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Effects of exercise therapy on cardiorespiratory fitness in schizophrenia patients
Scheewe TW, Takken T, Kahn RS, Cahn W, Backx FJG
Medicine and Science in Sports and Exercise 2012 Oct;44(10):1834-1842
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Increased mortality in schizophrenia is caused largely by coronary heart disease. Low cardiorespiratory fitness (CRF) is a key factor for coronary heart disease mortality. We compared CRF in patients with schizophrenia to CRF of matched, healthy controls and reference values. Also, we examined the effects of exercise therapy on CRF in schizophrenia patients and controls. METHODS: Sixty-three schizophrenia patients and 55 controls, matched for gender, age, and socioeconomic status, were randomized to exercise (n = 31) or occupational therapy (n = 32) and controls to exercise (n = 27) or life-as-usual (n = 28). CRF was assessed with an incremental cardiopulmonary exercise test and defined as the highest relative oxygen uptake (VO2peak) and peak work rate (Wpeak). Minimal compliance was 50% of sessions (n = 52). RESULTS: Male and female schizophrenia patients had a relative VO2peak of 34.3 (+/- 9.9) ml/kg/min and 24.0 (+/- 4.5) ml/kg/min, respectively. Patients had higher resting heart rate (p < 0.01) and lower peak heart rate (p < 0.001), peak systolic blood pressure (p = 0.02), relative VO2peak (p < 0.01), Wpeak (p < 0.001), respiratory exchange rate (p < 0.001), minute ventilation (p = 0.02), and heart rate recovery (p < 0.001) than controls. Relative VO2peak was 90.5 +/- 19.7% (p < 0.01) of predicted relative VO2peak in male and 95.9 +/- 14.9% (p = 0.18) in female patients. In patients, exercise therapy increased relative VO2peak compared to decreased relative VO2peak after occupational therapy. In controls, relative VO2peak increased after exercise therapy and to a lesser extend after life-as-usual (group p < 0.01; randomization p = 0.03). Exercise therapy increased Wpeak in patients and controls compared to decreased Wpeak in nonexercising patients and controls (p < 0.001). CONCLUSION: Patients had lower CRF-levels compared to controls and reference values. Exercise therapy increased VO2peak and Wpeak in patients and controls. VO2peak and Wpeak decreased in non-exercising patients.

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