Exercise can improve clinical outcomes in people with severe mental illness (SMI).
However, this population typically engages in low levels of physical activity with poor
adherence to exercise interventions. Understanding the motivating factors and barriers
towards exercise for people with SMI would help to maximize exercise participation. A
search of major electronic databases was conducted from inception until May 2016.
Quantitative studies providing proportional data on the motivating factors and/or barriers
towards exercise among patients with SMI were eligible. Random-effects meta-analyses were
undertaken to calculate proportional data and 95% confidence intervals (CI) for motivating
factors and barriers toward exercise. From 1468 studies, 12 independent studies of 6431
psychiatric patients were eligible for inclusion. Meta-analyses showed that 91% of people
with SMI endorsed ‘improving health’ as a reason for exercise (N = 6,
n = 790, 95% CI 80–94). Among specific aspects of health and
well-being, the most common motivations were ‘losing weight’ (83% of patients), ‘improving
mood’ (81%) and ‘reducing stress’ (78%). However, low mood and stress were also identified
as the most prevalent barriers towards exercise (61% of patients), followed by ‘lack of
support’ (50%). Many of the desirable outcomes of exercise for people with SMI, such as
mood improvement, stress reduction and increased energy, are inversely related to the
barriers of depression, stress and fatigue which frequently restrict their participation
in exercise. Providing patients with professional support to identify and achieve their
exercise goals may enable them to overcome psychological barriers, and maintain motivation
towards regular physical activity.