Effectiveness of high-intensity interval training on the mental and physical health of people with chronic schizophrenia

Wu, Meng Hsiu; Lee, Chin-Pang; Hsu, Shih Chieh; Chang, Chia Ming; Chen, Ching Yen

doi:10.2147/ndt.s81482

Cited by 52 publications

(39 citation statements)

References 34 publications

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“…diet, interpersonal encounter, environmental change) factors, which may, when taken together, help to explain the significant placebo rate in antipsychotic drug trials [1]. Exercise is one factor that has been shown to temporarily enhance treatment effects in schizophrenia [2][3][4][5][6][7][8]. Whether side effects are enhanced or dampened after exercise, however, has not been addressed in these studies.…”

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confidence: 99%

Exercise and Antipsychotic Drugs

Vs¹

2017

J Pat Care

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Both the beneficial and adverse effects of antipsychotic drugs are known to fluctuate over time even after steady state blood levels of the drug are achieved. This suggests that such effects are influenced, at least temporarily, by a number of endogenous (e.g. mood, stress level, circadian cycle) and exogenous (e.g. diet, interpersonal encounter, environmental change) factors, which may, when taken together, help to explain the significant placebo rate in antipsychotic drug trials [1]. Exercise is one factor that has been shown to temporarily enhance treatment effects in schizophrenia [2][3][4][5][6][7][8]. Whether side effects are enhanced or dampened after exercise, however, has not been addressed in these studies. The following case example suggests that physical activity can sometimes increase the side effects of drugs. Case ExampleTed was a young patient diagnosed with schizophrenia and treated for many years with antipsychotic fluphenazine enanthate depot injections administered every three weeks. Periodically and always unexpectedly, he would knock loudly on my office door, demanding to be seen at once. The complaint was always the same -that his muscles were stiff, a parkinsonian side effect of fluphenazine. The timing of these knocks was mysterious. They did not correspond to the time since last injection. They did not appear to correspond to any particular life event or emotional upset. Months would pass without any knocks and then there could be three in the same week.Ted was the one who finally figured it out. The knocks occurred during the months that he played soccer. His injection was in the upper outer quadrant of the buttock, the dorsogluteal muscle, and whenever those muscles were strongly activated as in soccer, blood flow to and from the depot site increased so much that his blood stream was inundated, his brain received more drug, more dopamine receptors were blocked [the mechanism of action of antipsychotic drugs, and, subsequently, his muscles became stiff, an effect of dopamine blockade [9,10]. Clinical experience reinforces the observation that side effects to depot intramuscular antipsychotic injection increase after exercise. This motivated a literature review of exercise effects on side effects of antipsychotic drugs, however administered. Exercise and Antipsychotic DrugsMary V. Seeman* Department of Psychiatry, University of Toronto, Canada Abstract Background: Exercise has been shown to reduce symptoms in patients with schizophrenia.

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confidence: 99%

Exercise and Antipsychotic Drugs

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2017

J Pat Care

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“…Previous research into HIIT for adults with mental illness has focused on patients with a particular diagnosis (e.g. schizophrenia, depression, substance use) [296][297][298][299] . Understanding the feasibility and acceptability of different exercise approaches for heterogeneous patient groups may guide the implementation of exercise programs in mental health services, where patient groups are likely to be diverse.…”

Section: Discussionmentioning

confidence: 99%

“…One pre/post study with outpatients with schizophrenia used "body weight exercises" to achieve age-predicted heart rate ranges over eight weeks for three sessions/week, using a 4x3.75-minute circuit protocol 299 . That study discontinued participants who did not meet prescribed training intensities, and found that the program significantly improved depression, anxiety, and negative symptoms of schizophrenia 299 .…”

Section: Physical Activity Attitudes and Preferences Of Adults With Mmentioning

confidence: 99%

“…That study discontinued participants who did not meet prescribed training intensities, and found that the program significantly improved depression, anxiety, and negative symptoms of schizophrenia 299 . Another pre/post study used a 14-week HIIT protocol with 10x20-sec intervals and 90-sec recovery periods with patients with first episode psychosis; global functioning and severity, and social/occupational functioning remained similar, but waist circumference and VO2max significantly improved 300 .…”

Section: Physical Activity Attitudes and Preferences Of Adults With Mmentioning

confidence: 99%

“…Preliminary evidence suggests that HIIT is a feasible exercise protocol for adults with mental illness. Mean attendance rates have ranged from 68%-92%, and attrition has ranged from 10%-36% 296,297,299,300 . Common reasons for withdrawal have been due to pain or physical discomfort from the exercise 296,300 , and lacking motivation 300 , however, no studies have compared the feasibility of HIIT and MICT.…”

Section: Objective 5: To Assess the Utility Of Two Different Kinds Ofmentioning

confidence: 99%

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Measuring and positively influencing physical activity and sedentary behaviour in adults with mental illness

Chapman¹

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Background: Mental illness has a high global prevalence, and is associated with higher risk of chronic physical conditions, and reduced psychosocial functioning and life expectancy. Physical activity (PA) protects against chronic disease and mortality risk, and reduces depression and anxiety. Prolonged sedentary behaviour (SB) can have deleterious metabolic consequences, and may be associated with poor mental health.Accurate measurement of PA and SB is important for assessing health risk, and evaluating behaviour change interventions. Objective measures (e.g. accelerometers) allow for unbiased measurement, but do not assess the context of participation, which may be important for intervention planning. Questionnaires can assess context, however, they are prone to reporting errors. The feasibility of using these measures, and the impact of standard data management procedures, has not been assessed in adults with mental illness.PA interventions may positively influence PA levels of adults with mental illness. It is important to understand PA attitudes when designing interventions, as well as the acceptability and efficacy of different exercise approaches. Aims and objectives:The overarching aim of this PhD was to measure, understand, and positively influence the PA patterns of non-institutionalised adults with mental illness. Specific objectives were to: i) assess the utility of questionnaires and accelerometers for measuring PA and SB; ii) investigate questionnaire and accelerometer data management procedures; iii) measure PA and SB levels; iv) assess PA attitudes and opinions; and v) assess the feasibility and acceptability of two exercise protocols. Data from two research studies are presented in six thesis chapters. Study 1Design: Cross-sectional.Method: Participants were adult clients of mental health services. Participants completed self-administered questionnaires on the time spent in PA and SB in different contexts, wore an ActiGraph GT3x+ accelerometer on the hip for 7-days, and rated the ease/difficulty of completing the questionnaires and accelerometry. Participants also completed self-administered questionnaires on PA attitudes and opinions.Results: 142 participants completed the questionnaires (mean age=40yrs, female=43%); of these, 99 (70%) completed the accelerometry (mean age=40yrs, female=47%).ii Participants found it easier to report PA than SB, and to complete accelerometry than questionnaires. Defining a valid day of accelerometry using standard absolute criteria biased the sample by excluding participants with short waking hours; defining a valid day relative to waking hours prevented this bias. The median self-reported time spent in moderate-to-vigorous physical activity (MVPA) and SB was 4.5 hours/week and 10.7 hours/day respectively. Walking for transport, and sitting to watch TV, contributed most to these self-report estimates. The median accelerometer-derived time spent in MVPA and SB was 26 minutes/day and 9.2 hours/day respectively; 7% of MVPA time was in bouts of 10 minutes or ...

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The CHANGE trial: no superiority of lifestyle coaching plus care coordination plus treatment as usual compared to treatment as usual alone in reducing risk of cardiovascular disease in adults with schizophrenia spectrum disorders and abdominal obesity

et al. 2016

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Life expectancy in patients with schizophrenia is reduced by 20 years for men and 15 years for women compared to the general population. About 60% of the excess mortality is due to physical illnesses, with cardiovascular disease being dominant. CHANGE was a randomized, parallel‐group, superiority, multi‐centre trial with blinded outcome assessment, testing the efficacy of an intervention aimed to improve cardiovascular risk profile and hereby potentially reduce mortality. A total of 428 patients with schizophrenia spectrum disorders and abdominal obesity were recruited and centrally randomized 1:1:1 to 12 months of lifestyle coaching plus care coordination plus treatment as usual (N=138), or care coordination plus treatment as usual (N=142), or treatment as usual alone (N=148). The primary outcome was 10‐year risk of cardiovascular disease assessed post‐treatment and standardized to age 60. At follow‐up, the mean 10‐year risk of cardiovascular disease was 8.4 ± 6.7% in the group receiving lifestyle coaching, 8.5 ± 7.5% in the care coordination group, and 8.0 ± 6.5% in the treatment as usual group (p=0.41). We found no intervention effects for any secondary or exploratory outcomes, including cardiorespiratory fitness, physical activity, weight, diet and smoking. In conclusion, the CHANGE trial did not support superiority of individual lifestyle coaching or care coordination compared to treatment as usual in reducing cardiovascular risk in patients with schizophrenia spectrum disorders and abdominal obesity.

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Effectiveness of high-intensity interval training on the mental and physical health of people with chronic schizophrenia

Cited by 52 publications

References 34 publications

Exercise and Antipsychotic Drugs

Exercise and Antipsychotic Drugs

Measuring and positively influencing physical activity and sedentary behaviour in adults with mental illness

The CHANGE trial: no superiority of lifestyle coaching plus care coordination plus treatment as usual compared to treatment as usual alone in reducing risk of cardiovascular disease in adults with schizophrenia spectrum disorders and abdominal obesity

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