What are the top 10 physical activity research questions in schizophrenia?

Vancampfort, Davy; Rosenbaum, Simon; Probst, Michel; Connaughton, Joanne; Plessis, Christy du; Yamamoto, Takatsugu; Stubbs, Brendon

doi:10.3109/09638288.2015.1116622

Cited by 31 publications

(14 citation statements)

References 79 publications

(87 reference statements)

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“…Interventions delivered in inpatient settings may offer more social support and cohesion [60], and therefore increase attendance with physical activity interventions and may consequently result in better cardiorespiratory fitness outcomes. The current findings also echo recent calls [61][62][63] for more research and clinical attention towards effective physical activity interventions in outpatient and community settings.…”

Section: General Findingssupporting

confidence: 87%

Cardiorespiratory Fitness in Severe Mental Illness: A Systematic Review and Meta-analysis

et al. 2016

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Background Cardiorespiratory fitness (CRF) among people with severe mental illness (SMI) (i.e., schizophrenia, bipolar disorder, and major depressive disorder) is a critical clinical risk factor given its relationship to cardiovascular disease and premature mortality.Objectives This study aimed to: (1) investigate the mean CRF in people with SMI versus healthy controls; (2) explore moderators of CRF; and (3) investigate whether CRF improved with exercise interventions and establish if fitness improves more than body mass index following exercise interventions. Methods Major electronic databases were searched systematically. A meta-analysis calculating Hedges' g statistic was undertaken.Results Across 23 eligible studies, pooled mean CRF was 28.7 mL/kg/min [95 % confidence interval (CI) 27.3 to 30.0 mL/kg/min, p\0.001, n = 980]. People with SMI had significantly lower CRF compared with controls (n = 310) (Hedges' g = -1.01, 95 % CI -1.18 to -0.85, p \ 0.001). There were no differences between diagnostic subgroups. In a multivariate regression, first-episode (b = 6.6, 95 % CI 0.6-12.6) and inpatient (b = 5.3, 95 % CI 1.6-9.0) status were significant predictors of higher CRF. Exercise improved CRF (Hedges' g = 0.33, 95 % CI = 0.21-0.45, p = 0.001), but did not reduce body mass index. Higher CRF improvements were observed following interventions at high intensity, with higher frequency (at least three times per week) and supervised by qualified personnel (i.e., physiotherapists and exercise physiologists). Conclusion The multidisciplinary treatment of people with SMI should include a focus on improving fitness to reduce all-cause mortality. Qualified healthcare professionals supporting people with SMI in maintaining an active lifestyle should be included as part of multidisciplinary teams in mental health treatment.

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Section: General Findingssupporting

confidence: 87%

Cardiorespiratory Fitness in Severe Mental Illness: A Systematic Review and Meta-analysis

et al. 2016

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“…Moreover, each of these populations engage in remarkably high levels of sedentary behaviour [46 [48] and have low levels of cardiorespiratory fitness [51]. People with SMI experience, a number of barriers from engaging in physical activity exist, such as side effects of medications, complications from obesity/poor physical health [52,53], lack of resources/professional support [54], various motivational factors [55], which calls for targeted interventions in this highly sedentary population [56][57][58].…”

Section: Low Levels Of Physical Activity and Fitnessmentioning

confidence: 99%

EPA guidance on physical activity as a treatment for severe mental illness: a meta-review of the evidence and Position Statement from the European Psychiatric Association (EPA), supported by the International Organization of Physical Therapists in Mental Health (IOPTMH)

et al. 2018

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Physical activity (PA) may be therapeutic for people with severe mental illness (SMI) who generally have low PA and experience numerous life style-related medical complications. We conducted a meta-review of PA interventions and their impact on health outcomes for people with SMI, including schizophrenia-spectrum disorders, major depressive disorder (MDD) and bipolar disorder. We searched major electronic databases until January 2018 for systematic reviews with/without meta-analysis that investigated PA for any SMI. We rated the quality of studies with the AMSTAR tool, grading the quality of evidence, and identifying gaps, future research needs and clinical practice recommendations. For MDD, consistent evidence indicated that PA can improve depressive symptoms versus control conditions, with effects comparable to those of antidepressants and psychotherapy. PA can also improve cardiorespiratory fitness and quality of life in people with MDD, although the impact on physical health outcomes was limited. There were no differences in adverse events versus control conditions. For MDD, larger effect sizes were seen when PA was delivered at moderate-vigorous intensity and supervised by an exercise specialist. For schizophrenia-spectrum disorders, evidence indicates that aerobic PA can reduce psychiatric symptoms, improves cognition and various subdomains, cardiorespiratory fitness, whilst evidence for the impact on anthropometric measures was inconsistent. There was a paucity of studies investigating PA in bipolar disorder, precluding any definitive recommendations. No cost effectiveness analyses in any SMI condition were identified. We make multiple recommendations to fill existing research gaps and increase the use of PA in routine clinical care aimed at improving psychiatric and medical outcomes.

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“…Despite the many potential physical, psychosocial, and cognitive benefits of physical activity for individuals with schizophrenia ( 5 ), individuals with schizophrenia engage in significantly less moderate and vigorous physical activity compared to controls ( 6 ). Research is now required to inform the development of evidence-based behavioral interventions for increasing physical activity that are tailored to this population ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

The Utility of the Health Action Process Approach Model for Predicting Physical Activity Intentions and Behavior in Schizophrenia

et al. 2017

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Research is needed to develop evidence-based behavioral interventions for preventing and treating obesity that are specific to the schizophrenia population. This study is the precursor to such intervention research where we examined the utility of the social cognitions outlined within the Health Action Process Approach (HAPA) model for predicting moderate to vigorous physical activity (MVPA) intentions and behavior among individuals with schizophrenia or schizoaffective disorder. A prospective cohort design [baseline (T1), week 2 (T2), and week 4 (T3)] was used to examine the HAPA constructs and MVPA across a sample of 101 adults (Mage = 41.5 ± 11.7 years; MBMI = 31.2 ± 7.8 kg/m 2 ; 59% male). Two hierarchical regression analyses were conducted controlling for age, gender, BMI, and previous self-reported MVPA. In the first regression, intentions at T1 were regressed onto the T1 motivational HAPA constructs (risk perception, affective attitudes, task self-efficacy) and social support; MVPA status (meeting vs. not meeting the MVPA guidelines) assessed via accelerometry at T3 was regressed onto T1 social support and intentions followed by T2 action and coping planning, and maintenance self-efficacy in the second analysis. Overall, the motivational and social support variables accounted for 28% of the variance in intentions, with affective attitudes (β = 0.33, p < 0.01) and task self-efficacy (β = 0.25, p < 0.05) exhibiting significant, positive relationships. For MVPA status, the model as a whole explained 39% of the variance, with the volitional HAPA constructs explaining a non-significant 3% of this total variance. These findings suggest a need for interventions targeting self-efficacy and affective attitudes within this clinical population.Keywords: schizophrenia, physical activity, determinants, theory based, accelerometry inTrODUcTiOn Recent data indicate 13-15 years of life lost to schizophrenia compared to the general population (1). Cardiovascular death is a major contributor to this increased mortality (2). Potential causes of this excess mortality are varied, although they can be broadly categorized in terms of the iatrogenic effects of treatment (e.g., metabolic side effects of medication), greater prevalence of engagement in unhealthy behaviors (e.g., smoking, physical inactivity), and limited access to health care (3). Given the compelling evidence that physical activity prevents premature mortality, cardiovascular disease, and type 2 diabetes in the general population (4), one increasing focus of attention has been attempts to reduce physical inactivity in this population. Despite the many potential physical, psychosocial, and cognitive benefits of physical activity for individuals with schizophrenia (5), individuals with schizophrenia engage in significantly less moderate and vigorous physical activity compared to controls (6). Research is now required to inform the development of evidence-based behavioral interventions for increasing physical activity that are tailored to this population (7). Theory...

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What are the top 10 physical activity research questions in schizophrenia?

Cited by 31 publications

References 79 publications

Cardiorespiratory Fitness in Severe Mental Illness: A Systematic Review and Meta-analysis

Cardiorespiratory Fitness in Severe Mental Illness: A Systematic Review and Meta-analysis

EPA guidance on physical activity as a treatment for severe mental illness: a meta-review of the evidence and Position Statement from the European Psychiatric Association (EPA), supported by the International Organization of Physical Therapists in Mental Health (IOPTMH)

The Utility of the Health Action Process Approach Model for Predicting Physical Activity Intentions and Behavior in Schizophrenia

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