Abstract
Individuals with schizophrenia have reduced rates of physical activity, yet substantial proportions do engage in independent and regular exercise. Previous studies have shown improvement in symptoms and cognitive function in response to supervised exercise programs in people with schizophrenia. There is little data on motivations of individuals who exercise independently, or their chosen type, duration, or setting of exercise. This study explores motivational parameters and subjective experiences associated with sustained, independent exercise in outpatients with a diagnosis of schizophrenia or schizoaffective disorder. Participants completed a semi-structured interview and then were given a prospective survey containing visual analog scales of symptom severity and the Subjective Exercise Experiences Scales to complete immediately before and after three sessions of exercise. Results from the semi-structured interview were analyzed by modified content analysis. The most important reason for exercise was self-image, followed closely by psychological and physical health. Among psychological effects, participants reported exercise was most helpful for mood and cognitive symptoms. The prospective ratings demonstrated 10–15% average improvements in global well-being, energy, and negative, cognitive and mood symptoms, with almost no change in psychosis, after individual exercise sessions. This suggests that non-psychotic parameters are more susceptible to inter-session decay of exercise effects, which may reinforce continued exercise participation.
Highlights
The benefits of exercise are well-established and include weight loss and improved cardiovascular fitness, and a reduction in risk of early mortality and cognitive decline [1, 2]
Twenty-three participants were enrolled in the study and completed the semi-structured interview
Our selected sample engaged in at least 90 min of exercise per week and reported an average of 4.2 sessions of running, weight lifting, cycling, swimming and other forms of exercise per week, with a majority reporting more than 45 min and nearly half reporting more than 60 min of exercise per session. These findings indicate that while people with schizophrenia can stereotypically be considered inactive, some individuals engage in types and durations of exercise that would be considered exceptional in the general population
Summary
The benefits of exercise are well-established and include weight loss and improved cardiovascular fitness, and a reduction in risk of early mortality and cognitive decline [1, 2]. More recent studies have shown that exercise can have therapeutic effects for patients with psychiatric disorders and can help to control and reduce the symptoms of schizophrenia [4, 5]. Randomized controlled trials (RCTs) have identified that exercise significantly improves negative symptoms (such as social withdrawal, anergia, or apathy) but few studies have shown an. A recent review of 10 RCTs found significant improvement in global cognition among those receiving an exercise intervention, with medium to large effect sizes for improvements in working memory, social cognition and attention [9]. Some studies have identified release of neurotrophic factors, changes in regional or global brain volume and even preservation of telomere length and integrity as possible biological underpinnings of these benefits [11]
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