title: Hiking in suicidal patients: neutral effects on markers of suicidality.
abstract: BACKGROUND
  Regular physical activity promotes physical and mental health. Psychiatric patients are prone to a sedentary lifestyle, and accumulating evidence has identified physical activity as a supplemental treatment option.
  
  
  METHODS
  This prospective, randomized, crossover study evaluated the effects of hiking in high-risk suicidal patients (n = 20) who performed 9 weeks of hiking (2-3 hikes/week, 2-2.5 hours each) and a 9-week control period.
  
  
  RESULTS
  All patients participated in the required 2 hikes per week and thus showed a compliance of 100%. Regular hiking led to significant improvement in maximal exercise capacity (hiking period Δ: +18.82 ± 0.99 watt, P < .001; control period: P = .134) and in aerobic capability at 70% of the individual heart rate reserve (hiking period Δ: +8.47 ± 2.22 watt; P = .010; control period: P = .183). Cytokines, associated previously with suicidality (tumor necrosis factor-α, interleukin-6, S100), remained essentially unchanged.
  
  
  CONCLUSIONS
  Hiking is an effective and safe form of exercise training even in high-risk suicidal patients. It leads to a significant improvement in maximal exercise capacity and aerobic capability without concomitant deterioration of markers of suicidality. Offering this popular mode of exercise to these patients might help them to adopt a physically more active lifestyle.
authors: Department of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Institute of Sports Medicine of the State of Salzburg, Sports Medicine of the Olympic Center Salzburg-Rif, Salzburg, Austria.
authors: Daniel
authors: D
authors: Neunhäuserer
authors: Josef
authors: J
authors: Sturm
authors: Mira M
authors: MM
authors: Baumgartlinger
authors: David
authors: D
authors: Niederseer
authors: Eveline
authors: E
authors: Ledl-Kurkowski
authors: Eva
authors: E
authors: Steidle
authors: Martin
authors: M
authors: Plöderl
authors: Clemens
authors: C
authors: Fartacek
authors: Karl
authors: K
authors: Kralovec
authors: Reinhold
authors: R
authors: Fartacek
authors: Josef
authors: J
authors: Niebauer
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D016207:Cytokines / Q000032:analysis*; D015444:Exercise / Q000502:physiology / Q000523:psychology*; D005081:Exercise Therapy / Q000379:methods* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology*; D010807:Physical Endurance / Q000502:physiology; D011446:Prospective Studies; D059020:Suicidal Ideation; D016138:Walking / Q000502:physiology / Q000523:psychology*
chemical_list: D016207:Cytokines
keywords: Depression; Endurance training; Hiking; Hopelessness; Physical exercise training; Suicide prevention