title: Exercise therapy for schizophrenia.
abstract: BACKGROUND
  The health benefits of physical activity and exercise are well documented and these effects could help people with schizophrenia.
  
  
  OBJECTIVE
  To determine the mental health effects of exercise/physical activity programmes for people with schizophrenia or schizophrenia-like illnesses.
  
  
  METHODS
  We searched the Cochrane Schizophrenia Group Trials Register (December 2008) which is based on regular searches of CINAHL, EMBASE, MEDLINE and PsycINFO. We also inspected references within relevant papers.
  
  
  METHODS
  We included all randomised controlled trials comparing any intervention where physical activity or exercise was considered to be the main or active ingredient with standard care or other treatments for people with schizophrenia or schizophrenia-like illnesses.
  
  
  METHODS
  We independently inspected citations and abstracts, ordered papers, quality assessed and data extracted. For binary outcomes we calculated a fixed-effect risk ratio (RR) and its 95% confidence interval (CI). Where possible, the weighted number needed to treat/harm statistic (NNT/H) and its 95% confidence interval (CI), was also calculated. For continuous outcomes, endpoint data were preferred to change data. We synthesised non-skewed data from valid scales using a weighted mean difference (WMD).
  
  
  RESULTS
  Three randomised controlled trials met the inclusion criteria. Trials assessed the effects of exercise on physical and mental health. Overall numbers leaving the trials were similar. Two trials (Beebe 2005 and Marzaloni 2008) compared exercise to standard care and both found exercise to significantly improve negative symptoms of mental state (Mental Health Inventory Depression: 1RCT, n=10, MD 17.50 CI 6.70 to 28.30, PANNS negative: 1RCT, n=10, MD -8.50 CI -11.11 to -5.89). 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 (1RCT, n=13, MD 79.50 CI 33.82 to 125.18), but no effect on peoples' weight/BMI was apparent. Duraiswamy 2007 compared exercise with yoga and found that yoga had a better outcome for mental state (PANNS total: 1RCT, n=41, MD 14.95 CI 2.60 to 27.30). The same trial also found those in the yoga group had significantly better quality of life scores (WHOQOL Physical: 1RCT, n=41, MD -9.22 CI -18.86 to 0.42). Adverse effects (AIMS total scores) were, however, similar.
  
  
  CONCLUSIONS
  Results of this Cochrane review are similar to existing reviews that have examined the health benefits of exercise in this population (Faulkner 2005). Although studies included in this review are small and used various measures of physical and mental health, results indicated that regular exercise programmes are possible in this population, and that they can have healthful effects on both the physical and mental health and well-being of individuals with schizophrenia. Larger randomised studies are required before any definitive conclusions can be drawn.
authors.affiliation: Faculty of Physical Education and Health, University of Toronto, 55 Harbord St, Toronto, Canada, On M5S 2W6.
authors.forename: Paul
authors.initials: P
authors.lastname: Gorczynski
authors.forename: Guy
authors.initials: G
authors.lastname: Faulkner
mesh_terms: D015444:Exercise / Q000523:psychology*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012559:Schizophrenia / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D015013:Yoga / Q000523:psychology
references.citation: JAMA. 2001 Apr 18;285(15):1987-91
references.pmid: 11308435
references.citation: Br J Med Psychol. 1978 Jun;51(2):155-9
references.pmid: 646961
references.citation: Acta Psychiatr Scand. 2007 Sep;116(3):226-32
references.pmid: 17655565
references.citation: Epidemiol Rev. 2008;30:67-76
references.pmid: 18480098
references.citation: Hosp Community Psychiatry. 1988 Nov;39(11):1172-7
references.pmid: 2906320
references.citation: Health Technol Assess. 1999;3(5):iii-92
references.pmid: 10982317
references.citation: Acta Psychiatr Scand Suppl. 1970;212:11-9
references.pmid: 4917967
references.citation: Schizophr Bull. 1987;13(2):261-76
references.pmid: 3616518
references.citation: Schizophr Res. 2005 Dec 1;80(1):45-53
references.pmid: 16198088
references.citation: BMJ. 1997 Sep 13;315(7109):629-34
references.pmid: 9310563
references.citation: Br J Psychiatry. 2000 Mar;176:249-52
references.pmid: 10755072
references.citation: Psychiatr Rehabil J. 2006 Spring;29(4):258-66
references.pmid: 16689036
references.citation: Am J Epidemiol. 1999 May 1;149(9):876-83
references.pmid: 10221325
references.citation: J Gen Intern Med. 1992 Nov-Dec;7(6):623-9
references.pmid: 1453246
references.citation: Am J Respir Crit Care Med. 1998 Nov;158(5 Pt 1):1384-7
references.pmid: 9817683
references.citation: Evid Based Nurs. 2001 Jan;4(1):4-6
references.pmid: 11707879
references.citation: Med J Aust. 2003 May 5;178(S9):S67-70
references.pmid: 12720526
references.citation: Therapie. 1999 Jul Aug;54(4):405-11
references.pmid: 10667106
references.citation: Aust N Z J Psychiatry. 2001 Apr;35(2):196-202
references.pmid: 11284901
references.citation: Stat Med. 2002 Oct 15;21(19):2971-80
references.pmid: 12325113
references.citation: J Clin Epidemiol. 2004 Jun;57(6):543-50
references.pmid: 15246122
references.citation: Br J Clin Psychol. 1986 May;25 ( Pt 2):125-33
references.pmid: 3730648
references.citation: BMJ. 1997 Sep 6;315(7108):600
references.pmid: 9302962
references.citation: JAMA. 2008 Jan 9;299(2):185-93
references.pmid: 18182600
references.citation: Br J Clin Psychol. 2007 Mar;46(Pt 1):95-111
references.pmid: 17472204
references.citation: BMJ. 2001 Jul 7;323(7303):42-6
references.pmid: 11440947
references.citation: Nervenarzt. 1991 May;62(5):283-7
references.pmid: 1865958
references.citation: Qual Life Res. 2004 Mar;13(2):299-310
references.pmid: 15085902
references.citation: J Clin Epidemiol. 1998 Nov;51(11):903-12
references.pmid: 9817107
references.citation: J Psychiatr Ment Health Nurs. 2008 Dec;15(10):808-15
references.pmid: 19012672
references.citation: Issues Ment Health Nurs. 2005 Jul;26(6):661-76
references.pmid: 16020076
references.citation: Schizophr Res. 2006 Jan 31;81(2-3):301-9
references.pmid: 16256309
references.citation: BMJ. 1996 Nov 9;313(7066):1200
references.pmid: 8916759
references.citation: Psychiatr Rehabil J. 2005 Fall;29(2):122-7
references.pmid: 16268007
references.citation: J Consult Clin Psychol. 1983 Oct;51(5):730-42
references.pmid: 6630688
references.citation: JAMA. 1996 Aug 28;276(8):637-9
references.pmid: 8773637
references.citation: Public Health Rep. 1985 Mar-Apr;100(2):126-31
references.pmid: 3920711
references.citation: Psychol Med. 1999 May;29(3):697-701
references.pmid: 10405091
references.citation: Psychiatr Serv. 2007 Apr;58(4):544-50
references.pmid: 17412858
references.citation: Curr Opin Psychiatry. 2008 Jul;21(4):398-402
references.pmid: 18520746
references.citation: BMJ. 2003 Sep 6;327(7414):557-60
references.pmid: 12958120