Exercise to treat psychopathology and other clinical outcomes in schizophrenia: A systematic review and meta-analysis
Abstract Background Psychopathology and side effects of antipsychotic drugs contribute to worsening physical health and long-term disability, and increasing the risk of mortality in these patients. The efficacy of exercise on these factors is not fully understood, and this lack of knowledge may hamp...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2023-01-01
|
| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S092493382300024X/type/journal_article |
| _version_ | 1797803763428229120 |
|---|---|
| author | Daniel Gallardo-Gómez Michael Noetel Francisco Álvarez-Barbosa Rosa María Alfonso-Rosa Javier Ramos-Munell Borja del Pozo Cruz Jesús del Pozo-Cruz |
| author_facet | Daniel Gallardo-Gómez Michael Noetel Francisco Álvarez-Barbosa Rosa María Alfonso-Rosa Javier Ramos-Munell Borja del Pozo Cruz Jesús del Pozo-Cruz |
| author_sort | Daniel Gallardo-Gómez |
| collection | DOAJ |
| description | Abstract
Background
Psychopathology and side effects of antipsychotic drugs contribute to worsening physical health and long-term disability, and increasing the risk of mortality in these patients. The efficacy of exercise on these factors is not fully understood, and this lack of knowledge may hamper the routine application of physical activity as part of the clinical care of schizophrenia.
Aims
To determine the effect of exercise on psychopathology and other clinical markers in patients with schizophrenia. We also looked at several moderators.
Method
MEDLINE, Web of Science, Scopus, CINAHL, SPORTDiscus, PsycINFO, and Cochrane Library databases were systematically searched from inception to October 2022. Randomized controlled trials of exercise interventions in patients 18–65 years old diagnosed with schizophrenia disorder were included. A multilevel random-effects meta-analysis was conducted to pool the data. Heterogeneity at each level of the meta-analysis was estimated via Cochran’s Q, I2, and R2.
Results
Pooled effect estimates from 28 included studies (1,460 patients) showed that exercise is effective to improve schizophrenia psychopathology (Hedges’ g = 0.28, [95% CI 0.14, 0.42]). Exercise presented stronger effects in outpatients than inpatients. We also found exercise is effective to improve muscle strength and self-reported disability.
Conclusions
Our meta-analysis demonstrated that exercise could be an important part in the management and treatment of schizophrenia. Considering the current evidence, aerobic and high-intensity interval training exercises may provide superior benefits over other modalities. However, more studies are warranted to determine the optimal type and dose of exercise to improve clinical outcomes in people with schizophrenia.
|
| first_indexed | 2024-03-13T05:25:48Z |
| format | Article |
| id | doaj.art-e88f9222690643f9b3c738a569338cf7 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-13T05:25:48Z |
| publishDate | 2023-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-e88f9222690643f9b3c738a569338cf72023-06-15T06:24:00ZengCambridge University PressEuropean Psychiatry0924-93381778-35852023-01-016610.1192/j.eurpsy.2023.24Exercise to treat psychopathology and other clinical outcomes in schizophrenia: A systematic review and meta-analysisDaniel Gallardo-Gómez0https://orcid.org/0000-0002-3029-026XMichael Noetel1https://orcid.org/0000-0002-6563-8203Francisco Álvarez-Barbosa2https://orcid.org/0000-0001-9107-0618Rosa María Alfonso-Rosa3https://orcid.org/0000-0002-4447-0659Javier Ramos-Munell4https://orcid.org/0000-0002-2628-1184Borja del Pozo Cruz5Jesús del Pozo-Cruz6Physical Education and Sports Department, Faculty of Education, University of Seville, Seville, Spain Epidemiology of Physical Activity and Fitness Across the Lifespan (EPAFit) Research Group, Faculty of Education, University of Seville, Sevilla, SpainInstitute for Positive Psychology & Education, Australian Catholic University, Sydney, NSW, AustraliaPhysical Education and Sports Department, Faculty of Education, University of Seville, Seville, Spain Epidemiology of Physical Activity and Fitness Across the Lifespan (EPAFit) Research Group, Faculty of Education, University of Seville, Sevilla, SpainEpidemiology of Physical Activity and Fitness Across the Lifespan (EPAFit) Research Group, Faculty of Education, University of Seville, Sevilla, Spain Human Motricity and Sports Performance Department, University of Seville, Epidemiology of Physical Activity and Fitness Across the Lifespan Research Group (EPAFit), Seville, SpainPhysical Education and Sports Department, Faculty of Education, University of Seville, Seville, Spain Epidemiology of Physical Activity and Fitness Across the Lifespan (EPAFit) Research Group, Faculty of Education, University of Seville, Sevilla, SpainEpidemiology of Physical Activity and Fitness Across the Lifespan (EPAFit) Research Group, Faculty of Education, University of Seville, Sevilla, Spain Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, SpainPhysical Education and Sports Department, Faculty of Education, University of Seville, Seville, Spain Epidemiology of Physical Activity and Fitness Across the Lifespan (EPAFit) Research Group, Faculty of Education, University of Seville, Sevilla, SpainAbstract Background Psychopathology and side effects of antipsychotic drugs contribute to worsening physical health and long-term disability, and increasing the risk of mortality in these patients. The efficacy of exercise on these factors is not fully understood, and this lack of knowledge may hamper the routine application of physical activity as part of the clinical care of schizophrenia. Aims To determine the effect of exercise on psychopathology and other clinical markers in patients with schizophrenia. We also looked at several moderators. Method MEDLINE, Web of Science, Scopus, CINAHL, SPORTDiscus, PsycINFO, and Cochrane Library databases were systematically searched from inception to October 2022. Randomized controlled trials of exercise interventions in patients 18–65 years old diagnosed with schizophrenia disorder were included. A multilevel random-effects meta-analysis was conducted to pool the data. Heterogeneity at each level of the meta-analysis was estimated via Cochran’s Q, I2, and R2. Results Pooled effect estimates from 28 included studies (1,460 patients) showed that exercise is effective to improve schizophrenia psychopathology (Hedges’ g = 0.28, [95% CI 0.14, 0.42]). Exercise presented stronger effects in outpatients than inpatients. We also found exercise is effective to improve muscle strength and self-reported disability. Conclusions Our meta-analysis demonstrated that exercise could be an important part in the management and treatment of schizophrenia. Considering the current evidence, aerobic and high-intensity interval training exercises may provide superior benefits over other modalities. However, more studies are warranted to determine the optimal type and dose of exercise to improve clinical outcomes in people with schizophrenia. https://www.cambridge.org/core/product/identifier/S092493382300024X/type/journal_articleExercisemeta-analysispsychopathologyschizophrenia |
| spellingShingle | Daniel Gallardo-Gómez Michael Noetel Francisco Álvarez-Barbosa Rosa María Alfonso-Rosa Javier Ramos-Munell Borja del Pozo Cruz Jesús del Pozo-Cruz Exercise to treat psychopathology and other clinical outcomes in schizophrenia: A systematic review and meta-analysis European Psychiatry Exercise meta-analysis psychopathology schizophrenia |
| title | Exercise to treat psychopathology and other clinical outcomes in schizophrenia: A systematic review and meta-analysis |
| title_full | Exercise to treat psychopathology and other clinical outcomes in schizophrenia: A systematic review and meta-analysis |
| title_fullStr | Exercise to treat psychopathology and other clinical outcomes in schizophrenia: A systematic review and meta-analysis |
| title_full_unstemmed | Exercise to treat psychopathology and other clinical outcomes in schizophrenia: A systematic review and meta-analysis |
| title_short | Exercise to treat psychopathology and other clinical outcomes in schizophrenia: A systematic review and meta-analysis |
| title_sort | exercise to treat psychopathology and other clinical outcomes in schizophrenia a systematic review and meta analysis |
| topic | Exercise meta-analysis psychopathology schizophrenia |
| url | https://www.cambridge.org/core/product/identifier/S092493382300024X/type/journal_article |
| work_keys_str_mv | AT danielgallardogomez exercisetotreatpsychopathologyandotherclinicaloutcomesinschizophreniaasystematicreviewandmetaanalysis AT michaelnoetel exercisetotreatpsychopathologyandotherclinicaloutcomesinschizophreniaasystematicreviewandmetaanalysis AT franciscoalvarezbarbosa exercisetotreatpsychopathologyandotherclinicaloutcomesinschizophreniaasystematicreviewandmetaanalysis AT rosamariaalfonsorosa exercisetotreatpsychopathologyandotherclinicaloutcomesinschizophreniaasystematicreviewandmetaanalysis AT javierramosmunell exercisetotreatpsychopathologyandotherclinicaloutcomesinschizophreniaasystematicreviewandmetaanalysis AT borjadelpozocruz exercisetotreatpsychopathologyandotherclinicaloutcomesinschizophreniaasystematicreviewandmetaanalysis AT jesusdelpozocruz exercisetotreatpsychopathologyandotherclinicaloutcomesinschizophreniaasystematicreviewandmetaanalysis |