Effects of a Long-Term Exercise Training Program on the Functional Capacity and Health-Related Quality of Life in Inpatients with Psychotic Disorders: A Randomized Controlled Trial

Background: This randomized controlled trial aimed to assess the effects of a yearly Multi-Component Exercise Training (MCET) program performed within the hospital setting on the functional capacity and Health-Related Quality of Life (HRQoL) of inpatients with psychotic disorders. Methods: Forty-eight inpatients of a public Psychiatric Hospital with a diagnosis of psychosis participated in the study and were randomly assigned to two groups: (i) the intervention group (mean age: 46.6 ± 13.2) and (ii) the control group (mean age: 47.7 ± 8.9). The MCET program consisted of moderate-intensity aerobic exercise (AE), Pilates exercises, and strengthening, balance, corrective and flexibility exercises, using rubber bands, mobility sticks and balls. Sessions were implemented three times per week over a 12-month period and each group session lasted for 30–45 min. The primary outcomes of the study included functional capacity and HRQoL. Functional capacity was assessed through measurements of strength (using handgrip and leg dynamometer), balance, and body positioning, while HRQoL was evaluated using the 36-Item Short Form Health Survey (SF-36). Results: At the end of the treatment, participants in the intervention group demonstrated significantly increased lower and upper extremity muscle strength by 35.9% (p < 0.01) and 23.6% (p < 0.01), respectively, improved balance by 18.1% (p < 0.001), and enhanced sit-and-reach and sit-to-stand results by 47.6% (p < 0.001) and 18.2% (p < 0.001), respectively, as well as increased distance covered at 6MWT by 26.2% (p < 0.001). Regarding the HRQoL, all the parameters of the SF-36 were improved, including general and mental health (p < 0.05), physical (p < 0.001) and social function (p < 0.05), physical (p < 0.01) and emotional roles (p < 0.01) and vitality and bodily pain (p < 0.001 and p < 0.05, respectively). The Physical Component Summary score (PCS) was enhanced significantly (p < 0.001), while the Mental Component Summary score (MCS) remained unchanged. Compliance with the 1-year ET program was 80%. Conclusions: The findings of the study indicated that a 1-year moderate-intensity MCET performed three times per week was safe, well accepted and efficient in improving physical functioning and HRQoL among inpatients with psychotic disorders. These results suggest that structured exercise interventions could be prescribed as add-ons to the pharmacological treatment for psychotic disorders.