accurate measurement of cardiovascular fitness in schizophrenia, yet existing measures used in the general population have not been tested on validity and reliability in this high-risk group. Therefore, we examined the reproducibility and feasibility of the Astrand-Rhyming sub-maximal exercise test in patients with schizophrenia or schizoaffective disorder. Secondary aims were to assess minimal detectable changes, practice effects and the presence of clinical symptoms that are associated with cardio-respiratory fitness (expressed as estimated oxygen uptake). From 47 patients with schizophrenia or schizoaffective disorder two trials of the Astrand-Rhyming test, administered within three days, were analysed. The intraclass correlation coefficient for the estimated oxygen uptake between the two tests was 0.92 (95% confidence interval: 0.85 to 0.95). The minimal detectable change was 6.5mlO 2 /min/kg. No practice effect could be detected. A backward regression analysis demonstrated that illness duration, negative symptoms and level of physical activity explained 63.0% of the variance in estimated oxygen uptake. The current study demonstrates that the Astrand-Rhyming test can be recommended for evaluating the aerobic fitness in patients with schizophrenia or schizoaffective disorder.

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Section: Factors Associated With the Astrand-rhyming Test Performancesupporting

confidence: 92%

Section: Factors Associated With the Astrand-rhyming Test Performancementioning

confidence: 47%

Section: Introductionmentioning

confidence: 99%

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Reliability and clinical correlates of the Astrand–Rhyming sub-maximal exercise test in patients with schizophrenia or schizoaffective disorder

Vancampfort

Guelinckx

Hert

et al. 2014

Psychiatry Research

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“…2015;37 (4) sets of 10 to 15 maximum repetitions of resistance exercises for six different muscle groups per week. 35 These sessions lasted 1 hour and took place twice a week for 6 months. Their results showed a 20% decrease in PANSS total score and significant decreases in positive, negative, and other PANSS scores as compared with a control group undergoing occupational therapy.…”

Section: Discussionmentioning

confidence: 99%

A 20-week program of resistance or concurrent exercise improves symptoms of schizophrenia: results of a blind, randomized controlled trial

Silva

Cassilhas

Àttux

et al. 2015

Rev. Bras. Psiquiatr.

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Objective: To evaluate the effects of 20 weeks of resistance and concurrent training on psychotic and depressive symptoms, quality of life outcomes, and serum IGF-1, IGFBP-3, and brain-derived neurotrophic factor (BDNF) concentrations in patients with schizophrenia. Methods: In this blind, randomized controlled clinical trial, 34 patients with schizophrenia were assigned to one of three groups: control (CTRL, n=13), resistance exercise (RESEX, n=12), or concurrent exercise (CONCEX, n=9). Symptoms, quality of life, strength, and other variables were assessed. Results: A significant time-by-group interaction was found for the RESEX and CONCEX groups on the Positive and Negative Syndrome Scale (PANSS) total score for disease symptoms (p = 0.007), positive symptoms (p = 0.003), and on the arm extension one-repetition maximum (1RM) test (p = 0.016). In addition, significant improvements on negative symptoms (p = 0.027), on the role-physical domain of the Short Form-36 Health Survey (p = 0.019), and on the chest press 1RM test (p = 0.040) were observed in the RESEX group. No changes were observed for the other variables investigated. Conclusions: In this sample of patients with schizophrenia, 20 weeks of resistance or concurrent exercise program improved disease symptoms, strength, and quality of life. ClinicalTrials.gov: NCT01674543.

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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.…”

mentioning

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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Exercise therapy improves mental and physical health in schizophrenia: a randomised controlled trial

Abstract: Exercise therapy, when performed once to twice a week, improved mental health and cardiovascular fitness and reduced need of care in patients with schizophrenia.

Cited by 212 publications

References 51 publications

Reliability and clinical correlates of the Astrand–Rhyming sub-maximal exercise test in patients with schizophrenia or schizoaffective disorder

Reliability and clinical correlates of the Astrand–Rhyming sub-maximal exercise test in patients with schizophrenia or schizoaffective disorder

A 20-week program of resistance or concurrent exercise improves symptoms of schizophrenia: results of a blind, randomized controlled trial

Exercise and Antipsychotic Drugs

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