Benefits of Physical Exercise in Schizophrenia
Condition: Schizophrenia
MeSH terms: Schizophrenia
Study type: Interventional

Summary: 
      Impairments in social integration, characterized by low marriage rates, few friendships, and
      a high frequency of living alone, affect the vast majority of Veterans with schizophrenia.
      The primary aim of this proposal is to test the efficacy of a novel rehabilitation treatment
      approach, engaging in physical exercise, at improving two determinants of social integration
      which are impaired in schizophrenia: cognition and affect.
    

Detailed description: 
      Difficulties in social integration pose a major mental health problem for Veterans with
      schizophrenia. Reviews of the literature indicate that Veterans with schizophrenia have lower
      marriage rates, fewer friendships, and higher rates of living alone than the general
      population. Poor social integration is also associated with early mortality. To gain traction
      on this problem, it will be necessary to find treatments that address key determinants of
      social integration. Evidence indicates that impairments in cognition and affect are among the
      key determinants of this area of functioning. Findings from the broader rehabilitation
      literature support a novel conceptual approach to this problem, namely engagement in physical
      exercise. Physical exercise is associated with improvements in attention, episodic memory,
      working memory, speed of processing, and executive control. In addition, physical exercise is
      associated with increases in positive affect and decreases in negative affect. Findings on
      the effects of physical exercise on cognition and affect have been reported for normal aging,
      mild cognitive impairment, neurodegenerative disorders, oncology, and depression, but is an
      area of investigation relatively new to schizophrenia. The proposed study will include 54
      Veterans with schizophrenia or schizoaffective disorder (aged 45-65) who will be matched on
      baseline levels of cardiorespiratory fitness, and then randomized (2:1) to a walking exercise
      group (n=36) or a control comparison group (n=18). Veterans in the exercise group will
      participate in a 12-week, instructor-led, outdoor brisk walking exercise program conducted in
      small groups (n=6), held 3 times per week, gradually increasing walking time until reaching a
      maximum of 40-minutes per session. The heart rate of each Veteran will be monitored during
      the walking sessions to help ensure maintenance of a target peak heart rate of 60% to 70% of
      the maximum for the individual's age (i.e., 220-age). Veterans in the control group will
      participate in instructor-led, non-aerobic stretching exercises in small groups (n=6) with
      the duration, frequency, and total number of sessions matched to the exercise group. Primary
      outcome measures of cardiorespiratory fitness, cognition, and positive and negative affect of
      participants in both groups will be measured at baseline and the 12-week end-point
      assessment.
    

Intervention name(s): Physical exercise; Stretching exercise
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Veterans in the physical exercise group will participate in a 12-week, instructor-led, outdoor brisk walking exercise program conducted in small groups, held 3 times per week, gradually increasing walking time until reaching a maximum of 40-minutes per session. The heart rate of each Veteran will be monitored during the walking sessions to help ensure maintenance of a target peak heart rate of 60% to 70% of the maximum for the individual's age (i.e., 220-age).; Veterans in the control condition will participate in instructor-led, non-aerobic stretching exercises conducted in small groups, held 3 times per week.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment