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Physical Exercise In Schizophrenia

*Tanjung Ayu Sumekar orcid scopus  -  Department of Psychiatry, Faculty of Medicine Universitas Diponegoro, Jl. Prof. Sudarto, SH, Tembalang, Semarang, Indonesia 50275, Indonesia
Hang Gunawan Asikin  -  Department of Psychiatry, Faculty of Medicine, Diponegoro University, Semarang, Indonesia, Indonesia
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Abstract

Background: Schizophrenia is a mental disorder characterized by positive and negative symptoms, with antipsychotics effectively addressing the former but less so the latter. Recent studies suggest that physical exercise may help alleviate negative and cognitive symptoms, though its role is not well established.

Objective: This review examines the role of physical exercise as a complementary intervention in the psychosocial rehabilitation of individuals with schizophrenia.

Methods: A narrative literature review was conducted, focusing on research exploring the effects of various exercise types on psychiatric symptoms, cognitive function, and physical health in individuals with schizophrenia.

Results: Physical exercise was found to improve cognitive function, reduce negative symptoms, and mitigate the metabolic side effects of antipsychotic medications. Neurobiological changes, such as increased neurogenesis and synaptic plasticity, were also observed, contributing to better mental health and quality of life. Aerobic and anaerobic exercises were particularly effective in reducing psychiatric symptoms and enhancing social integration.

Conclusion: Physical exercise offers significant benefits in schizophrenia care and should be integrated into multidisciplinary treatment strategies. Future research should focus on optimizing exercise protocols and assessing their long-term clinical impact.

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Keywords: Cognitive function; Mental health; Physical exercise; Psychosocial rehabilitation; Schizophrenia

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  1. Timmermans H. Grand Challenges in Global Mental Health. Nature. 2011 Jul;475:27–30. https://doi.org/10.1371/journal.pmed.1000=1434
  2. Woo TUW. Neurobiology of schizophrenia onset. Curr Top Behav Neurosci. 2014;16:267–95. https://doi.org/10.1007/7854_2013_243
  3. Howes OD, Kambeitz J, Kim E, Stahl D, Slifstein M, Abi-Dargham A, et al. The nature of dopamine dysfunction in schizophrenia and what this means for treatment: Meta-analysisof imaging studies. Arch Gen Psychiatry. 2012 Aug;69(8):776–86. https://doi.org/10.1001/ archgenpsychiatry.2012.169
  4. World Association for Psychosocial Rehabilitation. Psychosocial Rehabilitation:A Consensus Statement. In Geneva: World Association for Psychosocial Rehabilitation; 1996
  5. Lindamer LA, McKibbin C, Norman GJ, Jordan L, Harrison K, Abeyesinhe S, et al. Assessment of physical activity in middle-aged and older adults with schizophrenia. Schizophr Res. 2008 Sep;104(1–3):294–301. https://doi.org/10.1016 /j.schres.2008.04.040
  6. Vancampfort D, Knapen J, Probst M, Scheewe T, Remans S, De Hert M. A systematic review of correlates of physical activity in patients with schizophrenia. Vol. 125, Acta Psychiatrica Scandinavica. 2012. p. 352–62. https://doi.org/10.1111/j.1600-0447.2011.01814.x
  7. Vancampfort D, Probst M, Scheewe T, Knapen J, De Herdt A, De Hert M. The functional exercise capacity is correlated with global functioning in patients with schizophrenia. Acta Psychiatr Scand. 2012 May;125(5):382–7. https://doi.org/10.1111/j.1600-0447.2011.01825.x
  8. Pajonk FG, Wobrock T, Gruber ; Oliver, Scherk H, Berner D, Kaizl I, et al. Hippocampal Plasticity in Response to Exercise in Schizophrenia. Arch Gen Psychiatry. 2010;67(2):133–43. https://doi.org/10.1001/archgenpsychiatry.2009.193
  9. R Dwi Safra Yuli, Jumaini, Yesi Hasneli. Efektifitas Senam Aerobic Low Impact terhadap Penurunan Skor Halusinasi. JOM. 2015 Oct;2(2):97–110
  10. Dauwan M, Begemann MJH, Heringa SM, Sommer IE. Exercise improves clinical symptoms, quality of life, global functioning, and depression in schizophrenia: A systematic review and meta-analysis. Schizophr Bull. 2016 May 1;42(3):588–99. https://doi.org/10.1093/schbul/sbv164
  11. Linda S. Pescatello, Ross Arena, Deborah Riebe, Paul D. Thompson. ACSM’s Guidelines for Exercise Testing and Prescription. 9th ed. Philadelphia, PA: Victory Belt Publishing Inc.; 2014. 400 p
  12. Stubbs B, Chen LJ, Chung MS, Ku PW. Physical activity ameliorates the association between sedentary behavior and cardiometabolic risk among inpatients with schizophrenia: A comparison versus controls using accelerometry. Compr Psychiatry. 2017 Apr 1;74:144–50. https://doi.org/10.1016/j.comppsych.2017.01.010
  13. Scheewe TW, Backx FJG, Takken T, Jörg F, van Strater ACP, Kroes AG, et al. Exercise therapy improves mental and physical health in schizophrenia: A randomised controlled trial. Acta Psychiatr Scand. 2013 Jun;127(6):464–73. https://doi.org/10.1111/acps.12029
  14. Kim TW, Ji ES, Kim TW, Lee SW, Lee CY, Lee SJ. Postnatal treadmill exercise attenuates prenatal stress-induced apoptosis through enhancing serotonin expression in aged-offspring rats. J Exerc Rehabil. 2015 Feb 28;11(1):12–9. https://doi.org/10.12965/jer.150180
  15. Oertel-Knöchel V, Mehler P, Thiel C, Steinbrecher K, Malchow B, Tesky V, et al. Effects of aerobic exercise on cognitive performance and individual psychopathology in depressive and schizophrenia patients. Eur Arch Psychiatry Clin Neurosci. 2014 Oct 1;264(7):589–604. https://doi.org/10.1007/s00406-014-0485-9
  16. Vancampfort D, Probst M, Scheewe T, De Herdt A, Sweers K, Knapen J, et al. Relationships between physical fitness, physical activity, smoking and metabolic and mental health parameters in people with schizophrenia. Psychiatry Res. 2013 May 15;207(1–2):25–32. https://doi.org/10.1016/j.psychres.2012.09.026
  17. Gorczynski P, Faulkner G. Exercise therapy for schizophrenia. Cochrane Database of Systematic Reviews. 2010 May 12. https://doi.org/10.1002/14651858.CD004412.pub2
  18. Vancampfort D, Probst M, Helvik Skjaerven L, Catalán-Matamoros D, Lundvik-Gyllensten A, Gó mez-Conesa A, et al. Systematic Review of the Benefits of Physical Therapy Within a Multidisciplinary Care Approach for People With Schizophrenia [Internet]. 2012. Available from: https://academic.oup.com/ptj/article/92/1/11/2735106
  19. Falkai P, Malchow B, Schmitt A. Aerobic exercise and its effects on cognition in schizophrenia. Vol. 30, Current Opinion in Psychiatry. Lippincott Williams and Wilkins; 2017. p. 171–5. https://doi.org/10.1097/YCO.0000000000000326
  20. Vancampfort D, Probst M, De Hert M, Soundy A, Stubbs B, Stroobants M, et al. Neurobiological effects of physical exercise in schizophrenia: A systematic review. Vol. 36, Disability and Rehabilitation. Informa Healthcare; 2014. p. 1749–54. https://doi.org/10.3109/09638288.2013.874505
  21. van Praag H. Exercise and the brain: something to chew on. Vol. 32, Trends in Neurosciences. 2009. p. 283–90. https://doi.org/10.1016/j.tins.2008.12.007
  22. Kimhy D, Vakhrusheva J, Bartels MN, Armstrong HF, Ballon JS, Khan S, et al. The impact of aerobic exercise on brain-derived neurotrophic factor and neurocognition in individuals with schizophrenia: A single-blind, randomized clinical trial. Schizophr Bull. 2015 Jul 1;41(4):859–68. https://doi.org/10.1093/schbul/sbv022
  23. Rosenbaum S, Tiedemann A, Sherrington C, Curtis J, Ward PB. Physical activity interventions for people with mental illness: A systematic review and meta-analysis. J Sci Med Sport. 2014 Dec;18:e150. https://doi.org/10.4088/JCP.13r08765
  24. Yau SY, Li A, Sun X, Fontaine CJ, Christie BR, So KF. Potential Biomarkers for Physical Exercise-Induced Brain Health. In: Role of Biomarkers in Medicine. InTech; 2016. https://doi.org/10.5772/62458
  25. May A, Hajak G, Gänßbauer S, Steffens T, Langguth B, Kleinjung T, et al. Structural brain alterations following 5 days of intervention: Dynamic aspects of neuroplasticity. Cerebral Cortex. 2007 Jan;17(1):205–10. https://doi.org/10.1093/cercor/bhj138
  26. Holmen TL, Egeland J, Andersen E, Mordal J, Andreassen OA, Ueland T, et al. The Association Between Cardiorespiratory Fitness and Cognition Appears Neither Related to Current Physical Activity Nor Mediated by Brain-Derived Neurotrophic Factor in a Sample of Outpatients With Schizophrenia. Front Psychiatry. 2019 Oct 25;10. https://doi.org/10.3389/fpsyt.2019.00785
  27. Abdel-Baki A, Brazzini-Poisson V, Marois F, Letendre É, Karelis AD. Effects of aerobic interval training on metabolic complications and cardiorespiratory fitness in young adults with psychotic disorders: A pilot study. Schizophr Res. 2013 Sep;149(1–3):112–5. https://doi.org/10.1016/j.schres.2013.06.040
  28. Kang R, Wu Y, Li Z, Jiang J, Gao Q, Yu Y, et al. Effect of community-based social skills training and tai-chi exercise on outcomes in patients with chronic schizophrenia: A randomized, one-year study. Psychopathology. 2016 Nov 1;49(5):345–55. https://doi.org/10.1159/000448195
  29. Behere R V., Arasappa R, Jagannathan A, Varambally S, Venkatasubramanian G, Thirthalli J, et al. Effect of yoga therapy on facial emotion recognition deficits, symptoms and functioning in patients with schizophrenia. Acta Psychiatr Scand. 2011 Feb;123(2):147–53. https://doi.org/10.1111/j.1600-0447.2010.01605.x
  30. Marzolini S, Jensen B, Melville P. Feasibility and effects of a group-based resistance and aerobic exercise program for individuals with severe schizophrenia: A multidisciplinary approach. Ment Health Phys Act. 2009 Jun;2(1):29–36. https://doi.org/10.1016/j.mhpa/2008.11.001
  31. Vancampfort D, De Hert M, Knapen J, Maurissen K, Raepsaet J, Deckx S, et al. Effects of progressive muscle relaxation on state anxiety and subjective well-being in people with schizophrenia: A randomized controlled trial. Clin Rehabil. 2011 Jun;25(6):567–75. https://doi.org/10.1177/0269215510395633
  32. Vancampfort D, De Hert M, Knapen J, Wampers M, Demunter H, Deckx S, et al. State anxiety, psychological stress and positive well-being responses to yoga and aerobic exercise in people with schizophrenia: A pilot study. Disabil Rehabil. 2011;33(8):684–9. https://doi.org/10.3109/09638288.2010.509458
  33. Chen WC, Chu H, Lu RB, Chou YH, Chen CH, Chang YC, et al. Efficacy of progressive muscle relaxation training in reducing anxiety in patients with acute schizophrenia. J Clin Nurs. 2009 Aug;18(15):2187–96. https://doi.org/10.1111/j.1365-2702.2008.02773.x
  34. Duraiswamy G, Thirthalli J, Nagendra HR, Gangadhar BN. Yoga therapy as an add-on treatment in the management of patients with schizophrenia - A randomized controlled trial. Acta Psychiatr Scand. 2007 Sep;116(3):226–32. https://doi.org/10.1111/j.1600-0447.2007.01032.x
  35. Dogan O, Hastanesi CU, Abd P. The effects of physical exercises to mental state and quality of life in patients with schizophrenia. Vol. 15, Journal of Psychiatric and Mental Health Nursing. 2008. https://doi.org/10.1111/j.1365-2850.2008.01317
  36. Bogart LM, Cowgill BO, Elliott MN, Klein DJ, Hawes-Dawson J, Uyeda K, et al. A Randomized Controlled Trial of Students for Nutrition and Exercise: A Community-based Participatory Research Study. Journal of Adolescent Health. 2014;55(3):415–22. https://doi.org/10.1016/j.jadohealth.2014.03.003

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