Erin Gaylor week 7 EBP article

A study published in 2013 in Acta Psychiatrica Scandinavica examined the effects of both exercise and occupational therapy on 63 patients who had been diagnosed with either schizophrenia, schizoaffective, or schizophreniform disorder.  The 63 patients were randomly assigned to 2 hours of structured exercise or occupational therapy weekly for 6 months.  The assessments measuring mental and physical health were performed before and after the intervention.  Primary outcome measure for mental health change was measured by the Positive and Negative Syndrome Scale (PANSS) total score.  Secondary outcomes were measured by the Montgomery Asberg Depression Rating Scale (MADRS).  The Camberwell Assessment of Need (CAN) was used to measure the sum of met and unmet clinical and social needs.  Primary outcome for physical health was cardiorespiratory fitness (CRF) as assessed with a cycle ergo meter cardiopulmonary exercise test (CPET).  CRF was defined as peak work rate at the moment of exhaustion (Wpeak in Watts) and and highest oxygen uptake during the last 30 seconds of the test (VO2peak in ml/kg/min).  BMI, body fat percentage, blood pressure, triglyceride and cholesterol levels, and fasting plasma glucose levels were also measured.

The exercise group had 31 participants and met twice a week for an hour session for 6 months.  The sessions were supervised by a psychomotor therapist specialized in psychiatry.  The program included both muscle strengthening and cardiovascular exercises.  The muscle strength exercises consisted of 6 exercises per week: three times 10-15 repetitions maximum for biceps, triceps, abdominal, quadriceps, pectoral, and deltoid muscles.  The intensity of the exercises was increased gradually.

The occupational therapy group had 32 participants and also met twice a week for an hour session for 6 months.  The occupational therapy consisted of creative and recreational activities such as painting, reading, and computer activities.  The patients in this group were allowed a maximum of 60 minutes of moderate physical activity weekly outside the intervention.

The results for the compliant patients showed that both the exercise group and the OT group showed an improvement in PANSS total score.  The MADRS score of both groups also improved, but the exercise group showed significant improvements over the occupational therapy group.  CAN scores also improved for both groups, but most notably again for the exercise group. As expected, the exercise group also experienced greater improvements in cardiovascular fitness compared to the OT group.  For the other physical health measurements, the exercise group showed a trend reduction of fasting triglycerides.  This study provided evidence that both OT interventions focusing on muscle strengthening and cardiovascular exercise as well as creative and recreational activities can improve the mental and physical health of patients with schizophrenia. 

Scheewe, T. W., Backx, F. J., Takken, T., Jörg, F., Strater, A. C., Kroes, A. G., . . . Cahn, W. (2012). Exercise therapy improves mental and physical health in schizophrenia: A randomised controlled trial. Acta Psychiatrica Scandinavica Acta Psychiatr Scand, 127(6), 464-473. Retrieved February 21, 2015.