Optimal exercise dose and type for improving schizophrenia symptoms in adults: A systematic review and Bayesian network meta-analysis
Author: Yong Yang1, Yuan Yuan2, HaoYang Zhang3, XueYing Fu3, Tao Wang4, JunYu Wang5, Chu-Chun Fang6
Affiliation:
1 Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Chaohu University, Hefei 238000, China.
2 Department of Physical Education, Kunsan National University, Daehak-ro, Gunsan-si, Jeollabuk-do 541150, South Korea.
3 Institute of Physical Education, Henan University, Kaifeng 475001, China.
4 College of Physical Education and Health, Southwest University of Science and Technology, Mianyang 621010, China.
5 The School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China.
6 Physical Education Office, National Taipei University of Business, Taipei 100025, Taiwan; Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan. Electronic address: kammyfang@ntub.edu.tw.
Conference/Journal: Neurosci Biobehav Rev
Date published: 2024 Sep 25
Other:
Volume ID: 167 , Pages: 105896 , Special Notes: doi: 10.1016/j.neubiorev.2024.105896. , Word Count: 302
Background:
Exercise has shown promise in aiding patients with schizophrenia, potentially improving symptoms, quality of life, mood, and cognition. This review evaluates the effectiveness of different physical activities in this context, aiming to guide treatment and research towards the most beneficial exercise interventions for schizophrenia management.
Methods:
This systematic review and network meta-analysis searched PubMed, MEDLINE, Embase, PsycINFO, Cochrane CENTRAL, Web of Science, and CNKI up to March 30, 2024. We utilized the "gemtc," "MBNMAdose," "metafor," and "ggplot2" packages for data analysis in R. Additionally, our results were reported as standardized mean differences with 95 % confidence intervals. To assess the risk of bias in the included studies, we used ROB2 and CINeMA tools.
Results:
In the results section of our systematic review and network meta-analysis, we analyzed data from 47 studies involving 4031 participants. Our findings indicate that among the various exercise interventions examined for schizophrenia patients, yoga emerged as the most effective in improving Total symptoms, positive and negative symptoms. RT+AE (Resistance Training + Aerobic Exercise) showed the greatest improvement in general symptoms, whereas Tai Chi (TC) was the least effective. In terms of improvement of cognitive functions and depression, AE proved the most beneficial, while TC was found to be the least effective. EX+PT (Physical Exercise + Psychological Nursing) was identified as the most effective approach for improved quality of life, with TC again showing the least efficacy. The optimal total exercise dose to improve the patient's total symptoms was estimated to be 1200 METs-min/week. (SMD: -0.956, 95 %Crl: -1.376 to -0.536).
Conclusions:
Yoga, RT+AE, EX+PT, and Baduanjin have demonstrated enhanced efficacy in alleviating clinical symptoms, quality of life, depressive states, and cognitive functions in patients with schizophrenia. We identified optimal overall exercise doses and provided exercise guidance recommendations for healthcare professionals.
Keywords: Clinical symptoms; Dose-response; Exercise; Network meta-analysis; Schizophrenia.
PMID: 39326771 DOI: 10.1016/j.neubiorev.2024.105896
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