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Pérez-Romero N, Campos-Jara C, Pesce C, Araya Sierralta S, Cerda-Vega E, Ramirez-Campillo R, Campos-Jara R, Martínez-Salazar C, Arellano-Roco C, Hernández-Cifuentes V, Contreras-Osorio F. Effects of Physical Exercise on Executive Function in Schizophrenia: Systematic Review and Meta-Analysis. Sports (Basel) 2025; 13:123. [PMID: 40278749 PMCID: PMC12030906 DOI: 10.3390/sports13040123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2025] [Revised: 03/28/2025] [Accepted: 04/09/2025] [Indexed: 04/26/2025] Open
Abstract
Executive functions are often impaired in individuals with schizophrenia spectrum disorders. Understanding the impact of physical exercise on these cognitive domains is essential for developing effective interventions. The aim of this review is to assess the effect of physical exercise on executive functions in adults diagnosed with schizophrenia spectrum disorders. A systematic search was conducted in Web of Science, PubMed, Scopus, and EBSCO, initially from inception through January 2024, followed by an update through January 2025. Studies involved adults diagnosed with schizophrenia spectrum disorders, employed physical exercise as an intervention, and measured executive functions as outcomes. The selection followed PRISMA guidelines, with inclusion determined by consensus among multiple reviewers. Data extraction and risk of bias assessment were conducted independently by two reviewers using the Cochrane RoB 2 tool and GRADE approach for certainty of evidence. Meta-analyses were performed using random-effects models, with effect sizes (ES) and 95% confidence intervals (CI) calculated for each outcome. From 1517 records, 9 studies were included in the meta-analysis. The analysis revealed a small but significant effect of physical exercise on working memory (ES = 0.300, 95% CI = 0.060-0.539, p = 0.014; I2 = 0.0%, Q = 2.2, p = 0.951) and a non-significant effect on emotion recognition (ES = 0.51, 95% CI = -0.291-1.303, p = 0.213; I2 = 83%), inhibition (ES = 0.156, 95% CI = -0.173 to 0.484, p = 0.353; I2 = 0.0%, Q = 1.1, p = 0.781), and cognitive flexibility (ES = 0.240, 95% CI = -0.270 to 0.749, 95% PI = -1.706 to 2.185; p = 0.356; I2 = 53.2%, Q = 3.0, p = 0.094). Physical exercise, particularly aerobic exercise, appears to have a small beneficial effect on working memory in individuals with schizophrenia spectrum disorders. However, the evidence for its effect on emotion recognition is less clear and may be influenced by the type of exercise, such as yoga. Further research is needed to provide more robust conclusions. PROSPERO registration number: CRD42023392295.
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Affiliation(s)
- Nuria Pérez-Romero
- Exercise and Rehabilitation Sciences Institute, Postgraduate, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile;
| | - Christian Campos-Jara
- Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile; (C.C.-J.); (E.C.-V.)
| | - Caterina Pesce
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy;
| | | | - Enrique Cerda-Vega
- Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile; (C.C.-J.); (E.C.-V.)
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile; (R.R.-C.); (V.H.-C.)
| | | | - Cristian Martínez-Salazar
- Department of Physical Education, Sports and Recreation, Pedagogy in Physical Education, School of Education and Social Sciences and Humanities, Universidad de La Frontera, Temuco 4811230, Chile;
| | | | - Victoria Hernández-Cifuentes
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile; (R.R.-C.); (V.H.-C.)
| | - Falonn Contreras-Osorio
- Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile; (C.C.-J.); (E.C.-V.)
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Yin J, Sun Y, Zhu Y, Alifujiang H, Wang Y, An S, Huang H, Fu X, Deng H, Chen Y. Effects of yoga on clinical symptoms, quality of life and social functioning in patients with schizophrenia: A systematic review and meta-analysis. Asian J Psychiatr 2024; 93:103959. [PMID: 38342034 DOI: 10.1016/j.ajp.2024.103959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/04/2024] [Accepted: 02/02/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND Yoga is gradually being explored as a potential complementary intervention in addition to psychiatric drugs for schizophrenia. However, there are conflicts on the efficacy of yoga for schizophrenia. This meta-analysis was aimed to evaluate the association of yoga intervention with reductions on clinical symptoms and improvements in quality of life (QoL) as well as social functioning among schizophrenia. METHOD Systematic literature search was undertaken to identify all RCTs that compared yoga with active or passive controls for patients with schizophrenia from inception to July 2023. The outcomes were measurements of positive symptoms, negative symptoms, QoL and social functioning. Random-effects models were performed to calculate the effect sizes in the standardized mean differences reporting as Hedges' s g statistic. RESULTS 19 studies enrolling 1274 participants with schizophrenia were included. Yoga had a medium effect on positive symptoms in the short term (Hedges's g = 0.31) and small effect in the long term (Hedges's g = 0.18). Medium significant effects were also found on negative symptoms in both the short term (Hedges's g = 0.44) and the long term (Hedges's g = 0.35). Yoga had a significant impact on improving both total QoL (Hedges's g = 0.34) and social functioning (Hedges's g = 0.45) with medium effect sizes. CONCLUSIONS Yoga was associated with significant reductions on negative and positive symptoms, and significant improvements in QoL as well as social functioning in patients with schizophrenia. Future research should explore the long-term efficacy of yoga for schizophrenia, encompassing more diverse populations.
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Affiliation(s)
- Jingyu Yin
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yuqi Sun
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China; Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Yikang Zhu
- Shanghai Mental Health Center, Shanghai, China
| | | | - Yi Wang
- Mianyang Central Hospital, Mianyang, China
| | - Siyao An
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Huiqun Huang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xi Fu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China; Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Hong Deng
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.
| | - Ying Chen
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China.
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Pérez-Romero N, Campos-Jara C, Pesce C, Araya Sierralta S, Cerda-Vega E, Ramirez-Campillo R, Campos-Jara R, Martínez-Salazar C, Arellano-Roco C, Contreras-Osorio F. Effects of physical exercise on executive functions of individuals with schizophrenia spectrum disorders: Protocol for a systematic review and meta-analysis. PLoS One 2024; 19:e0296273. [PMID: 38165903 PMCID: PMC10760781 DOI: 10.1371/journal.pone.0296273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/04/2023] [Indexed: 01/04/2024] Open
Abstract
INTRODUCTION Executive functions are commonly impaired in individuals with schizophrenia spectrum disorders. Physical exercise has the potential for improving executive functions and can be easily implemented as a therapeutic method. However, there are only few systematic reviews of exercise effects in schizophrenia including cognitive outcomes, and no meta-analytical syntheses of effects on "cool" and "hot" executive functions. The purpose of this systematic review and meta-analysis will be to determine the effects of physical exercise on "cool" and "hot" executive functions of adults with schizophrenia spectrum disorders. METHODS AND ANALYSIS This protocol was guided by PRISMA-P guidelines. Studies will be searched using combinations of keywords and medical terms in the Web of Science, PubMed, Scopus, and EBSCO databases. Inclusion criteria will be determined as per PICOS approach. The risk of bias will be assessed using the Cochrane RoB2 tool. The certainty of evidence (per outcome) will be assessed using the GRADE method. The meta-analyses will be performed using the DerSimonian and Laird random effects model. Effect sizes (Hedges' g) with 95% confidence intervals will be calculated for each main outcome. CONCLUSIONS The results of this review may be useful for mental health professionals to design treatment plans for adults with schizophrenia spectrum disorders, offering potential benefits related to the quality of life and cognitive abilities of this population. PROSPERO REGISTRATION NUMBER CRD42023392295.
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Affiliation(s)
- Nuria Pérez-Romero
- Exercise and Rehabilitation Sciences Institute, Postgraduate, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago de Chile, Chile
| | - Christian Campos-Jara
- Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago de Chile, Santiago, Chile
| | - Caterina Pesce
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | | | - Enrique Cerda-Vega
- Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago de Chile, Santiago, Chile
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago de Chile, Santiago, Chile
| | | | - Cristian Martínez-Salazar
- Department of Physical Education, Sports, and Recreation, Pedagogy in Physical Education, School of Education and Social Sciences and Humanities, Universidad de La Frontera, Temuco, Chile
| | - Cristián Arellano-Roco
- Laboratorio de Neuromecanica Aplicada, Escuela de kinesiología, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago, Chile
| | - Falonn Contreras-Osorio
- Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago de Chile, Santiago, Chile
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El Kirat H, Khattabi A, Khalis M, Belrhiti Z. Effects of physical activity and nutrient supplementation on symptoms and well-being of schizophrenia patients: An umbrella review. Schizophr Res 2023; 262:112-120. [PMID: 37948884 DOI: 10.1016/j.schres.2023.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 10/21/2023] [Accepted: 10/22/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Physical activity and nutrient supplementation have been acknowledged to have moderate effects on symptoms and treatment compliance of patients suffering from mental disorders. However, there is still a lack of consensus on whether these interventions are effective on schizophrenia clinical and quality of life outcomes. Our objective was to provide a comprehensive review of systematic reviews that addressed the effects of physical activity and nutrient supplementation on treatment compliance, symptoms and improving the well-being of patients with schizophrenia. METHOD We carried out an umbrella review following Johanna Briggs Institute methodological guidance as follows: 1) Formulating a review question, 2) developing a search strategy, 3) systematic search in scientific databases (Medline, Cochrane Library, Science Direct), 4) study selection (title, abstract and full-text screening), 5) data extraction, 6) data charting and synthesis and 7) quality appraisal. RESULTS Our search strategy yielded 2214 articles published between 1960 and 2023. Nine systematic reviews fitted our inclusion criteria. Our umbrella review suggests that yoga is effective on positive and negative symptoms, and well-being, whereas aerobics is only effective on positive symptoms. We also found that supplementing polyunsaturated fatty acids and trace elements reduced schizophrenia's negative symptoms. CONCLUSION Our umbrella review highlighted moderate to low-quality evidence supporting the effectiveness of physical activity on negative and positive schizophrenia symptoms and the overall well-being of patients with schizophrenia. Our review findings support the need to promote physical activity and supplementation of micronutrients, a cost-effective strategy to promote healthy lifestyles in low and middle-income countries.
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Affiliation(s)
- Houda El Kirat
- Public Health and Management Department, International School of Public Health, Mohammed VI University of Health and Sciences, UM6SS, Casablanca, Morocco; Mohammed VI Center for Research and Innovation, CM6RI, Rabat, Morocco; National School of Public Health, Ministry of Health, and Social Protection, Morocco.
| | - Asmaa Khattabi
- Public Health and Management Department, International School of Public Health, Mohammed VI University of Health and Sciences, UM6SS, Casablanca, Morocco; Mohammed VI Center for Research and Innovation, CM6RI, Rabat, Morocco
| | - Mohamed Khalis
- Mohammed VI Center for Research and Innovation, CM6RI, Rabat, Morocco
| | - Zakaria Belrhiti
- Public Health and Management Department, International School of Public Health, Mohammed VI University of Health and Sciences, UM6SS, Casablanca, Morocco; Mohammed VI Center for Research and Innovation, CM6RI, Rabat, Morocco
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Reckziegel R, Goularte JF, Remus IB, Lapa CDO, Hasse-Sousa M, Martins DDS, Czepielewski LS, Gama CS. Association of daily-life functioning and obesity in individuals with schizophrenia and controls. J Psychiatr Res 2023; 163:305-309. [PMID: 37245317 DOI: 10.1016/j.jpsychires.2023.05.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/21/2023] [Accepted: 05/15/2023] [Indexed: 05/30/2023]
Abstract
Early weight gain following the diagnosis of schizophrenia (SCZ) has been associated with improved daily functioning. However, in the general population and in other psychiatric conditions such as bipolar disorder, increased body mass index (BMI) has been associated with worse functioning. The data on this association in chronic individuals with SCZ is still scarce. To address this gap in knowledge, our objective was to evaluate the association between BMI and psychosocial functioning in chronic outpatients with SCZ and in healthy individuals. Six-hundred individuals (n = 600), 312 with schizophrenia (SCZ) and 288 individuals with no personal or family history of severe mental illness (CTR), underwent weight, height and psychosocial functioning score (FAST) assessment. Linear regression models tested the association between FAST as dependent variable and BMI as independent variable, controlling for age, sex, use of clozapine and years of illness. In the CTR group, the highest BMI could predict a worse result in FAST, explaining about 22% of the variation found (Model: AdjR2 = 0.225 F(3,284) = 28.79 p < .001; BMI main effect: β = 0.509 t = 9.240 p < .001). In the SCZ group, there was no statistically significant association. Our findings corroborate the perception that increased BMI is associated with worse functioning status in the general population. In chronic SCZ, whatsoever, there is no association. Our findings suggest that patients with higher BMI in the SCZ group may compensate for the possible impairment of functionality due to increased body weight, through improved adherence and responsiveness to prescribed psychopharmacological treatment, leading to better control of psychiatric symptoms.
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Affiliation(s)
- Ramiro Reckziegel
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Zip Code: 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação Em Psiquiatria e Ciências Do Comportamento, Universidade Federal Do Rio Grande Do Sul, Ramiro Barcelos, 2400 - 2° Andar, Zip Code: 90035-003, Porto Alegre, Brazil
| | - Jeferson Ferraz Goularte
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Zip Code: 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação Em Psiquiatria e Ciências Do Comportamento, Universidade Federal Do Rio Grande Do Sul, Ramiro Barcelos, 2400 - 2° Andar, Zip Code: 90035-003, Porto Alegre, Brazil
| | - Isadora Bosini Remus
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Zip Code: 90035-903, Porto Alegre, Brazil
| | - Clara de Oliveira Lapa
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Zip Code: 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação Em Psiquiatria e Ciências Do Comportamento, Universidade Federal Do Rio Grande Do Sul, Ramiro Barcelos, 2400 - 2° Andar, Zip Code: 90035-003, Porto Alegre, Brazil
| | - Mathias Hasse-Sousa
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Zip Code: 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação Em Psiquiatria e Ciências Do Comportamento, Universidade Federal Do Rio Grande Do Sul, Ramiro Barcelos, 2400 - 2° Andar, Zip Code: 90035-003, Porto Alegre, Brazil
| | - Dayane Dos Santos Martins
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Zip Code: 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação Em Psiquiatria e Ciências Do Comportamento, Universidade Federal Do Rio Grande Do Sul, Ramiro Barcelos, 2400 - 2° Andar, Zip Code: 90035-003, Porto Alegre, Brazil
| | - Letícia Sanguinetti Czepielewski
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Zip Code: 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação Em Psicologia, Departamento de Psicologia Do Desenvolvimento e da Personalidade, Instituto de Psicologia, Universidade Federal Do Rio Grande Do Sul, Ramiro Barcelos, 2600 - Térreo, Zip Code:90035-003, Porto Alegre, Brazil
| | - Clarissa Severino Gama
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Zip Code: 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação Em Psiquiatria e Ciências Do Comportamento, Universidade Federal Do Rio Grande Do Sul, Ramiro Barcelos, 2400 - 2° Andar, Zip Code: 90035-003, Porto Alegre, Brazil.
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Suen YN, Lee EHM, Lam COB, Hui CLM, Chan SKW, Chang WC, Chen EYH. Evaluating a pilot community-based FITMIND exercise programme for psychosis in Hong Kong. BMC Psychiatry 2023; 23:385. [PMID: 37259084 DOI: 10.1186/s12888-023-04901-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 05/25/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Exercise interventions can improve clinical symptoms and cognition in patients with psychosis in addition to their physical health. However, their benefits may not be maximally generalised to those who cannot access gymnasium facilities, which were commonly required previously. This study evaluated a 12-week community exercise programme named FITMIND, which aims to help patients with psychosis establish exercise habits through easy-to-learn aerobic exercise and yoga, with the support of trained volunteers. METHOD This study analysed the profiles of 49 patients with psychosis who were referred by the case manager of the early psychosis programme in the public hospital in Hong Kong or enrolled in the programme through the project website. The outcome measures were working memory, physical activity (PA) participation, quality of life, and mood symptoms. RESULTS At baseline, seven participants (14.3%) met the recommendation of the PA for severe mental illnesses. After the 12-week programme, participants demonstrated significant improvement in vigorous-intensity PA, moderate-to-vigorous PA, compliance with international guidelines for PA, and mood symptoms. CONCLUSION The FITMIND exercise programme is a feasible community-based intervention that can improve PA participation and mood in patients with psychosis. Further systematic studies are needed to examine the long-term beneficial effects of the programme.
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Affiliation(s)
- Yi Nam Suen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Edwin Ho Ming Lee
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Christina Oi Bun Lam
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Christy Lai Ming Hui
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Sherry Kit Wa Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
| | - Wing Chung Chang
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
| | - Eric Yu Hai Chen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China.
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Impact of Physical Exercise Alone or in Combination with Cognitive Remediation on Cognitive Functions in People with Schizophrenia: A Qualitative Critical Review. Brain Sci 2023; 13:brainsci13020320. [PMID: 36831863 PMCID: PMC9954055 DOI: 10.3390/brainsci13020320] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/31/2023] [Accepted: 02/11/2023] [Indexed: 02/16/2023] Open
Abstract
Physical exercise and cognitive remediation represent the psychosocial interventions with the largest basis of evidence attesting their effectiveness in improving cognitive performance in people living with schizophrenia according to recent international guidance. The aims of this review are to provide an overview of the literature on physical exercise as a treatment for cognitive impairment in schizophrenia and of the studies that have combined physical exercise and cognitive remediation as an integrated rehabilitation intervention. Nine meta-analyses and systematic reviews on physical exercise alone and seven studies on interventions combining physical exercise and cognitive remediation are discussed. The efficacy of physical exercise in improving cognitive performance in people living with schizophrenia is well documented, but more research focused on identifying moderators of participants response and optimal modalities of delivery is required. Studies investigating the effectiveness of integrated interventions report that combining physical exercise and cognitive remediation provides superior benefits and quicker improvements compared to cognitive remediation alone, but most studies included small samples and did not explore long-term effects. While physical exercise and its combination with cognitive remediation appear to represent effective treatments for cognitive impairment in people living with schizophrenia, more evidence is currently needed to better understand how to implement these treatments in psychiatric rehabilitation practice.
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Zechner M, Anderson EZ, Murphy AA, Zazzarino A, Karyczak S. Physical therapy students' perceptions for working with persons with mental illness in the USA. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:367. [PMID: 36618450 PMCID: PMC9818621 DOI: 10.4103/jehp.jehp_1543_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 08/30/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Physical therapists provide important services for improving health and function for the general population; however, physical therapy (PT) is infrequently accessed by persons with a primary diagnosis of severe mental illness (SMI). This study examined the attitudes of PT students before and during their participation in a service-learning (SL) program for people with SMI. MATERIALS AND METHODS A cross-sectional institutional review board approved qualitative study collected 1-h semi-structured qualitative interviews from seven graduates of a doctor of PT program. Participants were from a New Jersey University program in the USA who participated in an SMI SL experience. Participants were asked about participant attitudes toward people with SMI and their observations during a SL experience using an interview guide. All interviews were digitally recorded, transcribed, and coded using interpretive phenomenological analysis by a team of researchers. This type of qualitative analysis aims to explore participants understanding of their experience without pre-conceived theoretical direction. Recordings, transcripts, and field notes were reviewed for recurring ideas that were summarized into codes. Through independent coding, reflexivity memos, and consensus meetings, data were further analyzed to identify themes. Investigator triangulation addressed differences and aided consensus development. RESULTS Before the SL experience, the students reported negative perceptions about people with SMI and feelings of uncertainty and unpreparedness to work with this population. According to student reports, SL supported their personal and professional development and allowed them to see that PT services are beneficial for people with SMI. CONCLUSIONS The results of this study indicate that PT students have negative attitudes of people with SMI and feel unprepared to work with this population. The results also support SL as an effective strategy for helping students in their preparation for working with people with SMI.
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Affiliation(s)
- Michelle Zechner
- Department of Psychiatric Rehabilitation and Counseling Professions, School of Health Professions, Rutgers, The State University of New Jersey, New Brunswick-Piscataway, New Jersey, United States
| | - Ellen Z. Anderson
- Department of Rehabilitation and Movement Sciences, School of Health Professions, Rutgers, The State University of New Jersey, New Brunswick-Piscataway, New Jersey, United States
| | - Ann A. Murphy
- Department of Psychiatric Rehabilitation and Counseling Professions, School of Health Professions, Rutgers, The State University of New Jersey, New Brunswick-Piscataway, New Jersey, United States
| | - Anthony Zazzarino
- Department of Psychiatric Rehabilitation and Counseling Professions, School of Health Professions, Rutgers, The State University of New Jersey, New Brunswick-Piscataway, New Jersey, United States
| | - Sean Karyczak
- Department of Psychiatric Rehabilitation and Counseling Professions, School of Health Professions, Rutgers, The State University of New Jersey, New Brunswick-Piscataway, New Jersey, United States
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Heywood SE, Connaughton J, Kinsella R, Black S, Bicchi N, Setchell J. Physical Therapy and Mental Health: A Scoping Review. Phys Ther 2022; 102:pzac102. [PMID: 35926073 DOI: 10.1093/ptj/pzac102] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/17/2021] [Accepted: 05/09/2022] [Indexed: 11/14/2022]
Abstract
OBJECTIVES Coexistence of mental and physical health conditions is prevalent. To achieve optimal physical therapy outcomes, neither should be treated in isolation. This review aimed to map intersections between physical therapy and mental health. METHODS This was a scoping review searching MEDLINE, CINAHL, PsycInfo, Cochrane, and PEDro databases. Two independent researchers screened studies of physical therapy practice with adolescents/adults with mental health disorders or research using primary mental health outcomes in physical health conditions or clinicians' perspective. Data were extracted on study type, participants, topics, publication year, and country. RESULTS The search yielded 3633 studies with 135 included. Five studies included adolescents. More than one-half were published since 2015. Studies specific to participants with mental health diagnoses included schizophrenia (n = 12), depressive disorders (n = 8), eating disorders (n = 6), anxiety disorders (n = 4), bipolar disorders (n = 1), somatic disorders (n = 5), and trauma and stressor-related disorders (n = 8) or varied mental health diagnoses (n = 14). Forty-one studies had primary mental health outcomes or clinical practice approaches with a mental health emphasis with participants with physical health conditions (musculoskeletal [n = 13], neurological [n = 7], other [n = 21]). Systematic reviews or randomized controlled trials predominantly involved exercise therapy and/or physical activity. Descriptions of physical therapists as participants (n = 35) included 4 main topics: (1) mental health screening; (2) knowledge, attitudes, and experiences; (3) key practice components; and (4) research priorities. CONCLUSION Physical therapy intersects with people experiencing mental health disorders across a broad spectrum of diagnoses, covering a range of interventions with a small but growing evidence base. IMPACT Exercise and physical activity studies dominated the highest levels of evidence and future focus, although economic evaluations and consumer-driven or patient experience studies are needed. There is a contrast between the confidence and knowledge of specialized physical therapists working within mental health settings and those in general practice settings. Inspiring, integrated education is required to further improve health care outcomes following physical therapy for people with mental health disorders or symptoms.
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Affiliation(s)
- Sophie E Heywood
- Physiotherapy Department, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Joanne Connaughton
- School of Physiotherapy, The University of Notre Dame, Fremantle, Western Australia, Australia
| | - Rita Kinsella
- Physiotherapy Department, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Susie Black
- Physiotherapy Department, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Nadia Bicchi
- Physiotherapy Department, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Jenny Setchell
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
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Muth AK, Losecaat Vermeer A, Terenzi D, Park SQ. The impact of diet and lifestyle on wellbeing in adults during COVID-19 lockdown. Front Nutr 2022; 9:993180. [PMID: 36276821 PMCID: PMC9582278 DOI: 10.3389/fnut.2022.993180] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/23/2022] [Indexed: 11/13/2022] Open
Abstract
A healthy diet and lifestyle may protect against adverse mental health outcomes, which is especially crucial during stressful times, such as the COVID-19 pandemic. This preregistered longitudinal online study explored whether diet and lifestyle (physical activity, sleep, and social interactions) were associated with wellbeing and mood during a light lockdown in Germany. Participants (N = 117, 72 males; 28 ± 9 years old) answered mental health and lifestyle questionnaires (social connections, sleep, activity) followed by submitting 1 week of food and mood-lifestyle diary (food intake, positive and negative mood, mental wellbeing, sleep quality, physical activity level, quantity and quality of social interactions) via a smartphone app. We used multivariate linear and mixed-effects models to associate mood and wellbeing with dietary components and lifestyle factors. Interindividual analyses revealed that sleep and social interaction significantly impacted mood and wellbeing. Interestingly, fruit and vegetable intake correlated with wellbeing, even when controlling for all lifestyle factors. Fruit and vegetable intake also significantly correlated with daily fluctuations in wellbeing within individuals next to sleep, physical activity, and social interactions. We observed gender differences in fruit and vegetable intake and anxiety levels. Our results emphasize the importance of diet contributing to individual wellbeing, even in the challenging times of a pandemic. Future research is necessary to test if our findings could extend to other populations.
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Affiliation(s)
- Anne-Katrin Muth
- Department of Decision Neuroscience and Nutrition, German Institute of Human Nutrition (DIfE), Potsdam-Rehbrücke, Germany,Neuroscience Research Center, and Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Annabel Losecaat Vermeer
- Department of Decision Neuroscience and Nutrition, German Institute of Human Nutrition (DIfE), Potsdam-Rehbrücke, Germany,Neuroscience Research Center, and Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Damiano Terenzi
- Department of Decision Neuroscience and Nutrition, German Institute of Human Nutrition (DIfE), Potsdam-Rehbrücke, Germany,Neuroscience Research Center, and Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany,Deutsches Zentrum für Diabetes, Neuherberg, Germany,*Correspondence: Damiano Terenzi,
| | - Soyoung Q. Park
- Department of Decision Neuroscience and Nutrition, German Institute of Human Nutrition (DIfE), Potsdam-Rehbrücke, Germany,Neuroscience Research Center, and Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany,Deutsches Zentrum für Diabetes, Neuherberg, Germany,Soyoung Q. Park,
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11
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Effectiveness of personal recovery facilitators in adults with schizophrenia and other psychoses: A systematic review of reviews and narrative synthesis. Schizophr Res 2022; 246:132-147. [PMID: 35777151 DOI: 10.1016/j.schres.2022.06.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/14/2022] [Accepted: 06/19/2022] [Indexed: 01/12/2023]
Abstract
This review aimed to examine the evidence base for the use of personal recovery facilitators [non-psychopharmacological approaches] for adults with a diagnosis of schizophrenia and other psychoses. A systematic review (umbrella review) was conducted of reviews published in English between January 2010 and February 2022, which examined the effectiveness of personal recovery facilitators to support aspects of personal recovery as defined by the CHIME framework (connectedness, hope and optimism, identity, meaning and purpose, and empowerment). Twenty-one systematic reviews on thirteen different types of personal recovery facilitators [PRFs] were included in this umbrella review. Only one review sought to directly measure personal recovery processes according to the CHIME framework. Outcome measures mostly aligned with the processes of hope (21 reviews) and connectedness (19 reviews). Those related to empowerment (2 reviews), identity (5 reviews) and meaning and purpose (1 review) were less frequently the focus of PRFs. Yoga and music therapy showed the most promise as PRFs. Vocational treatments and integrated supported employment show good potential as personal recovery facilitators. However, together with narrative photovoice, art making and exhibition, they require further robust research to fully examine their impact. Personal recovery is only beginning to be considered as an intended outcome of interventions for persons with schizophrenia and other psychoses. This may be due in part to the continued predominance of the biomedical model approach to recovery within statutory services. Future evaluations of PRFs should include outcome measures that directly assess personal recovery according to the CHIME framework or other measures developed in consultation with recipients of these approaches. Review registration number and date: PROSPERO 2020 CRD42020215471: 10/11/20.
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12
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Tatta J, Willgens AM, Palombaro KM. Mindfulness and Acceptance-Based Interventions in Physical Therapist Practice: The Time Is Now. Phys Ther 2022; 102:6481182. [PMID: 35079796 DOI: 10.1093/ptj/pzab293] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/03/2021] [Accepted: 11/04/2021] [Indexed: 12/20/2022]
Abstract
UNLABELLED One in 5 adults in the United States lives with a mental illness, and many more struggle with stress-related chronic illnesses. Physical therapists often see the physical effects that stress has on the body, but there is an underutilization of evidence-based stress management strategies with patients and clients. Mindfulness and acceptance-based interventions (MABIs) constitute a family of methods that emphasize present-moment awareness, nonjudgment, and values-based living. They operate by teaching patients to cope with stressful thoughts, emotions, and physical sensations. MABIs are associated with improved health outcomes in areas commonly seen in physical therapist practice, including health promotion, physical function, injury prevention, pain management, immune function, and noncommunicable diseases. The purpose of this Perspective article is to (1) describe MABIs; (2) discuss the relevance of MABIs to physical therapist practice; (3) discuss the positive impact of MABIs for pain, sports, immune function, physical and mental health promotion, and wellness; and (4) identify MABI outcome measures related to health behavior change. It is time. IMPACT Contemporary practice requires that physical therapists manage patient care by addressing both the mind and body. Given the existing research on MABIs, it is time to translate the evidence into minimum accreditable standards for health promotion and prevention of chronic, noncommunicable disease. This approach would have far-reaching benefits for individuals, family units, communities, and society as a whole. LAY SUMMARY Mindfulness instruction delivered by a physical therapist can help improve physical and mental well-being.
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Affiliation(s)
- Joe Tatta
- Integrative Pain Science Institute, New York, New York, USA
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13
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KOTA M, UEZONO S, ISHIBASHI Y, KURAMOCHI S, KITAKAZE S, KAGANOI S. Outcomes of Physiotherapy on Activities of Daily Living and Discharge to the Community in Psychiatric Long-term Care Ward Patients. Phys Ther Res 2022; 25:84-91. [DOI: 10.1298/ptr.e10159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/12/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Munetsugu KOTA
- Department of Health Sciences, Hiroshima Cosmopolitan University, Japan
| | - Sae UEZONO
- Department of Rehabilitation, Hirakawa Hospital, Japan
| | | | | | | | - Seiji KAGANOI
- Department of Rehabilitation, Geisei Hospital, Japan
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14
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Nourollahimoghadam E, Gorji S, Gorji A, Khaleghi Ghadiri M. Therapeutic role of yoga in neuropsychological disorders. World J Psychiatry 2021; 11:754-773. [PMID: 34733640 PMCID: PMC8546763 DOI: 10.5498/wjp.v11.i10.754] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/28/2021] [Accepted: 08/02/2021] [Indexed: 02/06/2023] Open
Abstract
Yoga is considered a widely-used approach for health conservation and can be adopted as a treatment modality for a plethora of medical conditions, including neurological and psychological disorders. Hence, we reviewed relevant articles entailing various neurological and psychological disorders and gathered data on how yoga exerts positive impacts on patients with a diverse range of disorders, including its modulatory effects on brain bioelectrical activities, neurotransmitters, and synaptic plasticity. The role of yoga practice as an element of the treatment of several neuropsychological diseases was evaluated based on these findings.
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Affiliation(s)
| | - Shaghayegh Gorji
- Epilepsy Research Center, Münster University, Münster 48149, Germany
| | - Ali Gorji
- Epilepsy Research Center, Münster University, Münster 48149, Germany
- Department of Neuroscience, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran
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15
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Pancotti F, Mele S, Callegari V, Bivi R, Saracino F, Craighero L. Efficacy of Facial Exercises in Facial Expression Categorization in Schizophrenia. Brain Sci 2021; 11:brainsci11070825. [PMID: 34206553 PMCID: PMC8301751 DOI: 10.3390/brainsci11070825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/15/2021] [Accepted: 06/21/2021] [Indexed: 11/16/2022] Open
Abstract
Embodied cognition theories suggest that observation of facial expression induces the same pattern of muscle activation, and that this contributes to emotion recognition. Consequently, the inability to form facial expressions would affect emotional understanding. Patients with schizophrenia show a reduced ability to express and perceive facial emotions. We assumed that a physical training specifically developed to mobilize facial muscles could improve the ability to perform facial movements, and, consequently, spontaneous mimicry and facial expression recognition. Twenty-four inpatient participants with schizophrenia were randomly assigned to the experimental and control group. At the beginning and at the end of the study, both groups were submitted to a facial expression categorization test and their data compared. The experimental group underwent a training period during which the lip muscles, and the muscles around the eyes were mobilized through the execution of transitive actions. Participants were trained three times a week for five weeks. Results showed a positive impact of the physical training in the recognition of others’ facial emotions, specifically for the responses of “fear”, the emotion for which the recognition deficit in the test is most severe. This evidence suggests that a specific deficit of the sensorimotor system may result in a specific cognitive deficit.
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Affiliation(s)
- Francesco Pancotti
- Department of Neuroscience and Rehabilitation, University of Ferrara, via Fossato di Mortara 19, 44121 Ferrara, Italy;
| | - Sonia Mele
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Vincenzo Callegari
- Integrated Department of Mental Health and Addictive Behavior, Local Health Trust of Ferrara, 44124 Ferrara, Italy; (V.C.); (R.B.); (F.S.)
| | - Raffaella Bivi
- Integrated Department of Mental Health and Addictive Behavior, Local Health Trust of Ferrara, 44124 Ferrara, Italy; (V.C.); (R.B.); (F.S.)
| | - Francesca Saracino
- Integrated Department of Mental Health and Addictive Behavior, Local Health Trust of Ferrara, 44124 Ferrara, Italy; (V.C.); (R.B.); (F.S.)
| | - Laila Craighero
- Department of Neuroscience and Rehabilitation, University of Ferrara, via Fossato di Mortara 19, 44121 Ferrara, Italy;
- Correspondence: ; Tel.: +39-0532-455928
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16
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[Implementation of exercise therapy in daily clinical practice in psychiatric clinics in Germany]. DER NERVENARZT 2020; 91:642-650. [PMID: 31463534 DOI: 10.1007/s00115-019-0782-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Exercise therapy has proven to be effective in the treatment of multiple mental illnesses. As mental disorders result in tremendous costs for the healthcare system as well as a huge burden for the affected individuals, improving treatment strategies according to latest scientific evidence should be of highest priority. In 2016 a first study provided indications that only a minority of patients are treated with exercise therapy during their stay in hospital. Hence, the aim of this study was to assess the actual extent of exercise therapy usage in psychiatric inpatients in Germany, thereby giving a scientific foundation to the call for a better standard of care. To achieve this, a retrospective analysis was performed on pre-existing data from 2693 patients who were treated in 1 of 4 participating university hospitals. Only 23% of these patients participated in exercise therapy with a mean training duration of 36 min per week. Patients with the diagnosis of schizophrenia or patients with multiple comorbidities were even less likely to participate in exercise therapy. With these findings it becomes evident that the healthcare situation concerning exercise therapy is insufficient. Solid evidence for the effectiveness of exercise therapy, the current treatment guidelines as well as the positive side effects, especially when compared to side effects of pharmacotherapy (i.e. weight gain) should motivate healthcare officials to make an effort to improve this situation.
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17
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Hátlová B, Adámková Ségárd M, Probst M, Chytrý V, Chalupová E. The effect of psychomotor therapy on mental health in in-patient schizophrenia treatment: A randomized, double-blind intervention study. ACTA GYMNICA 2020. [DOI: 10.5507/ag.2020.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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18
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Nuño L, Barrios M, Vancampfort D, Rojo E, Gómez-Benito J, Guilera G. Functioning in schizophrenia: a Delphi study covering the perspective of physiotherapists. Disabil Rehabil 2020; 43:3733-3740. [PMID: 32285708 DOI: 10.1080/09638288.2020.1748729] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE This qualitative study explores the barriers, personal characteristics/resources, and environmental factors that experienced physiotherapists identify as relevant in the assessment and treatment of persons living with schizophrenia, and whether the identified aspects are represented in the International Classification of Functioning, Disability and Health Core Sets for schizophrenia. METHODS A three-round Delphi study with physiotherapists was conducted between April and July 2018. In the first round, participants had to list all the aspects they considered to be relevant when assessing and/or treating individuals with schizophrenia, and they were asked six open-ended questions. Their responses were linked to categories. In the second and third rounds, physiotherapists had to judge whether each category/personal factor was relevant for describing functioning in schizophrenia. RESULTS Thirteen of 22 eligible physiotherapists from eight countries responded to the first round, and 10 completed all three rounds. Eighty-two (84.5%) of the 97 categories in the Comprehensive Core Set for schizophrenia and all 25 categories in the Brief Core Set were considered relevant. A total of five categories were additionally identified. CONCLUSIONS The barriers, personal characteristics/resources, and environmental factors from the physiotherapists' perspective have been identified. The results largely confirm the content validity of the Core Sets for schizophrenia.Implications for rehabilitationThis study shows which barriers, personal characteristics/resources, and environmental factors in persons with schizophrenia are relevant from physiotherapists' perspective and should be integrated in the rehabilitation process.The content validity of the Comprehensive and Brief Core Sets for schizophrenia is largely supported from the physiotherapists' perspective and therefore could be used in the assessment of functioning in persons with schizophrenia.The Comprehensive and Brief ICF Core Sets for schizophrenia could be used to plan and assess multidisciplinary rehabilitation interventions.
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Affiliation(s)
- Laura Nuño
- Clinical Institute of Neurosciences (ICN), Hospital Clinic, Barcelona, Spain
| | - Maite Barrios
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain.,Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Emilio Rojo
- Hospital Benito Menni CASM, Sisters Hospitallers, Sant Boi de Llobregat, Spain.,Department of Psychiatry, International University of Catalonia, Sant Cugat del Vallès, Spain
| | - Juana Gómez-Benito
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain.,Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Georgina Guilera
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain.,Institute of Neurosciences, University of Barcelona, Barcelona, Spain
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19
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Lu SM, Lin MF, Chang HJ. Progressive muscle relaxation for patients with chronic schizophrenia: A randomized controlled study. Perspect Psychiatr Care 2020; 56:86-94. [PMID: 31012119 DOI: 10.1111/ppc.12384] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 04/08/2019] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To evaluate progressive muscle relaxation (PMR) as an intervention for anxiety, psychotic symptoms, and quality of life (QOL) in patients with chronic schizophrenia. DESIGN AND METHODS Eighty patients were recruited from a Taiwanese psychiatry ward. The intervention group received group PMR; control group received treatment-as-usual. RESULTS The results indicated that PMR might have a short-term effect on reducing anxiety, improving psychotic syndromes, and QOL among patients with chronic schizophrenia; however, the effectiveness at the 3-month follow-up was not evident. PRACTICE IMPLICATIONS Both the psychiatric patients and the health institutions may be able to list PMR as a clinical routine care, and then become a mental health practice strategy for mental patients to improve the quality of mental care. IMPLICATIONS FOR NURSING PRACTICE Our studies suggest that prevention of severe mental illness among patients with schizophrenia requires PMR interventions. PMR had an immediate effect, and it is possible that a shorter intervention period using this approach would also be successful.
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Affiliation(s)
- Shu-Min Lu
- School of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, Taiwan
| | - Mei-Feng Lin
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsiu-Ju Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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20
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Riedl L, Nagels A, Sammer G, Straube B. A Multimodal Speech-Gesture Training Intervention for Patients With Schizophrenia and Its Neural Underpinnings - the Study Protocol of a Randomized Controlled Pilot Trial. Front Psychiatry 2020; 11:110. [PMID: 32210849 PMCID: PMC7068208 DOI: 10.3389/fpsyt.2020.00110] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 02/07/2020] [Indexed: 01/02/2023] Open
Abstract
UNLABELLED Dysfunctional social communication is one of the most stable characteristics in patients with schizophrenia that also affects quality of life. Interpreting abstract speech and integrating nonverbal modalities is particularly affected. Considering the impact of communication on social life but failure to treat communication dysfunctions with usual treatment, we will investigate the possibility to improve verbal and non-verbal communication in schizophrenia by applying a multimodal speech-gesture training (MSG training). Here we describe the newly developed MSG training program and the study design for the first clinical investigation. The intervention contains perceptive rating (match/mismatch of sentence and gesture) and memory tasks (n-back tasks), imitation and productive tasks (e.g., SG fluency-similar to verbal fluency where words are accompanied by gesture). In addition, we offer information about gesture as meta-learning element as well as homework for reasons of transfer to everyday life as part of every session. In the MSG training intervention, we offer eight sessions (60 min each) of training. The first pilot study is currently conducted as a single-center, randomized controlled trial of speech-gesture intervention versus wait-list control with a follow-up. Outcomes are measured through pre-post-fMRI and standardized psychological questionnaires comparing two subject groups (30 patients with schizophrenia and 30 healthy controls). Patients and healthy controls are randomized in two intervention groups (with 20 being in the wait-training group and 10 in the training-follow-up group). With our study design we will be able to demonstrate the beneficial effect of the MSG training intervention on behavioral and neural levels. CLINICAL TRIAL REGISTRATION DRKS.de, identifier DRKS00015118.
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Affiliation(s)
- Lydia Riedl
- Translational Neuroimaging Lab, Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Arne Nagels
- Department of English and Linguistics, Johannes-Gutenberg-University, Mainz, Germany
| | - Gebhard Sammer
- Department of Psychiatry and Psychotherapy, Justus-Liebig-University, Gießen, Germany
| | - Benjamin Straube
- Translational Neuroimaging Lab, Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
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21
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Bayo-Tallón V, Esquirol-Caussa J, Pàmias-Massana M, Planells-Keller K, Palao-Vidal DJ. Effects of manual cranial therapy on heart rate variability in children without associated disorders: Translation to clinical practice. Complement Ther Clin Pract 2019; 36:125-141. [PMID: 31383430 DOI: 10.1016/j.ctcp.2019.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 06/11/2019] [Accepted: 06/30/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND and purpose: Heart rate variability (HRV) represents a marker of autonomic activity, self-regulation and psychiatric illness. Few studies of manual therapy have investigated the neurophysiological effects of manual cranial therapy (MC-t). This study assessed the neurophysiological short/medium-term effects of two manual therapy interventions: massage therapy (Mss-t) and MC-t. MATERIALS AND METHODS A double-blind clinical trial was conducted with 50 healthy children, randomized into two groups who received a Mss-t intervention or MC-t. The variables analysed included vital signs (temperature, respiratory rate, heart rate, blood pressure) and HRV components, including the root mean square of successive differences (RMSSD), high frequency (HF), low frequency (LF) and LF/HF ratio. RESULTS Both interventions produced short-term parasympathetic effects, although the effects of MC-t were more persistent. CONCLUSION The persistence of the MC-t intervention suggested a prominent vagal control and better self-regulation. Autonomic imbalances in mental pathologies may benefit from the neurophysiological effects of MC-t.
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Affiliation(s)
- Vanessa Bayo-Tallón
- Universitary Research Service of Physical Therapy, Servei Universitari de Recerca en Fisioteràpia -S.U.R.F, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain.
| | - Jordi Esquirol-Caussa
- Universitary Research Service of Physical Therapy, Servei Universitari de Recerca en Fisioteràpia -S.U.R.F, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain.
| | - Montserrat Pàmias-Massana
- Executive Direction of Adult, Child and Juvenile Mental Health Area at Corporación Sanitaria y Universitaria Parc Taulí (Neurosciences) (Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Kalia Planells-Keller
- Executive Direction of Adult, Child and Juvenile Mental Health Area at Corporación Sanitaria y Universitaria Parc Taulí (Neurosciences) (Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Diego J Palao-Vidal
- Executive Direction of Adult, Child and Juvenile Mental Health Area at Corporación Sanitaria y Universitaria Parc Taulí (Neurosciences) (Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
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22
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Ang MS, Nurjono M, Lee J. The effects of clinical illness severity and physical activity on health-related quality of life in schizophrenia. Qual Life Res 2019; 28:1509-1520. [PMID: 30805880 DOI: 10.1007/s11136-019-02126-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Quality of life is an important clinical outcome in individuals with schizophrenia. Illness severity and physical activity (PA) were independently reported to influence health-related quality of life (HRQoL) in people with schizophrenia. This study attempts to examine the intensity and types of PA and their impact on HRQoL, as well as the relative contributions of illness severity, PA, and sedentary behavior (SB) to HRQoL in people with schizophrenia. METHODS Demographic information was collected from 297 community-dwelling individuals with schizophrenia. Severity of illness was assessed on the Clinical Global Impression-Severity (CGI-S); PA and SB were assessed on the Global Physical Activity Questionnaire (GPAQ); HRQoL was assessed on the RAND-36. Regression analyses were conducted to examine the impact of different types and intensities of PA on HRQoL, and the relative impact of CGI-S, GPAQ-PA, and GPAQ-SB on HRQoL. RESULTS Most participants had low PA level, and travel is the main type of PA adopted. Leisure time, travel-related, work-related, moderate-, and vigorous-intensity PA were all not associated with HRQoL. Lower severity of illness was significantly associated with better physical (PHC), mental (MHC) and global (GHC) health composites of the RAND-36 (GHC: t = - 5.628, p < 0.001, PHC: t = - 4.026, p < 0.001, MHC: t = - 5.534, p < 0.001). Both PA and SB were not significantly associated with PHC, MHC, and GHC. CONCLUSION Severity of illness has a significant impact on HRQoL in people with schizophrenia. However, we found no evidence to support the association between physical activity and sedentary behavior with HRQoL.
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Affiliation(s)
- Mei San Ang
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, Singapore, 539747, Singapore
| | - Milawaty Nurjono
- Centre for Health Services Research and Policy Research, Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, Singapore
| | - Jimmy Lee
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, Singapore, 539747, Singapore. .,North Region & Department of Psychosis, Institute of Mental Health, Singapore, Singapore. .,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
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Perez-Cruzado D, Cuesta-Vargas A, Vera-Garcia E, Mayoral-Cleries F. Medication and physical activity and physical fitness in severe mental illness. Psychiatry Res 2018; 267:19-24. [PMID: 29879601 DOI: 10.1016/j.psychres.2018.05.055] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 04/23/2018] [Accepted: 05/22/2018] [Indexed: 10/16/2022]
Abstract
Anti-psychotic medication has emerged as the primary medical treatment for people with severe mental illness, despite the great risks involved in the use of this medication. In addition, this population suffers from problems of obesity, sedentary lifestyle and poor physical fitness, which is aggravated by the use of this type of medication. The objective of this study is to explore the influence of the most commonly used antipsychotics in this population (Olanzapine and Risperidone) on physical activity and the physical fitness of people with severe mental illness. Sixty-two people between 26 and 61 years of age with severe mental illness were assessed. All participants were evaluated with a battery of 11 physical tests to assess their physical fitness and with the IPAQ-short version questionnaire to determine their level of physical activity. The doses of Risperidone and Olanzapine were also evaluated in all participants. Significant differences were found for physical activity, with higher levels reported in those patients with severe mental illness who did not take any of these medications. Regarding physical fitness, significant differences were only found for the consumption of Risperidone, with better physical fitness levels seen in patients who did not consume this medication; on the other hand, for the consumption of Olanzapine, differences were found in muscular strength, balance and aerobic condition with better values in non-Olanzapine consumers compared with Olanzapine consumers.
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Affiliation(s)
| | - Antonio Cuesta-Vargas
- Department of Physiotherapy, University of Malaga, Spain; School of Clinical Science, Faculty of Health Science, Queensland University Technology, Australia.
| | - Elisa Vera-Garcia
- Department of Physiotherapy, University of Malaga, Spain; Hospital Regional de Málaga, Grupo de Investigación de Salud Mental, IBIMA, Spain.
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Dahle D, Noordsy D. Factors motivating spontaneous exercise in individuals with schizophrenia-spectrum disorders. Schizophr Res 2018; 199:436-437. [PMID: 29656908 DOI: 10.1016/j.schres.2018.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 02/03/2018] [Accepted: 03/12/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Danielle Dahle
- McLean Hospital, Harvard Medical School, United States; Dartmouth-Hitchcock Medical Center, Department of Psychiatry, 1 Medical Center Dr., Lebanon, NH 03756, United States.
| | - Douglas Noordsy
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, United States
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25
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Kandola A, Vancampfort D, Herring M, Rebar A, Hallgren M, Firth J, Stubbs B. Moving to Beat Anxiety: Epidemiology and Therapeutic Issues with Physical Activity for Anxiety. Curr Psychiatry Rep 2018; 20:63. [PMID: 30043270 PMCID: PMC6061211 DOI: 10.1007/s11920-018-0923-x] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE OF REVIEW The purpose of this paper was to provide a comprehensive narrative review of the relationship between physical activity (PA) and anxiety and the rationale for including it as a treatment option for anxiety disorders. Several gaps in the literature are highlighted alongside recommendations for future research. RECENT FINDINGS PA in the general population has established efficacy in preventing and managing cardiovascular disease and improving wellbeing. Recent epidemiological data further suggests that people who are more active may be less likely to have anxiety disorders. In addition, evidence from systematic reviews of randomised control trials suggests that exercise training, a subset of PA, can reduce symptoms in anxiety and stress-related disorders, such as post-traumatic stress disorder, agoraphobia and panic disorder. Anxiety disorders are common, burdensome and costly to individuals and wider society. In addition to the profound negative impact on individuals' wellbeing and functioning, they are associated with worsened physical health, including a higher risk for cardiovascular diseases and premature mortality. Although pharmacotherapy and psychological interventions are helpful for many, these treatment approaches are not effective for everyone and are insufficient to address common physical health complications, such as the elevated risk of cardiovascular disease. Given the combined anxiolytic and physical health benefits of increased activity, PA presents a promising additional treatment option for people with anxiety disorders. However, there remain key gaps in the literature regarding the mechanisms underlying the effects of PA, optimal PA protocols, methods of improving adherence and the importance of physical fitness. These must be addressed for PA to be successfully implemented in mental health services.
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Affiliation(s)
- Aaron Kandola
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
- KU Leuven Department of Neurosciences, UPC KU Leuven, Kortenberg, Belgium
| | - Matthew Herring
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Amanda Rebar
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Joseph Firth
- NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Ganguly P, Soliman A, Moustafa AA. Holistic Management of Schizophrenia Symptoms Using Pharmacological and Non-pharmacological Treatment. Front Public Health 2018; 6:166. [PMID: 29930935 PMCID: PMC5999799 DOI: 10.3389/fpubh.2018.00166] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 05/17/2018] [Indexed: 12/16/2022] Open
Abstract
Individuals with schizophrenia lead a poor quality of life, due to poor medical attention, homelessness, unemployment, financial constraints, lack of education, and poor social skills. Thus, a review of factors associated with the holistic management of schizophrenia is of paramount importance. The objective of this review is to improve the quality of life of individuals with schizophrenia, by addressing the factors related to the needs of the patients and present them in a unified manner. Although medications play a role, other factors that lead to a successful holistic management of schizophrenia include addressing the following: financial management, independent community living, independent living skill, relationship, friendship, entertainment, regular exercise for weight gained due to medication administration, co-morbid health issues, and day-care programmes for independent living. This review discusses the relationship between different symptoms and problems individuals with schizophrenia face (e.g., homelessness and unemployment), and how these can be managed using pharmacological and non-pharmacological methods. Thus, the target of this review is the carers of individuals with schizophrenia, public health managers, counselors, case workers, psychiatrists, and clinical psychologists aiming to enhance the quality of life of individuals with schizophrenia.
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Affiliation(s)
- Pronab Ganguly
- School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW, Australia
| | - Abdrabo Soliman
- Department of Social Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Ahmed A Moustafa
- School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW, Australia.,Marcs Institute for Brain and Behaviour, Western Sydney University, Sydney, NSW, Australia
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27
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Perez-Cruzado D, Cuesta-Vargas AI, Vera-Garcia E, Mayoral-Cleries F. The relationship between quality of life and physical fitness in people with severe mental illness. Health Qual Life Outcomes 2018; 16:82. [PMID: 29720196 PMCID: PMC5930752 DOI: 10.1186/s12955-018-0909-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 04/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Quality of life of people with severe mental illness may be decrease by the high occurrence of metabolic and cardiovascular diseases. Physical fitness emerges as a modifying factor in this population through physical activity and this modification could influence in the quality of life of this population. The aim of the present study is to determine the contribution of physical fitness to the quality of life of people with severe mental illness. METHODS In the current study, a physiotherapist and an occupational therapist assessed 62 people with severe mental illness. Physical fitness was measured with a range of 11 fitness tests that covered flexibility, strength, balance, and endurance. To assess quality of life the EQ-5D-3 L scale was used, which measures five dimensions (mobility, self-care, usual activities, pain-discomfort, and anxiety-depression). RESULTS Significant correlations are presented between the quality of life and primary variables of physical fitness (balance, endurance, and upper limb strength). Endurance explained 22.9% of the variance of the quality of life in people with severe mental illness. Functional reach added another 36.2% variance to the prediction of quality of life. CONCLUSIONS The results of the present study suggest that some variables of physical fitness are associated with quality of life in people with severe mental illness. The improvement in physical fitness of this population should be a primary objective. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02413164 "retrospective registered" Registered Febr 2017.
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Affiliation(s)
- D. Perez-Cruzado
- Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, Av/ Arquitecto Peñalosa s/n, Malaga, Spain
- Clinimetric Research Group of Biomedicine Research Institute of Malaga (IBIMA) Spain, Regional University Hospital, Málaga, Spain
| | - A. I. Cuesta-Vargas
- Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, Av/ Arquitecto Peñalosa s/n, Malaga, Spain
- Clinimetric Research Group of Biomedicine Research Institute of Malaga (IBIMA) Spain, Regional University Hospital, Málaga, Spain
- School of Clinical Science, Faculty of Health Science, Queensland University Technology, Brisbane, QLD Australia
| | - E. Vera-Garcia
- Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, Av/ Arquitecto Peñalosa s/n, Malaga, Spain
- Mental Health Research Group of Biomedicine Research Institute of Malaga (IBIMA) Spain, Regional University Hospital, Malaga, Spain
| | - F. Mayoral-Cleries
- Mental Health Research Group of Biomedicine Research Institute of Malaga (IBIMA) Spain, Regional University Hospital, Malaga, Spain
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van der Stouwe ECD, van Busschbach JT, de Vries B, Cahn W, Aleman A, Pijnenborg GHM. Neural correlates of exercise training in individuals with schizophrenia and in healthy individuals: A systematic review. Neuroimage Clin 2018; 19:287-301. [PMID: 30023171 PMCID: PMC6050351 DOI: 10.1016/j.nicl.2018.04.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 03/27/2018] [Accepted: 04/16/2018] [Indexed: 12/17/2022]
Abstract
A body of evidence has revealed positive effects of physical exercise on behavioral, cognitive and physical outcomes in patients with schizophrenia. Notably, the effect of exercise at the neural level may be particularly relevant as well as it is hypothesized that exercise may stimulate the brain in a way that might normalize neural alterations related to the disorder. The aim of the current systematic review was to provide an up to date overview of studies investigating the neural effects of exercise in individuals with a schizophrenia spectrum disorder and healthy individuals. The majority of included studies focused on hippocampal effects, reporting beneficial effects of exercise. In addition, in schizophrenia increased extrastriate body area (EBA) activation and increased white matter fiber integrity in tracts relevant to the disorder were found and in healthy individuals decreased connectivity of the dorsolateral prefrontal cortex (DLPFC) indicating greater cognitive efficiency was reported. Comparing individuals with a schizophrenia spectrum disorder and healthy individuals within a similar age range, most studies found similar effects on hippocampal volume and white matter tracts for both groups, although the effect in schizophrenia spectrum disorders may be attenuated which is in line with previous literature on brain plasticity. The current review indicates a lack of studies investigating neural correlates other than the hippocampus. Although those studies that did focus on other neural correlates revealed promising results, these have not been replicated in other studies and call for replication. Furthermore, future studies should expand their focus, by investigating neural mechanisms underlying positive effects of physical exercise on positive symptoms, negative symptoms and symptoms such as depression, social withdrawal and social cognition.
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Affiliation(s)
- E C D van der Stouwe
- Department of Neuroscience, BCN Neuroimaging Center, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713, AW, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Rob Giel Onderzoekcentrum, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands.
| | - J T van Busschbach
- University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Rob Giel Onderzoekcentrum, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands; Department of Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, 8017, CA, Zwolle, The Netherlands.
| | - B de Vries
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712, TS, Groningen, The Netherlands.
| | - W Cahn
- Department of Psychiatry, Rudolf Magnus Institute for Neuroscience, University Medical Center Utrecht, Heigelberglaan 100, 3584, CX, Utrecht, The Netherlands.
| | - A Aleman
- Department of Neuroscience, BCN Neuroimaging Center, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713, AW, Groningen, The Netherlands.
| | - G H M Pijnenborg
- Department of Neuroscience, BCN Neuroimaging Center, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713, AW, Groningen, The Netherlands; Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712, TS, Groningen, The Netherlands; Department of Psychotic Disorders, GGZ-Drenthe, Dennenweg 9, 9404, LA, Assen, The Netherlands.
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Vancampfort D, Stubbs B, Probst M, Mugisha J. Physiotherapy for people with mental health problems in Sub-Saharan African countries: a systematic review. Arch Physiother 2018; 8:2. [PMID: 29423279 PMCID: PMC5787323 DOI: 10.1186/s40945-018-0043-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 01/18/2018] [Indexed: 01/03/2023] Open
Abstract
Background There is a need for psychosocial interventions to address the escalating mental health burden in Sub-Saharan Africa (SSA). Physiotherapists could have a central role in reducing the burden and facilitating recovery within the multidisciplinary care of people with mental health problems. The aim of this systematic review was to explore the role of physiotherapists within the current mental health policies of SSA countries and to explore the current research evidence for physiotherapy to improve functional outcomes in people with mental health problems in SSA. Methods The Mental Health Atlas and MiNDbank of the World Health Organization were screened for the role of physiotherapy in mental health plans. Next, we systematically searched PubMed from inception until August 1st, 2017 for relevant studies on physiotherapy interventions in people with mental health problems in SSA. The following search strategy was used: "physiotherapy" OR "physical therapy" OR "rehabilitation" AND "mental" OR "depression" OR "psychosis" OR "schizophrenia" OR "bipolar" AND the name of the country. Results The current systematic review shows that in 22 screened plans only 2 made reference to the importance of considering physiotherapy within the multidisciplinary treatment. The current evidence (N studies = 3; n participants = 94) shows that aerobic exercise might reduce depression and improve psychological quality of life, self-esteem, body image and emotional stress in people with HIV having mental health problems. In people with depression moderate to high but not light intensity aerobic exercise results in significantly less depressive symptoms (N = 1, n = 30). Finally, there is evidence for reduction in post-traumatic stress symptoms (avoidance and arousal), anxiety and depression following body awareness related exercises (N = 1, n = 26). Conclusions Our review demonstrated that physiotherapy is still largely neglected in the mental health care systems of SSA. This is probably due to poor knowledge of the benefits of physiotherapy within mental health care by policymakers, training institutes, and other mental health care professionals in SSA. Based on the current scientific evidence, this paper recommends the adoption of physiotherapy within mental health care services and investment in research and in training of professionals in SSA.
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Affiliation(s)
- Davy Vancampfort
- 1Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Tervuursevest 101, 3001 Leuven, Belgium.,2KU Leuven - University of Leuven, University Psychiatric Center KU Leuven, Leuvensesteenweg 517, 3070 Kortenberg, Belgium
| | - Brendon Stubbs
- 3Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.,4Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Michel Probst
- 1Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Tervuursevest 101, 3001 Leuven, Belgium
| | - James Mugisha
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda.,6Kyambogo University, Kampala, Uganda
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30
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Fornaro M, Solmi M, Veronese N, De Berardis D, Buonaguro EF, Tomasetti C, Perna G, Preti A, Carta MG. The burden of mood-disorder/cerebrovascular disease comorbidity: essential neurobiology, psychopharmacology, and physical activity interventions. Int Rev Psychiatry 2017; 29:425-435. [PMID: 28681620 DOI: 10.1080/09540261.2017.1299695] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cardio-vascular diseases (CVDs) and CVD-related disorders (including cerebrovascular diseases; CBVDs) are a major public health concern as they represent the leading cause of mortality and morbidity in developed countries. Patients with CVDs and CBVDs co-morbid with mood disorders, especially bipolar disorder (BD) and major depressive disorder (MDD), suffer reduced quality-of-life and significant disability adjusted for years of life and mortality. The relationship between CVDs/CBVDs and mood disorders is likely to be bidirectional. Evidence for shared genetic risk of pathways involved in stress reaction, serotonin or dopamine signalling, circadian rhythms, and energy balance was reported in genome-wide association studies. There is some evidence of a neuroprotective effect of various antidepressants, which may be boosted by physical exercise, especially by aerobic ones. Patients with CVDs/CBVDs should be routinely attentively evaluated for the presence of mood disorders, with tools aimed at detecting both symptoms of depression and of hypomania/mania. Behavioural lifestyle interventions targeting nutrition and exercise, coping strategies, and attitudes towards health should be routinely provided to patients with mood disorders, to prevent the risk of CVDs/CBVDs. A narrative review of the evidence is herein provided, focusing on pharmacological and physical therapy interventions.
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Affiliation(s)
- Michele Fornaro
- a Department of Neuroscience, Reproductive Science and Odontostomatology , School of Medicine 'Federico II' Naples , Naples , Italy.,b Department of Psychiatry , Columbia University Medical Center, New York State Psychiatric Institute , New York , NY , USA
| | - Marco Solmi
- c Neuroscience Department , University of Padua , Padua , Italy.,d Institute for Clinical Research and Education in Medicine, I.R.E.M , Padua , Italy
| | - Nicola Veronese
- d Institute for Clinical Research and Education in Medicine, I.R.E.M , Padua , Italy.,e Department of Medicine (DIMED), Geriatrics Division , University of Padova , Padova , Italy
| | - Domenico De Berardis
- f Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment , Hospital 'G. Mazzini' , Teramo , Italy
| | - Elisabetta Filomena Buonaguro
- a Department of Neuroscience, Reproductive Science and Odontostomatology , School of Medicine 'Federico II' Naples , Naples , Italy
| | - Carmine Tomasetti
- a Department of Neuroscience, Reproductive Science and Odontostomatology , School of Medicine 'Federico II' Naples , Naples , Italy
| | - Giampaolo Perna
- g Department of Psychiatry and Neuropsychology , Maastricht University , Maastricht , Netherlands.,h Department of Clinical Neurosciences, FoRiPsi , Hermanas Hospitalarias-Villa San Benedetto Menni Hospital , Albese con Cassano , Como , Italy.,i Department of Psychiatry and Behavioural Sciences, Leonard Miller School of Medicine , University of Miami , Miami , FL , USA
| | - Antonio Preti
- j Center of Liaison Psychiatry and Psychosomatics , University Hospital, University of Cagliari , Monserrato , Cagliari , Italy
| | - Mauro Giovanni Carta
- k Department of Public Health, Clinical and Molecular Medicine , University of Cagliari , Monserrato , Cagliari , Italy
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Hahn LA, Mackinnon A, Foley DL, Morgan VA, Waterreus A, Watts GF, Castle DJ, Liu D, Galletly CA. The role of arterial elasticity and cardiovascular peripheral resistance as clinically relevant indices of health status in people with psychosis. Schizophr Res 2017; 184:88-95. [PMID: 27939827 DOI: 10.1016/j.schres.2016.11.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 10/09/2016] [Accepted: 11/29/2016] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Hypertension is one of the most important risk factors for cardiovascular disease (CVD). Systolic and diastolic blood pressure (BP) are higher in people with psychosis compared to the general population, but there is little research into measures of the elasticity of the arterial wall (pulse pressure; PP) and peripheral resistance (mean arterial pressure; MAP). PP and MAP can provide an additional perspective on the functioning of the circulatory system. This study investigated PP and MAP in people with psychosis, using factors known to be related to PP and MAP in the general population. METHOD Participants included 1421 people aged 18-64years, from the second Australian national survey of psychosis, untreated with antihypertensive medication. We tested the interaction and main effects between age and gender on PP, MAP, systolic BP and diastolic BP. Odds ratios were calculated in people exceeding the at-risk thresholds for PP and MAP. Multiple linear regression was used to test whether factors associated with at-risk PP and MAP in the general population were similarly associated in the psychosis population. RESULTS The interaction effect between age and gender on PP, MAP, systolic BP and diastolic BP was not statistically significant. Variables that retained significance in the regression model in explaining higher PP and MAP were: male gender, higher age, and having a family history of hypertension. CONCLUSION Clinicians monitoring and treating CV risk in this population need to ensure that they have recorded whether there is a family history of hypertension, and should be especially, more vigilant in men and in older patients.
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Affiliation(s)
- Lisa A Hahn
- Level 4, Eleanor Harrald Building, Royal Adelaide Hospital, University of Adelaide, Discipline of Psychiatry, Adelaide, SA 5000, Australia.
| | - Andrew Mackinnon
- Black Dog Institute and University of New South Wales, Sydney, NSW, Australia; Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.
| | - Debra L Foley
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, VIC, Australia.
| | - Vera A Morgan
- Neuropsychiatric Epidemiology Research Unit, School of Psychiatry & Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia.
| | - Anna Waterreus
- Neuropsychiatric Epidemiology Research Unit, School of Psychiatry & Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia.
| | - Gerald F Watts
- Cardiometabolic Clinic, Department of Cardiology, Royal Perth Hospital, School of Medicine and Pharmacology, The University of Western Australia, Crawley, WA, Australia.
| | - David J Castle
- St Vincent's Hospital, Melbourne and Department of Psychiatry, The University of Melbourne, VIC, Australia.
| | - Dennis Liu
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Northern Adelaide Local Area Health Network, Adelaide, SA, Australia.
| | - Cherrie A Galletly
- Discipline of Psychiatry, School of Medicine, University of Adelaide Ramsay Health Care, Mental Health Services, Northern Adelaide Local Health Network, Adelaide, SA, Australia.
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Lutgens D, Gariepy G, Malla A. Psychological and psychosocial interventions for negative symptoms in psychosis: systematic review and meta-analysis. Br J Psychiatry 2017; 210:324-332. [PMID: 28302699 DOI: 10.1192/bjp.bp.116.197103] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 12/10/2016] [Accepted: 01/27/2017] [Indexed: 01/15/2023]
Abstract
BackgroundNegative symptoms observed in patients with psychotic disorders undermine quality of life and functioning. Antipsychotic medications have a limited impact. Psychological and psychosocial interventions, with medication, are recommended. However, evidence for the effectiveness of specific non-biological interventions warrants detailed examination.AimsTo conduct a meta-analytic and systematic review of the literature on the effectiveness of non-biological treatments for negative symptoms in psychotic disorders.MethodWe searched for randomised controlled studies of psychological and psychosocial interventions in psychotic disorders that reported outcome on negative symptoms. Standardised mean differences (SMDs) in values of negative symptoms at the end of treatment were calculated across study domains as the main outcome measure.ResultsA total of 95 studies met our criteria and 72 had complete quantitative data. Compared with treatment as usual cognitive-behavioural therapy (pooled SMD -0.34, 95% CI -0.55 to -0.12), skills-based training (pooled SMD -0.44, 95% CI -0.77 to -0.10), exercise (pooled SMD -0.36, 95% CI -0.71 to -0.01), and music treatments (pooled SMD -0.58, 95% CI -0.82 to -0.33) provide significant benefit. Integrated treatment models are effective for early psychosis (SMD -0.38, 95% CI -0.53 to -0.22) as long as the patients remain in treatment. Overall quality of evidence was moderate with a high level of heterogeneity.ConclusionsSpecific psychological and psychosocial interventions have utility in ameliorating negative symptoms in psychosis and should be included in the treatment of negative symptoms. However, more effective treatments for negative symptoms need to be developed.
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Affiliation(s)
- Danyael Lutgens
- Danyael Lutgens, MSc, Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montréal, Quebec; Genevieve Gariepy, PhD, McGill University, Institute for Health and Social Policy, Montréal, Quebec; Ashok Malla, MD, FRCPC, McGill University, Douglas Mental Health University Institute, Montréal, Quebec, Canada
| | - Genevieve Gariepy
- Danyael Lutgens, MSc, Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montréal, Quebec; Genevieve Gariepy, PhD, McGill University, Institute for Health and Social Policy, Montréal, Quebec; Ashok Malla, MD, FRCPC, McGill University, Douglas Mental Health University Institute, Montréal, Quebec, Canada
| | - Ashok Malla
- Danyael Lutgens, MSc, Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montréal, Quebec; Genevieve Gariepy, PhD, McGill University, Institute for Health and Social Policy, Montréal, Quebec; Ashok Malla, MD, FRCPC, McGill University, Douglas Mental Health University Institute, Montréal, Quebec, Canada
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Okkels N, Mogensen RB, Crean LC, Vestergaard CH, Skadhede S, Rasmussen C, Shanmuganathan JWD, Hansen KB, Munk-Jørgensen P. Treatment profiles in a Danish psychiatric university hospital department. Nord J Psychiatry 2017; 71:289-295. [PMID: 28112009 DOI: 10.1080/08039488.2017.1279212] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Despite concerns about rising treatment of psychiatric patients with psychotropic medications and declining treatment with psychotherapy, actual treatment profiles of psychiatric patients are largely unknown. AIMS To describe patterns in the treatment of patients in a large psychiatric university hospital department. METHODS A descriptive mapping of treatment of in- and outpatients in a psychiatric department at Aarhus University Hospital Risskov, Denmark. Information was collected by healthcare staff using a 25-item survey form. The p-value was calculated with a chi-squared test and p < 0.05 was considered significant. The study was preceded by a pilot study on 41 patients. RESULTS Over a 1 month period, a total of 343 consecutive patients were assessed and hereof 200 were included in the age range 18-90 years (mean 53.76); 86 men and 114 women. One-hundred and eighty-eight patients (94%) used psychotropic medication, 37 (19%) as monotherapy, and 148 (74%) in combination with non-pharmacological therapy. Ninety-seven (49%) had psychotherapy and 104 (52%) social support. Among inpatients, 21 (64%) had physical therapy, and 10 (30%) electroconvulsive therapy. In total, 163 (82%) had non-pharmacological therapy. Fifty-two (26%) patients had monotherapy, and 148 (74%) polytherapy. Mean number of treatment modalities used per patient was 2.07 for all patients and 3.23 for inpatients. CONCLUSIONS In this department, polytherapy including non-pharmacological modalities is applied widely across all settings and patient categories. However, psychotropic medication clearly dominates as the most frequently applied treatment.
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Affiliation(s)
- Niels Okkels
- a Department of Affective Disorders , Aarhus University Hospital Risskov , Risskov , Denmark.,b Psychiatric Research Academy , Aarhus University Hospital Risskov , Risskov , Denmark.,c Clinic for OCD and Anxiety , Aarhus University Hospital Risskov , Risskov , Denmark
| | - Rasmus Beyer Mogensen
- d Department of Organic Psychiatric Disorders and Emergency Ward , Aarhus University Hospital Risskov , Risskov , Denmark
| | - Lea Catherine Crean
- b Psychiatric Research Academy , Aarhus University Hospital Risskov , Risskov , Denmark.,e Department of Mathematics , Aarhus University , Aarhus , Denmark
| | - Claus Høstrup Vestergaard
- d Department of Organic Psychiatric Disorders and Emergency Ward , Aarhus University Hospital Risskov , Risskov , Denmark
| | - Søren Skadhede
- d Department of Organic Psychiatric Disorders and Emergency Ward , Aarhus University Hospital Risskov , Risskov , Denmark
| | - Camilla Rasmussen
- d Department of Organic Psychiatric Disorders and Emergency Ward , Aarhus University Hospital Risskov , Risskov , Denmark
| | | | - Kenneth Brandt Hansen
- d Department of Organic Psychiatric Disorders and Emergency Ward , Aarhus University Hospital Risskov , Risskov , Denmark
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Gyllensten AL, Forsberg KA. Computerized physical activity training for persons with severe mental illness - experiences from a communal supported housing project. Disabil Rehabil Assist Technol 2016; 12:780-788. [DOI: 10.1080/17483107.2016.1263881] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Karl-Anton Forsberg
- Department of Research and Development in Social Psychiatry, Socialpsykiatriskt Kunskapscenter, Umeå, Sweden
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Pedersen BK, Saltin B. Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports 2016; 25 Suppl 3:1-72. [PMID: 26606383 DOI: 10.1111/sms.12581] [Citation(s) in RCA: 1881] [Impact Index Per Article: 209.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2015] [Indexed: 12/12/2022]
Abstract
This review provides the reader with the up-to-date evidence-based basis for prescribing exercise as medicine in the treatment of 26 different diseases: psychiatric diseases (depression, anxiety, stress, schizophrenia); neurological diseases (dementia, Parkinson's disease, multiple sclerosis); metabolic diseases (obesity, hyperlipidemia, metabolic syndrome, polycystic ovarian syndrome, type 2 diabetes, type 1 diabetes); cardiovascular diseases (hypertension, coronary heart disease, heart failure, cerebral apoplexy, and claudication intermittent); pulmonary diseases (chronic obstructive pulmonary disease, asthma, cystic fibrosis); musculo-skeletal disorders (osteoarthritis, osteoporosis, back pain, rheumatoid arthritis); and cancer. The effect of exercise therapy on disease pathogenesis and symptoms are given and the possible mechanisms of action are discussed. We have interpreted the scientific literature and for each disease, we provide the reader with our best advice regarding the optimal type and dose for prescription of exercise.
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Affiliation(s)
- B K Pedersen
- The Centre of Inflammation and Metabolism and The Center for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - B Saltin
- The Copenhagen Muscle Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Preliminary Effectiveness and Sustainability of Group Aerobic Exercise Program in Patients with Schizophrenia. J Nerv Ment Dis 2016; 204:644-50. [PMID: 27218221 DOI: 10.1097/nmd.0000000000000534] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The objective of this study was to examine the feasibility and sustained effect of a group aerobic exercise program in patients with schizophrenia. Twenty-four schizophrenic patients participated in a group-based individually tailored 90-minute outdoor cycling session per week for 3 months with intervention to enhance motivation. Physical health was evaluated by anthropometric measures, cardiorespiratory (CR) fitness, and blood tests. Mental health was assessed on self-esteem, interpersonal relationship, quality of life, and global function. Attrition rate for the exercise program was 8.3%. Exercise program significantly increased participant's self-esteem, positive relationship, global function, and quality of life. CR fitness significantly improved after 3 months. At the 9-month follow-up, 6 months after program completion, only in interpersonal relationship change the improved effects were maintained. These findings support the feasibility of group aerobic exercise program with high level of adherence and its long-term benefits in positive relationship change.
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Kandola A, Hendrikse J, Lucassen PJ, Yücel M. Aerobic Exercise as a Tool to Improve Hippocampal Plasticity and Function in Humans: Practical Implications for Mental Health Treatment. Front Hum Neurosci 2016; 10:373. [PMID: 27524962 PMCID: PMC4965462 DOI: 10.3389/fnhum.2016.00373] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 07/11/2016] [Indexed: 12/24/2022] Open
Abstract
Aerobic exercise (AE) has been widely praised for its potential benefits to cognition and overall brain and mental health. In particular, AE has a potent impact on promoting the function of the hippocampus and stimulating neuroplasticity. As the evidence-base rapidly builds, and given most of the supporting work can be readily translated from animal models to humans, the potential for AE to be applied as a therapeutic or adjunctive intervention for a range of human conditions appears ever more promising. Notably, many psychiatric and neurological disorders have been associated with hippocampal dysfunction, which may underlie the expression of certain symptoms common to these disorders, including (aspects of) cognitive dysfunction. Augmenting existing treatment approaches using AE based interventions may promote hippocampal function and alleviate cognitive deficits in various psychiatric disorders that currently remain untreated. Incorporating non-pharmacological interventions into clinical treatment may also have a number of other benefits to patient well being, such as limiting the risk of adverse side effects. This review incorporates both animal and human literature to comprehensively detail how AE is associated with cognitive enhancements and stimulates a cascade of neuroplastic mechanisms that support improvements in hippocampal functioning. Using the examples of schizophrenia and major depressive disorder, the utility and implementation of an AE intervention to the clinical domain will be proposed, aimed to reduce cognitive deficits in these, and related disorders.
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Affiliation(s)
- Aaron Kandola
- Brain and Mental Health Lab, School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, MelbourneVIC, Australia; Amsterdam Brain and Cognition, University of AmsterdamAmsterdam, Netherlands
| | - Joshua Hendrikse
- Brain and Mental Health Lab, School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne VIC, Australia
| | - Paul J Lucassen
- Centre for Neuroscience, Swammerdam Institute of Life Sciences, University of Amsterdam Amsterdam, Netherlands
| | - Murat Yücel
- Brain and Mental Health Lab, School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne VIC, Australia
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Dauwan M, Begemann MJH, Heringa SM, Sommer IE. Exercise Improves Clinical Symptoms, Quality of Life, Global Functioning, and Depression in Schizophrenia: A Systematic Review and Meta-analysis. Schizophr Bull 2016; 42:588-99. [PMID: 26547223 PMCID: PMC4838091 DOI: 10.1093/schbul/sbv164] [Citation(s) in RCA: 246] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Physical exercise may be valuable for patients with schizophrenia spectrum disorders as it may have beneficial effect on clinical symptoms, quality of life and cognition. METHODS A systematic search was performed using PubMed (Medline), Embase, PsychInfo, and Cochrane Database of Systematic Reviews. Controlled and uncontrolled studies investigating the effect of any type of physical exercise interventions in schizophrenia spectrum disorders were included. Outcome measures were clinical symptoms, quality of life, global functioning, depression or cognition. Meta-analyses were performed using Comprehensive Meta-Analysis software. A random effects model was used to compute overall weighted effect sizes in Hedges' g. RESULTS Twenty-nine studies were included, examining 1109 patients. Exercise was superior to control conditions in improving total symptom severity (k = 14, n = 719: Hedges' g = .39, P < .001), positive (k = 15, n = 715: Hedges' g = .32, P < .01), negative (k = 18, n = 854: Hedges' g = .49, P < .001), and general (k = 10, n = 475: Hedges' g = .27, P < .05) symptoms, quality of life (k = 11, n = 770: Hedges' g = .55, P < .001), global functioning (k = 5, n = 342: Hedges' g = .32, P < .01), and depressive symptoms (k = 7, n = 337: Hedges' g = .71, P < .001). Yoga, specifically, improved the cognitive subdomain long-term memory (k = 2, n = 184: Hedges' g = .32, P < .05), while exercise in general or in any other form had no effect on cognition. CONCLUSION Physical exercise is a robust add-on treatment for improving clinical symptoms, quality of life, global functioning, and depressive symptoms in patients with schizophrenia. The effect on cognition is not demonstrated, but may be present for yoga.
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Affiliation(s)
- Meenakshi Dauwan
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical Neurophysiology and MEG Center, Neuroscience Campus, VU University Medical Center, Amsterdam, The Netherlands
| | - Marieke J H Begemann
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sophie M Heringa
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Iris E Sommer
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
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Rosenbaum S, Tiedemann A, Stanton R, Parker A, Waterreus A, Curtis J, Ward PB. Implementing evidence-based physical activity interventions for people with mental illness: an Australian perspective. Australas Psychiatry 2016; 24:49-54. [PMID: 26139698 DOI: 10.1177/1039856215590252] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Physical activity (PA) and exercise is increasingly being recognised as an efficacious component of treatment for various mental disorders. The association between PA and cardiometabolic disease is well established, as is the strong link between mental illness, sedentary behaviour and poor cardiometabolic health. Examples of successful integration of clinical PA programs within mental health treatment facilities are increasing. The aim of this review was to summarise the evidence regarding PA and mental illness, and to present examples of clinical exercise programs within Australian mental health facilities. METHODS A narrative synthesis of systematic reviews and clinical trials was conducted. RESULTS Evidence supporting the inclusion of PA programs as an adjunct to treatment for various conditions was presented; including depression, schizophrenia, anxiety disorders, post-traumatic stress disorder and substance abuse. In light of the available evidence, the inclusion of clinical PA programs within mental health treatment, facilitated by dedicated clinicians (exercise physiologists / physiotherapists) was justified. CONCLUSIONS PA is a feasible, effective and acceptable adjunct to usual care for a variety of mental disorders. There is a clear need for greater investment in initiatives aiming to increase PA among people experiencing mental illness, given the benefits to both mental and physical health outcomes.
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Affiliation(s)
- Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, NSW, and; Early Psychosis Programme, The Bondi Centre, South Eastern Sydney Local Health District, Sydney, NSW, and; Musculoskeletal Division, George Institute for Global Health and Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Anne Tiedemann
- Musculoskeletal Division, George Institute for Global Health and Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Robert Stanton
- School of Medical and Applied Sciences Central Queensland University, Rockhampton, QLD, Australia
| | - Alexandra Parker
- Orygen, the National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, VIC, and; Headspace National Youth Mental Health Foundation Ltd, Melbourne, VIC, Australia
| | - Anna Waterreus
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia
| | - Jackie Curtis
- School of Psychiatry, University of New South Wales, Sydney, NSW, and; Early Psychosis Programme, The Bondi Centre, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, NSW, and; Schizophrenia Research Unit, Ingham Institute for Applied Medical Research, South Western Sydney Local Health District, Liverpool, NSW, Australia
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[Guideline-conform psychiatric psychotherapeutic treatment for patients with schizophrenia : A normative evaluation of necessary personnel requirements]. DER NERVENARZT 2016; 87:286-94. [PMID: 26820457 DOI: 10.1007/s00115-015-0056-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Although national treatment guidelines and current publications of the German Federal Joint Committee (Gemeinsamer Bundesausschuss) recommend cognitive behavior therapy for all patients with schizophrenia, the implementation of these recommendations in current inpatient and outpatient treatment is only rudimentary. OBJECTIVES The aim of this study was to systematically search randomized controlled studies (RCTs), meta-analyses and the guidelines of the German Association for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) and the British National Institute for Health and Clinical Excellence (NICE) in order to assess the number of personnel necessary for psychiatric and therapeutic inpatient treatment in line with present guidelines. Moreover, the number of staff required was compared with the personnel resources designated by the German psychiatry personnel regulations (Psych-PV). METHODS The German and NICE guidelines, RCTs and meta-analyses were analyzed and an adequate weekly treatment plan for an inpatient unit was developed. Moreover, the number of personnel necessary to realize the treatment plan was calculated. RESULTS In order to realize adequate inpatient treatment approximately 107 min extra for medical psychotherapeutic personnel per patient and week (of which 72 min for psychotherapy) and another 60 min for nursing staff per patient and week are required in addition to the current Psych-PV regulations. Thus, implementation in an open ward with 20 inpatients would require 3.62 positions for physicians, 0.7 positions in psychology and 12.85 positions for nursing staff (including management positions and night shifts). DISCUSSION These evidence-based recommendations for precise specifications of inpatient treatment should lead to improved inpatient treatment in line with present guidelines. Moreover, outpatients and day patients could be included in this treatment model. The results should be considered in the construction of the future prospective payment system for inpatient psychiatric healthcare in Germany.
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Vancampfort D, Rosenbaum S, Probst M, Connaughton J, du Plessis C, Yamamoto T, Stubbs B. What are the top 10 physical activity research questions in schizophrenia? Disabil Rehabil 2016; 38:2235-43. [DOI: 10.3109/09638288.2015.1116622] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kang R, Wu Y, Li Z, Jiang J, Gao Q, Yu Y, Gao K, Yan Y, He Y. Effect of Community-Based Social Skills Training and Tai-Chi Exercise on Outcomes in Patients with Chronic Schizophrenia: A Randomized, One-Year Study. Psychopathology 2016; 49:345-355. [PMID: 27584836 DOI: 10.1159/000448195] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 06/25/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Antipsychotic drugs are limited in their ability to improve negative symptoms, quality of life, and medication adherence in patients with schizophrenia. The addition of nonpharmacological interventions like social skills training has a positive effect on medication adherence and decreases rehospitalization rates but is limited in improving patients' symptoms, aggressive behaviors, and quality of life. Aerobic exercise, especially Tai-chi, can potentially reduce psychopathological and negative symptoms, decrease aggressive behaviors, and improve quality of life. It is an ideal rehabilitation intervention for patients with schizophrenia. However, no study has investigated the effects of social skills training plus Tai-chi on outcomes among outpatients with schizophrenia. This study analyzes the effect of antipsychotics combined with community-based integrated interventions on outcomes of schizophrenia. METHODS In this study, a 24-session social skills training plus Tai-chi was used in community settings among patients with schizophrenia. A total of 244 patients were randomly assigned to medication treatment alone (MTA group) or community-based integrated intervention (CBII group), which accepted social skills training plus Tai-chi in addition to medication treatment. Generalized linear mixed models were used to evaluate the intervention effect (group effect), intervention effect over time (time effect), and interaction effect (group × time effect). t tests were used to evaluate between-group differences on clinical variables. Multiple linear regression analysis was used to analyze the differences between the intervention at 12 months and baseline for the Positive and Negative Syndrome Scale (PANSS) negative symptoms and quality of life-social domain. RESULTS Compared with the MTA group, the CBII group had lower scores on PANSS (F = 17.312, p < 0.001) and negative symptoms (F = 44.909, p < 0.001), a lower risk for aggressive behavior (F = 12.382, p < 0.001), and a greater improvement in adherence to medication (F = 12.391, p < 0.001) after 1 year of intervention. The changes in PANSS total scores, negative scores, and social domain of the World Health Organization Quality of Life Scale-Brief version (WHOQOL-BREF) from baseline to 12 months were significant between the two groups (PANSS total score: t = 4.839, p < 0.001; negative symptoms: t = 8.250, p < 0.001, and quality of life-social domain: t = -2.171, p = 0.031). Multiple linear regression analysis also showed that the intervention was significantly effective for changes from baseline to 12 months on PANSS total score (B = 0.804, p < 0.001), negative score (B = 0.709, p < 0.001), and social domain of quality of life (B = -0.673, p = 0.044). CONCLUSIONS This study suggested that the community-based integrated intervention such as social skills training plus Tai-chi should be part of a rehabilitation effort for patients with schizophrenia in order to improve clinical symptoms, quality of life, and medication adherence.
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Affiliation(s)
- Ruiying Kang
- Department of Epidemiology and Biostatics, School of Public Health, Capital Medical University, Beijing, China
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Lin J, Chan SK, Lee EH, Chang WC, Tse M, Su WW, Sham P, Hui CL, Joe G, Chan CL, Khong PL, So KF, Honer WG, Chen EY. Aerobic exercise and yoga improve neurocognitive function in women with early psychosis. NPJ SCHIZOPHRENIA 2015; 1:15047. [PMID: 27336050 PMCID: PMC4849465 DOI: 10.1038/npjschz.2015.47] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 10/13/2015] [Accepted: 10/19/2015] [Indexed: 12/04/2022]
Abstract
Impairments of attention and memory are evident in early psychosis, and are
associated with functional disability. In a group of stable, medicated women
patients, we aimed to determine whether participating in aerobic exercise or
yoga improved cognitive impairments and clinical symptoms. A total of 140 female
patients were recruited, and 124 received the allocated intervention in a
randomized controlled study of 12 weeks of yoga or aerobic exercise compared
with a waitlist group. The primary outcomes were cognitive functions including
memory and attention. Secondary outcome measures were the severity of psychotic
and depressive symptoms, and hippocampal volume. Data from 124 patients were
included in the final analysis based on the intention-to-treat principle. Both
yoga and aerobic exercise groups demonstrated significant improvements in
working memory (P<0.01) with moderate to large effect
sizes compared with the waitlist control group. The yoga group showed additional
benefits in verbal acquisition (P<0.01) and attention
(P=0.01). Both types of exercise improved overall and
depressive symptoms (all P⩽0.01) after 12 weeks. Small
increases in hippocampal volume were observed in the aerobic exercise group
compared with waitlist (P=0.01). Both types of exercise
improved working memory in early psychosis patients, with yoga having a larger
effect on verbal acquisition and attention than aerobic exercise. The
application of yoga and aerobic exercise as adjunctive treatments for early
psychosis merits serious consideration. This study was supported by the Small
Research Funding of the University of Hong Kong (201007176229), and RGC funding
(C00240/762412) by the Authority of Research, Hong Kong.
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Affiliation(s)
- Jingxia Lin
- Department of Psychiatry, The University of Hong Kong , Hong Kong, China
| | - Sherry Kw Chan
- Department of Psychiatry, The University of Hong Kong , Hong Kong, China
| | - Edwin Hm Lee
- Department of Psychiatry, The University of Hong Kong , Hong Kong, China
| | - Wing Chung Chang
- Department of Psychiatry, The University of Hong Kong , Hong Kong, China
| | - Michael Tse
- Institute of Human Performance, The University of Hong Kong , Hong Kong, China
| | - Wayne Weizhong Su
- Department of Psychiatry, University of British Columbia , Vancouver, British Columbia, Canada
| | - Pak Sham
- Department of Psychiatry, The University of Hong Kong , Hong Kong, China
| | - Christy Lm Hui
- Department of Psychiatry, The University of Hong Kong , Hong Kong, China
| | - Glen Joe
- Institute of Human Performance, The University of Hong Kong , Hong Kong, China
| | - Cecilia Lw Chan
- Department of Social Work & Social Administration, The University of Hong Kong , Hong Kong, China
| | - P L Khong
- Department of Diagnostic Radiology, The University of Hong Kong , Hong Kong, China
| | - Kwok Fai So
- Department of Anatomy, The University of Hong Kong , Hong Kong, China
| | - William G Honer
- Department of Psychiatry, University of British Columbia , Vancouver, British Columbia, Canada
| | - Eric Yh Chen
- Department of Psychiatry, The University of Hong Kong , Hong Kong, China
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Chalfoun C, Karelis AD, Stip E, Abdel-Baki A. Running for your life: A review of physical activity and cardiovascular disease risk reduction in individuals with schizophrenia. J Sports Sci 2015; 34:1500-15. [PMID: 26630458 DOI: 10.1080/02640414.2015.1119875] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Individuals with schizophrenia have a greater risk for cardiometabolic risk factors (e.g. central obesity, insulin resistance, hypertension and dyslipidaemia), cardiovascular diseases and mortality. This risky profile may be explained by the adverse effects of antipsychotic medications and an unhealthy lifestyle (e.g. smoking, poor nutrition and low physical activity). In the general population, physical activity has been shown to be the optimal strategy to improve both cardiometabolic parameters and cardiorespiratory fitness levels. Accordingly, an emerging literature of non-pharmacological interventions (e.g. cognitive behavioural therapy, diet and physical activity) has been studied in individuals with schizophrenia. Therefore, the purpose of this review was 1) to conduct a critical literature review of non-pharmacological interventions that included some kind of physical activity (including supervised and unsupervised exercise training) and target cardiometabolic risk factors in individuals with schizophrenia. 2) To describe the contribution of physical activity alone by reviewing trials of supervised exercise training programmes only. A literature review via systematic keyword search for publications in Medline, PubMed, Embase and PsycINFO was performed. Many non-pharmacological interventions are efficient in reducing cardiovascular disease risk factors when combined with physical activity. Supervised physical activity has been successful in decreasing cardiovascular disease risk, and aerobic interval training appears to provide more benefits by specifically targeting cardiorespiratory fitness levels. In conclusion, physical activity is an effective strategy for addressing cardiovascular disease risk in individuals with schizophrenia. Long-term studies are needed to evaluate the feasibility and impact of exercise training programmes in individuals with schizophrenia.
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Affiliation(s)
- Claire Chalfoun
- a Department of Psychiatry, Faculty of Medicine , Université de Montréal , Montreal , Canada
| | - Antony D Karelis
- b Department of Exercise Science , Université du Québec à Montréal , Montreal , Canada
| | - Emmanuel Stip
- a Department of Psychiatry, Faculty of Medicine , Université de Montréal , Montreal , Canada.,c CHUM Research Centre (CRCHUM) , Montreal , Canada
| | - Amal Abdel-Baki
- a Department of Psychiatry, Faculty of Medicine , Université de Montréal , Montreal , Canada.,c CHUM Research Centre (CRCHUM) , Montreal , Canada.,d Clinique Jeunes Adultes Psychotiques (JAP) , Centre Hospitalier de l'Université de Montréal (CHUM) - Notre-Dame Hospital , Montreal , Canada
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Vera-Garcia E, Mayoral-Cleries F, Vancampfort D, Stubbs B, Cuesta-Vargas AI. A systematic review of the benefits of physical therapy within a multidisciplinary care approach for people with schizophrenia: An update. Psychiatry Res 2015; 229:828-39. [PMID: 26254795 DOI: 10.1016/j.psychres.2015.07.083] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 06/15/2015] [Accepted: 07/30/2015] [Indexed: 11/25/2022]
Abstract
This systematic review summarizes the most recent evidence from randomized controlled trials (RCTs) considering the effectiveness of physical therapy interventions (aerobic exercises, strength exercises, relaxation training, basic body awareness exercises, or a combination of these) within the multidisciplinary management of schizophrenia. Two authors searched PubMed, PsycINFO, EMBASE, Web of Science, Physiotherapy Evidence Database (PEDro), and the Cochrane Library considering RCTs published from July 1, 2011-October 1, 2014. Thirteen RCTs representing 549 participants met the inclusion criteria. Overall, the results demonstrate that aerobic exercise significantly reduces psychiatric symptoms, potentially improves mental and physical quality of life and reduces metabolic risk and weight. Specifically, yoga reduces psychiatric symptoms, whilst Tai-chi and progressive muscle relaxation may also have benefits to patients. Two RCTs reported on adverse events. No adverse event was observed supporting the notion that physical therapy is safe in people with schizophrenia. There was considerable heterogeneity in the design, implementation and outcomes in the included studies precluding a meaningful meta-analysis. In general, the quality of physical therapy RCTS is improving and current research demonstrates that physical therapy approaches are valuable interventions and can help improve the psychiatric, physical and quality of life of people with schizophrenia.
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Affiliation(s)
- Elisa Vera-Garcia
- Hospital Regional Universitario de Malaga, Departamento de Salud Mental, Malaga Spain. Instituto de Biomedicina de Málaga (IBIMA), Spain; Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Andalucia Tech, Cátedra de Fisioterapia y Discapacidad, Instituto de Biomedicina de Málaga (IBIMA), Grupo de Clinimetria (FE-14), Spain
| | - Fermín Mayoral-Cleries
- Hospital Regional Universitario de Malaga, Departamento de Salud Mental, Malaga Spain. Instituto de Biomedicina de Málaga (IBIMA), Spain
| | - Davy Vancampfort
- University of Leuven, Department of Rehabilitation Sciences, Belgium
| | - Brendon Stubbs
- University of Greenwich, School of Health and Social Care, UK
| | - Antonio I Cuesta-Vargas
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Andalucia Tech, Cátedra de Fisioterapia y Discapacidad, Instituto de Biomedicina de Málaga (IBIMA), Grupo de Clinimetria (FE-14), Spain.
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Fraser SJ, Chapman JJ, Brown WJ, Whiteford HA, Burton NW. Physical activity attitudes and preferences among inpatient adults with mental illness. Int J Ment Health Nurs 2015; 24:413-20. [PMID: 26332079 DOI: 10.1111/inm.12158] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The life expectancy of adults with mental illness is worse than that of the general population and is largely due to poor physical health status. Physical activity has been consistently recommended for the prevention and management of many chronic physical health conditions and can also have benefits for mental health. This cross sectional study assessed the attitudes towards and preferences for physical activity among inpatient adults with mental illness, and differences by distress and gender. Self-report questionnaires were completed by 101 patients. Findings indicated that inpatient adults with mental illness are interested in doing physical activity while in hospital, primarily to maintain good physical health and improve emotional wellbeing. Fewer than half of participants agreed that physical activity has benefits for serious mental illness. Participants indicated a preference for walking and physical activity that can be done alone, at a fixed time and with a set routine and format. Major barriers were fatigue and lack of motivation. Females were more likely than males to prefer activities done with others of the same gender (P = 0.001) and at the same level of ability (P < 0.001). There were no significant differences by level of distress. These findings can inform physical activity intervention programming in hospital settings, which may contribute to decreasing the chronic disease burden and improve the psychological wellbeing in adults with mental illness.
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Affiliation(s)
- Sarah J Fraser
- The School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Justin J Chapman
- The School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Wendy J Brown
- The School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Harvey A Whiteford
- The School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Nicola W Burton
- The School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
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Svatkova A, Mandl RC, Scheewe TW, Cahn W, Kahn RS, Hulshoff Pol HE. Physical Exercise Keeps the Brain Connected: Biking Increases White Matter Integrity in Patients With Schizophrenia and Healthy Controls. Schizophr Bull 2015; 41:869-78. [PMID: 25829377 PMCID: PMC4466190 DOI: 10.1093/schbul/sbv033] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
It has been shown that learning a new skill leads to structural changes in the brain. However, it is unclear whether it is the acquisition or continuous practicing of the skill that causes this effect and whether brain connectivity of patients with schizophrenia can benefit from such practice. We examined the effect of 6 months exercise on a stationary bicycle on the brain in patients with schizophrenia and healthy controls. Biking is an endemic skill in the Netherlands and thus offers an ideal situation to disentangle the effects of learning vs practice. The 33 participating patients with schizophrenia and 48 healthy individuals were assigned to either one of two conditions, ie, physical exercise or life-as-usual, balanced for diagnosis. Diffusion tensor imaging brain scans were made prior to and after intervention. We demonstrate that irrespective of diagnosis regular physical exercise of an overlearned skill, such as bicycling, significantly increases the integrity, especially of motor functioning related, white matter fiber tracts whereas life-as-usual leads to a decrease in fiber integrity. Our findings imply that exercise of an overlearned physical skill improves brain connectivity in patients and healthy individuals. This has important implications for understanding the effect of fitness programs on the brain in both healthy subjects and patients with schizophrenia. Moreover, the outcome may even apply to the nonphysical realm.
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Affiliation(s)
- Alena Svatkova
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands;,Multimodal and Functional Neuroimaging Research Group, Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
| | - René C.W. Mandl
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Thomas W. Scheewe
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Wiepke Cahn
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - René S. Kahn
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hilleke E. Hulshoff Pol
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands;,To whom correspondence should be addressed; Hilleke E. Hulshoff Pol, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; tel: 31-88-75-56019, fax: 31-88-75-554-43, e-mail:
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Loh SY, Abdullah A, Abu Bakar AK, Thambu M, Nik Jaafar NR. Structured Walking and Chronic Institutionalized Schizophrenia Inmates: A pilot RCT Study on Quality of Life. Glob J Health Sci 2015; 8:238-48. [PMID: 26234968 PMCID: PMC4804032 DOI: 10.5539/gjhs.v8n1p238] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 04/19/2015] [Accepted: 05/17/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Lifestyle moderate-intensity physical activity can lower the risk of over twenty chronic health conditions, whilst inactivity reduces daily functioning and physical health of individuals living with schizophrenia. This study conducted in 2014 examines the effect of structured walking participation on QOL, psychosocial functioning and symptoms in Hospital Permai, one of the largest psychiatry institution in Asia METHOD Chronic patients with schizophrenia (n=104) who met inclusion criteria were randomised to either a 3-month structured walking intervention or a treatment-as-usual arm. The Positive and Negative Syndrome Scale (PANSS), global functioning (PSP) and QOL (SF-36) were measured at baseline and after the 3-month interval. RESULTS At 3 month follow-up, there were significant within group differences in QOL (SF-36), psychiatric symptoms (PANSS), and personal and social performance (PSP). There were statistically significant increase in the median SF-36 scores, with increases shown in physical functioning (p<.001), physical role limitations (p<.05), social functioning (p<.01) in the intervention group compared to treatment-as-usual group. Statistically significant reduction of median PANSS score of the intervention group were noted in positive (p<0.001) and negative (p<0.01) symptom, and general psychopathology (p<0.01) scales. Statistically significant increase in the median PSP score (p<0.01) was found in the intervention group compared with the treatment-as-usual group. Between-group differences at post intervention (favouring Intervention) were significant for PANSS positive and SF36 Physical CONCLUSION In long stayed chronic inmates, a simple but consistent, organized walking intervention has the potential to bring improvement in functioning, reduction in psychiatric symptoms and quality of Life. The emphasis of rehabilitation should target at lifestyle redesign intervention.
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Stanton R, Happell B, Reaburn P. Investigating the exercise-prescription practices of nurses working in inpatient mental health settings. Int J Ment Health Nurs 2015; 24:112-20. [PMID: 25639383 DOI: 10.1111/inm.12125] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Nurses working in mental health are well positioned to prescribe exercise to people with mental illness. However, little is known regarding their exercise-prescription practices. We examined the self-reported physical activity and exercise-prescription practices of nurses working in inpatient mental health facilities. Thirty-four nurses completed the Exercise in Mental Illness Questionnaire - Health Practitioner Version. Non-parametric bivariate statistics revealed no relationship between nurses' self-reported physical activity participation and the frequency of exercise prescription for people with mental illness. Exercise-prescription parameters used by nurses are consistent with those recommended for both the general population and for people with mental illness. A substantial number of barriers to effective exercise prescription, including lack of training, systemic issues (such as prioritization and lack of time), and lack of consumer motivation, impact on the prescription of exercise for people with mental illness. Addressing the barriers to exercise prescription could improve the proportion of nurses who routinely prescribe exercise. Collaboration with exercise professionals, such as accredited exercise physiologists or physiotherapists, might improve knowledge of evidence-based exercise-prescription practices for people with mental illness, thereby improving both physical and mental health outcomes for this vulnerable population.
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Affiliation(s)
- Robert Stanton
- Central Queensland University, Institute for Health and Social Science Research, Centre for Mental Health Nursing Innovation, School of Nursing and Midwifery, Rockhampton, Queensland, Australia
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