Firth Joseph, Carney Rebekah, French Paul, Elliott Rebecca, Cotter Jack, Yung Alison R
Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK.
Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK.
Early Interv Psychiatry. 2018 Aug;12(4):578-585. doi: 10.1111/eip.12365. Epub 2016 Sep 1.
The aims of this study were to examine if people with first-episode psychosis (FEP) are able to continue adhering to exercise after a supervised intervention and to explore if the benefits of exercise can be sustained.
Twenty-eight persons with FEP took part in a 10-week exercise intervention that provided each participant with twice-weekly accompaniment to exercise activities of their own choice, of whom 20 were re-assessed 6 months after the intervention. Long-term adherence to exercise was assessed, and measures of psychiatric symptoms, physical health, neurocognition and social functioning were administered at baseline, post-intervention and 6-month follow-up.
During the supervised intervention, participants achieved 124.4 min of moderate-to-vigorous exercise per week. After 6 months, physical activity levels had decreased significantly (P = 0.025) and only 55% of participants had continued to exercise weekly. Repeated-measures analysis of variance found that the significant improvements in psychiatric symptoms and social functioning observed immediately after the intervention were maintained at 6 months (P = 0.001). However, post hoc analyses showed that symptomatic reductions were only maintained for those who continued to exercise, whereas symptom scores increased among those who had ceased exercising. Previously observed improvements in waist circumference and verbal memory were lost by 6 months.
Long-term exercise participation is associated with significant benefits for symptoms, cognition and social functioning in FEP. However, adherence to unsupervised exercise is low. Future research should explore the effectiveness of 'step-down' support following supervised interventions, and aim to establish sustainable methods for maintaining regular exercise in order to facilitate functional recovery and maintain physical health.
本研究旨在检验首发精神病（FEP）患者在接受监督干预后是否能够继续坚持锻炼，并探讨锻炼的益处能否得以维持。
28名FEP患者参加了一项为期10周的锻炼干预，该干预为每位参与者提供每周两次陪伴其进行自主选择的锻炼活动，其中20名患者在干预6个月后接受了重新评估。评估了长期锻炼坚持情况，并在基线、干预后和6个月随访时对精神症状、身体健康、神经认知和社会功能进行了测量。
在监督干预期间，参与者每周进行124.4分钟的中等至剧烈运动。6个月后，身体活动水平显著下降（P = 0.025），只有55%的参与者继续每周锻炼。重复测量方差分析发现，干预后立即观察到的精神症状和社会功能的显著改善在6个月时得以维持（P = 0.001）。然而，事后分析表明，症状减轻仅在继续锻炼的患者中得以维持，而停止锻炼的患者症状评分增加。先前观察到的腰围和言语记忆方面的改善在6个月时消失。
长期参与锻炼对FEP患者的症状、认知和社会功能有显著益处。然而，无监督锻炼的依从性较低。未来的研究应探索监督干预后“逐步减少”支持的有效性，并旨在建立维持定期锻炼的可持续方法，以促进功能恢复和保持身体健康。
