Bhatia Triptish, Mazumdar Sati, Wood Joel, He Fanyin, Gur Raquel E, Gur Ruben C, Nimgaonkar Vishwajit L, Deshpande Smita N
1GRIP-NIH Project,Department of Psychiatry,PGIMER-Dr. R.M.L. Hospital,New Delhi,India.
2Department of Biostatistics,University of Pittsburgh,Pittsburgh,PA,USA.
Acta Neuropsychiatr. 2017 Apr;29(2):102-114. doi: 10.1017/neu.2016.42. Epub 2016 Aug 12.
Yoga and physical exercise have been used as adjunctive intervention for cognitive dysfunction in schizophrenia (SZ), but controlled comparisons are lacking. Aims A single-blind randomised controlled trial was designed to evaluate whether yoga training or physical exercise training enhance cognitive functions in SZ, based on a prior pilot study.
Consenting, clinically stable, adult outpatients with SZ (n=286) completed baseline assessments and were randomised to treatment as usual (TAU), supervised yoga training with TAU (YT) or supervised physical exercise training with TAU (PE). Based on the pilot study, the primary outcome measure was speed index for the cognitive domain of 'attention' in the Penn computerised neurocognitive battery. Using mixed models and contrasts, cognitive functions at baseline, 21 days (end of training), 3 and 6 months post-training were evaluated with intention-to-treat paradigm.
Speed index of attention domain in the YT group showed greater improvement than PE at 6 months follow-up (p<0.036, effect size 0.51). In the PE group, 'accuracy index of attention domain showed greater improvement than TAU alone at 6-month follow-up (p<0.025, effect size 0.61). For several other cognitive domains, significant improvements were observed with YT or PE compared with TAU alone (p<0.05, effect sizes 0.30-1.97).
Both YT and PE improved attention and additional cognitive domains well past the training period, supporting our prior reported beneficial effect of YT on speed index of attention domain. As adjuncts, YT or PE can benefit individuals with SZ.
瑜伽和体育锻炼已被用作精神分裂症(SZ)认知功能障碍的辅助干预措施,但缺乏对照比较。目的:基于先前的一项试点研究,设计了一项单盲随机对照试验,以评估瑜伽训练或体育锻炼训练是否能增强SZ患者的认知功能。
286名同意参与研究、临床稳定的成年SZ门诊患者完成了基线评估,并被随机分配至常规治疗(TAU)组、TAU联合监督瑜伽训练(YT)组或TAU联合监督体育锻炼训练(PE)组。基于试点研究,主要结局指标是宾夕法尼亚计算机化神经认知测试中“注意力”认知领域的速度指数。采用混合模型和对比分析,采用意向性分析范式评估基线、训练21天(训练结束时)、训练后3个月和6个月时的认知功能。
在6个月随访时,YT组注意力领域的速度指数改善程度大于PE组(p<0.036,效应量0.51)。在PE组中,注意力领域的准确性指数在6个月随访时比单独TAU组有更大改善(p<0.025,效应量0.61)。对于其他几个认知领域,与单独TAU组相比,YT或PE组有显著改善(p<0.05,效应量0.30 - 1.97)。
YT和PE均能在训练期过后显著改善注意力及其他认知领域,支持我们先前报道的YT对注意力领域速度指数的有益作用。作为辅助手段,YT或PE对SZ患者有益。