Dance/Movement Therapy for Bone Mineral Density in Schizophrenia
Condition: Schizophrenia
MeSH terms: Schizophrenia
Study type: Interventional

Summary: 
      Fractures are common accidents for long-term hospitalized patients with schizophrenia (SZ) in
      psychiatric hospitals, and once they occur, patients usually endure the pain of fractures for
      a long time. Accumulating evidence has supported implementing dance/movement therapy (DMT) as
      a promising intervention for patients with SZ. However, no study has been conducted to
      investigate its role in balance ability and metabolic parameters in SZ. This study was
      designed to investigate the treatment outcome of a 12-week DMT intervention on bone mineral
      density, balance ability, and metabolic profile in patients with SZ using a randomized,
      controlled trial design.
    

Detailed description: 
      Schizophrenia (SZ) is a chronic, severe psychiatric disorder that affects approximately 1% of
      the population (Barnett 2018). The psychiatric symptoms and high rate of relapse of SZ can
      significantly impair cognitive and social functioning, including problem-solving skills,
      interpersonal relationships, and work performance (Brekke et al., 2005). Moreover,
      individuals with SZ usually have higher disability and premature mortality rates compared to
      the general population (McCutcheon et al., 2020). Falls are a common concern in hospital
      settings, with studies reporting a fall rate between three and five falls per 1000 bed days
      (Healey et al., 2008; Oliver et al., 2010; Pham et al., 2022).Osteoporosis and its
      precursors, e.g. osteopenia and low bone mineral density (BMD), have been reported in chronic
      patients with SZ (Kishimoto et al., 2012; Stubbs et al., 2014; Gomez et al., 2016; Cui et
      al., 2018) and were strong predictors for subsequent falls and fractures in psychiatric
      hospitals (Stubbs et al. 2015; Stubbs et al., 2018).

      Dance/movement therapy (DMT), as one of the creative arts therapies (Millard et al., 2021),
      is an emerging therapy for the rehabilitation of patients with SZ in recent years (Xia and
      Grant 2009; Ren and Xia 2013; Millman et al., 2021; Wu et al., 2022). DMT therapy uses dance
      activities and body movements to enhance well-being, mood, and quality of life. DMT therapy
      uses movement, dance, and interpersonal communication to explore a person's emotional,
      cognitive, social, and physical integration, enabling patients to enhance self-expression,
      accept and reconnect with their bodies, and strengthen their fitness (de Witte et al., 2021).
      The patients share their emotions, concerns, and coping strategies with others through
      dance/movement (Biondo et al., 2021; Bryl et al., 2022). It can be applied to individuals of
      all ages, races, and genders and can be efficacious in individuals who experience losses in
      social, physical, and psychological functions. DMT has also been used to improve the
      cognition and social function of patients with mental diseases in psychiatric hospitals
      (Millman et al. 2021). In particular, a few studies have reported a critical role of DMT
      intervention in negative symptoms in chronic patients with SZ (Röhricht and Priebe 2006;
      Priebe et al., 2016). However, there is still a lack of evidence that whether DMT is an
      effective therapy to increase the mean bone mineral density and reduce the risk of fractures
      due to falls in long-term hospitalized patients with SZ.

      In the present study, we hypothesized that DMT intervention was effective to increase BMD and
      balance ability and decrease the metabolic parameters in long-term hospitalized male veterans
      with SZ as compared to the control group. We also examined whether DMT intervention can
      significantly change BMI, the levels of lipid profile, and serum calcium in patients.
    

Intervention name(s): dance/movement therapy; treatment as usual
Intervention type(s): Behavioral; Behavioral
Intervention description(s): dance/movement therapy plus treat as usual; The patients received regular daily antipsychotic medication and supportive psychotherapy once a week. They also participated in daily activities from Monday to Friday for at least two hours each day, including indoor activities (watching TV, playing games, playing poker) and outside activities (walking and doing radio gymnastics).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment