Aerobic Interval Training Integrated In Collaborative Care Of Outpatients With Schizophrenia: One-year Outcomes

Abstract

Although aerobic interval training (AIT) is recognised to attenuate the risk of cardiovascular disease (CVD) and premature mortality, it appears that it rarely arrives at patients’ doorsteps. PURPOSE: This study investigated 1-year outcomes when AIT was integrated with municipal and specialised health service in collaborative care of outpatients with schizophrenia. METHODS: Forty-eight outpatients (28 men, 35±10 (SD) years; 20 women, 35±12 years) with schizophrenia spectrum disorders (ICD-10) were randomised to either a collaborative care group provided transportation and training supervision and walking/running 4x4-minutes at ~90% of peak heart rate (HRpeak) 2 d·wk-1 (TG), or a control group (CG) given 2 introductory AIT sessions and advised to continue training. RESULTS: Directly assessed peak oxygen uptake (V̇O2peak) increased in the TG (3-months: 2.7±3.1 mL·kg-1·min-1; 6-months: 3.2±3.0 mL·kg-1·min-1; 1-year: 3.3±3.1 mL·kg-1·min-1; all p<0.001; different from CG: p<0.05-0.001). In contrast, V̇O2peak remained unchanged (3/6-months) and decreased (1-year: -1.8±3.8 mL·kg-1·min-1, p<0.05) in the CG. One-year cardiac effects revealed increased HRpeak (3±7 b·min-1, p<0.05; different from CG: p<0.01) in the TG and decreased HRpeak (-3±7 b·min-1, p<0.05) in the CG, while peak stroke volume tended to be higher (0.87±2.15 mL·b-1, p=0.12) in the TG compared to the CG. Conventional risk factors (body weight, waist circumference, blood pressure and lipids/glucose) were unaltered. One-year regular AIT rates were 15/25 (TG; different from CG: p<0.0001) and 0/23 (CG), respectively. CONCLUSIONS: AIT was successfully integrated in long-term collaborative care of outpatients with schizophrenia, advocating this model for aerobic capacity improvement and CVD risk reduction in future treatment.