title: A randomized controlled trial on the psychophysiological effects of physical exercise and Tai-chi in patients with chronic schizophrenia.
abstract: The chronic and prevalent natures of schizophrenia result in long-term institutionalization for the patients. Conventional treatment of anti-psychotic medication on management of psychotic symptoms often brings on severe side effects and reduces patients' well-being. Tai-chi is a mind-body exercise that underscores motor coordination and relaxation. This 3-arm randomized controlled trial investigated the psychophysiological benefits of Tai-chi on 153 chronic schizophrenia patients, who were recruited from a mental health rehab complex and randomized into Tai-chi, exercise, or waitlist control groups. Both intervention groups received 12weeks of specific intervention plus standard medication received by the controls. All participants completed psychiatric interviews, self-report questionnaires, performance tasks, and salivary cortisol measures at baseline, 3-month, and 6-month follow-up on psychotic symptoms, motor coordination, memory, daily living function, and stress. Multigroup latent growth modeling was used to evaluate the intervention effects on the outcomes. Compared to controls, the Tai-chi group showed significant decreases in motor deficits and increases in backward digit span and mean cortisol, while the exercise group displayed significant decreases in motor deficits, negative and depression symptoms and increases in forward digit span, daily living function, and mean cortisol. The two interventions did not show significantly different therapeutic effects, except for fewer symptom manifestations in the exercise group. These results suggest psychophysiological benefits for Tai-chi on chronic schizophrenia patients in terms of motor coordination and memory. Though both Tai-chi and exercise groups tended to manifest fewer symptoms than the control group, the exercise group showed better symptoms management than the Tai-chi group.
authors.affiliation: Centre on Behavioral Health, The University of Hong Kong, 2/F, The HKJC Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong; Dept of Social Work & Social Administration, Jockey Club Tower, The Centennial Campus, The University of Hong Kong, Hong Kong. Electronic address: tinho@hku.hk.
authors.forename: Rainbow T H
authors.initials: RT
authors.lastname: Ho
authors.affiliation: Centre on Behavioral Health, The University of Hong Kong, 2/F, The HKJC Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong.
authors.forename: Ted C T
authors.initials: TC
authors.lastname: Fong
authors.affiliation: Centre on Behavioral Health, The University of Hong Kong, 2/F, The HKJC Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong.
authors.forename: Adrian H Y
authors.initials: AH
authors.lastname: Wan
authors.affiliation: The Providence Garden for Rehab, Hong Kong Sheng Kung Hui Welfare Council Limited, No. 82, Tsun Wen Road, Tuen Mun, New Territories, Hong Kong.
authors.forename: Friendly S W
authors.initials: FS
authors.lastname: Au-Yeung
authors.affiliation: The Providence Garden for Rehab, Hong Kong Sheng Kung Hui Welfare Council Limited, No. 82, Tsun Wen Road, Tuen Mun, New Territories, Hong Kong.
authors.forename: Cathy P K
authors.initials: CP
authors.lastname: Wong
authors.affiliation: The Providence Garden for Rehab, Hong Kong Sheng Kung Hui Welfare Council Limited, No. 82, Tsun Wen Road, Tuen Mun, New Territories, Hong Kong.
authors.forename: Winnie Y H
authors.initials: WY
authors.lastname: Ng
authors.affiliation: Centre on Behavioral Health, The University of Hong Kong, 2/F, The HKJC Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong.
authors.forename: Irene K M
authors.initials: IK
authors.lastname: Cheung
authors.affiliation: Centre on Behavioral Health, The University of Hong Kong, 2/F, The HKJC Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong.
authors.forename: Phyllis H Y
authors.initials: PH
authors.lastname: Lo
authors.affiliation: Dept of Social Work & Social Administration, Jockey Club Tower, The Centennial Campus, The University of Hong Kong, Hong Kong.
authors.forename: S M
authors.initials: SM
authors.lastname: Ng
authors.affiliation: Dept of Social Work & Social Administration, Jockey Club Tower, The Centennial Campus, The University of Hong Kong, Hong Kong.
authors.forename: Cecilia L W
authors.initials: CL
authors.lastname: Chan
authors.affiliation: Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong.
authors.forename: Eric Y H
authors.initials: EY
authors.lastname: Chen
mesh_terms: D000328:Adult; D002908:Chronic Disease; D015444:Exercise / Q000502:physiology; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000503:physiopathology* / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D011795:Surveys and Questionnaires; D026302:Tai Ji / Q000379:methods*; D013997:Time Factors
keywords: Chronic schizophrenia; Physical exercise; Psychotic symptoms; Randomized controlled trial; Salivary cortisol; Tai-chi