title: Effects of Endurance Training Combined With Cognitive Remediation on Everyday Functioning, Symptoms, and Cognition in Multiepisode Schizophrenia Patients.
abstract: Aerobic exercise has been shown to improve symptoms in multiepisode schizophrenia, including cognitive impairments, but results are inconsistent. Therefore, we evaluated the effects of an enriched environment paradigm consisting of bicycle ergometer training and add-on computer-assisted cognitive remediation (CACR) training. To our knowledge, this is the first study to evaluate such an enriched environment paradigm in multiepisode schizophrenia. Twenty-two multiepisode schizophrenia patients and 22 age- and gender-matched healthy controls underwent 3 months of endurance training (30min, 3 times/wk); CACR training (30min, 2 times/wk) was added from week 6. Twenty-one additionally recruited schizophrenia patients played table soccer (known as "foosball" in the United States) over the same period and also received the same CACR training. At baseline and after 6 weeks and 3 months, we measured the Global Assessment of Functioning (GAF), Social Adjustment Scale-II (SAS-II), schizophrenia symptoms (Positive and Negative Syndrome Scale), and cognitive domains (Verbal Learning Memory Test [VLMT], Wisconsin Card Sorting Test [WCST], and Trail Making Test). After 3 months, we observed a significant improvement in GAF and in SAS-II social/leisure activities and household functioning adaptation in the endurance training augmented with cognitive remediation, but not in the table soccer augmented with cognitive remediation group. The severity of negative symptoms and performance in the VLMT and WCST improved significantly in the schizophrenia endurance training augmented with cognitive remediation group from week 6 to the end of the 3-month training period. Future studies should investigate longer intervention periods to show whether endurance training induces stable improvements in everyday functioning.
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany; berend.malchow@med.uni-muenchen.de.
authors.forename: Berend
authors.initials: B
authors.lastname: Malchow
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany; Department of Sports Medicine, University Medical Center Goettingen, Goettingen, Germany;
authors.forename: Katriona
authors.initials: K
authors.lastname: Keller
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany;
authors.forename: Alkomiet
authors.initials: A
authors.lastname: Hasan
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany;
authors.forename: Sebastian
authors.initials: S
authors.lastname: Dörfler
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany;
authors.forename: Thomas
authors.initials: T
authors.lastname: Schneider-Axmann
authors.affiliation: Department of Sports Medicine, University Medical Center Goettingen, Goettingen, Germany;
authors.forename: Ursula
authors.initials: U
authors.lastname: Hillmer-Vogel
authors.affiliation: Institute of Mental Health, University of British Columbia, Vancouver, British Columbia, Canada;
authors.forename: William G
authors.initials: WG
authors.lastname: Honer
authors.affiliation: Institute of Psychiatric Phenomics and Genomics, Ludwig Maximilian University, Munich, Germany;
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Schulze
authors.affiliation: Department of Sports Medicine, University Medical Center Goettingen, Goettingen, Germany;
authors.forename: Andree
authors.initials: A
authors.lastname: Niklas
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany; Center of Mental Health, County Hospitals Darmstadt-Dieburg, Groß-Umstadt, Germany;
authors.forename: Thomas
authors.initials: T
authors.lastname: Wobrock
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany; Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Andrea
authors.initials: A
authors.lastname: Schmitt
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany;
authors.forename: Peter
authors.initials: P
authors.lastname: Falkai
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000209:etiology / Q000534:rehabilitation*; D015444:Exercise / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care; D010807:Physical Endurance / Q000502:physiology; D011214:Practice, Psychological; D012559:Schizophrenia / Q000150:complications / Q000628:therapy*
keywords: aerobic exercise; cognitive remediation; endurance training; everyday functioning; schizophrenia