Exercise And Physical Activity Promotion Improves Cardiorespiratory Fitness, Symptoms Of Disease And Well-being In Patiens With Schizophrenia

Abstract

Patients suffering from Schizophrenia (SZ) show low fitness, a sedentary lifestyle and comorbidities like diabetes and cardiovascular diseases, resulting in 20 years less of life expectancy. PURPOSE: To evaluate the impact of an intervention combining exercise and physical activity promotion (PAP) on cardiorespiratory fitness (CRF), severity of SZ, symptoms of disease and well-being. METHODS: 35 patients were randomized into an intervention (n=19, aged 39.0 ± 13.6 years, BMI 28.3 ± 7.3) or control group (n=16, aged 36.0 ± 9.3 years, BMI 25.7 ± 5.2), directly after inpatient treatment for SZ. Intervention included two sessions of high intensity indoor cycling (IC; each 45min), and one session of PAP (60min) per week for three months. In months 4-6, the intervention was reduced to one session IC and one session PAP per week. The control group received a physiologically ineffective control intervention. Measurements were conducted at baseline (t0), after three (t1) and 6 months (t2) of intervention, and after 12 months (six-month follow up, t3). Measurements included CRF (bicycle ergometry), severity of SZ (PANSS-Score), well-being (SF-36), and psychological distress (SCL-90). RESULTS: The intervention improved significantly severity of SZ (t0: 55.4 ± 16.3, t2: 34.8 ± 3.3, p<.05), well-being (t0: 50.4 ± 10.1, t2: 60.5 ± 7.1, p<.05) and psychological distress (t0: 159 ± 47.4, t2: 119.8 ± 34.3, p<.05). For CRF, patients were able to improve their physical capacity, expressed as W/kg (t0: 1.85 ± 0.6, t2: 2.13 ± 0.6, p<.05), but did not significantly improve their peak oxygen uptake, expressed as ml/min/kg (29.0 ± 7.0, t2: 30.5 ± 8.7, n.s.). Six month after the intervention, only improvements in severity of SZ, well-being and psychological distress remained statistically significant (PANSS: 38.0 ± 9.0, SF-36: 59.2 ± 8.0, SCL-90: 119.2 ± 36.6, all p<.05). CONCLUSION: Exercise and PAP significantly improves CRF, severity of SZ, well-being and psychological distress in SZ patients. Effects on CRF are declining shortly after the end of the intervention. We recommend the implementation of exercise and PAP into the post-acute care of SZ patients. Moreover, it is necessary to further strengthen the sustainability of effects with respect to CRF, in order to prevent fall-backs and health detriments caused by low physical fitness.