Exercise Therapy for Schizophrenia

Regular exercise as adjunctive therapy might possibly improve the physical and mental health and well-being of the patients with schizophrenia, although the evidence is insufficient. Level of evidence: "D"

A Cochrane review [Abstract] 1 included 3 RCTs with 86 patients with schizophrenia. All trials last between 12 and 16 weeks, the experimental conditions identified in each of the included studies differed in exercise duration and intensity. Two trials compared exercise to standard care and both found exercise to significantly improve negative symptoms of mental state (Mental Health Inventory Depression: MD 17.50, CI 6.70 to 28.30, PANSS negative: MD -8.50, CI -11.11 to -5.89; 1 RCT, n=10). No absolute effects were found for positive symptoms of mental state. Physical health improved significantly in the exercise group compared to those in standard care (MD 79.50, CI 33.82 to 125.18; 1 RCT, n=13), but no effect on peoples' weight/BMI was apparent. One trial compared exercise with yoga and found that yoga had a better outcome for mental state (PANSS total: MD 14.95, CI 2.60 to 27.30; 1 RCT, n=41). The same trial also found those in the yoga group had significantly better quality of life scores (WHOQOL Physical: MD -9.22, CI -18.86 to 0.42; 1 RCT, n=41). Adverse effects (AIMS total scores) were, however, similar.

Comment: The quality of evidence is downgraded by study quality (inadequate allocation concealment, short-term follow-up), inconsistency (heterogeneity in treatments) and imprecise results (few patients and wide confidence intervals).