Key result
Exercise therapy significantly increased peak work rate (P<0.001) and relative oxygen uptake in patients with schizophrenia and healthy controls compared to nonexercising groups.
Why the study?
Does exercise therapy improve cardiorespiratory fitness in patients with schizophrenia compared to occupational therapy?
RCT (n=118)
randomized
Does exercise therapy improve cardiorespiratory fitness in patients with schizophrenia compared to occupational therapy?
Exercise therapy effectively improves cardiorespiratory fitness (VO2peak and peak work rate) in patients with schizophrenia, potentially mitigating their elevated risk of coronary heart disease mortality.
Supports integrating exercise therapy into schizophrenia care; extends RCT evidence to a high CHD-mortality population.
BACKGROUND: Increased mortality in schizophrenia is caused largely by coronary heart disease (CHD). Low cardiorespiratory fitness (CRF) is a key factor for CHD mortality. We compared CRF in patients with schizophrenia to CRF of matched healthy controls and reference values. Also, we examined the effects of exercise therapy on CRF in patients with schizophrenia and in controls. METHODS: Sixty-three patients with schizophrenia and 55 controls, matched for gender, age, and socioeconomic status, were randomized to exercise (n = 31) or occupational therapy (n = 32) and controls to exercise (n = 27) or life as usual (n = 28). CRF was assessed with an incremental cardiopulmonary exercise test and defined as the highest relative oxygen uptake (VO(2peak)) and peak work rate (W(peak)). Minimal compliance was 50% of sessions (n = 52). RESULTS: Male and female patients with schizophrenia had a relative VO(2peak) of 34.3 ± 9.9 and 24.0 ± 4.5 mL.kg(-1).min(-1), respectively. Patients had higher resting HR (P < 0.01) and lower peak HR (P < 0.001), peak systolic blood pressure (P = 0.02), relative VO(2peak) (P < 0.01), W(peak) (P < 0.001), RER (P < 0.001), minute ventilation (P = 0.02), and HR recovery (P < 0.001) than controls. Relative VO(2peak) was 90.5% ± 19.7% (P < 0.01) of predicted relative VO(2peak) in male and 95.9% ± 14.9% (P = 0.18) in female patients. In patients, exercise therapy increased relative VO(2peak) compared with decreased relative VO(2peak) after occupational therapy. In controls, relative VO(2peak) increased after exercise therapy and to a lesser extent after life as usual (group, P < 0.01; randomization, P = 0.03). Exercise therapy increased W(peak) in patients and controls compared with decreased W(peak) in nonexercising patients and controls (P < 0.001). CONCLUSION: Patients had lower CRF levels compared with controls and reference values. Exercise therapy increased VO(2peak) and W(peak) in patients and controls. VO(2peak) and W(peak) decreased in nonexercising patients.
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Scheewe et al. (2012) conducted an RCT in Schizophrenia (n=118). Exercise therapy vs. Occupational therapy or life as usual was evaluated on Cardiorespiratory fitness (highest relative oxygen uptake [VO2peak] and peak work rate [Wpeak]) (p=<0.001). Exercise therapy significantly increased peak work rate (P<0.001) and relative oxygen uptake in patients with schizophrenia and healthy controls compared to nonexercising groups.
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