Ziebart Christina, Bobos Pavlos, MacDermid Joy C, Furtado Rochelle, Sobczak Daniel J, Doering Michele
Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada.
Faculty of Health Sciences, School of Physical Therapy, Western University, London, ON, Canada.
Front Psychiatry. 2022 Aug 16;13:807140. doi: 10.3389/fpsyt.2022.807140. eCollection 2022.
Treatment of psychosis typically focuses on medication, but some of these medications can have unintended side effects, exercise has global health benefits, with minimal side effects. The purpose of this systematic review and meta-analysis is to investigate the effectiveness and safety of exercise and physical activity on psychotic symptoms, in people with psychosis when compared to usual care, in a hospital setting.
A systematic electronic search of the literature was performed in June 2022, in PubMed, Scopus, and PsychINFO with no date restrictions. We included randomized trials (RCTs) with patients with psychosis that received an exercise intervention within a hospital setting. The primary outcome of interest was Positive and Negative Symptom Severity Scale (PANSS) overall score. Secondary outcomes were adverse or serious adverse events.
A total of 24 trials were included in this systematic review, with 9 included in the meta-analysis, including 1,426 participants. Aerobic had more pronounced effects when compared to usual care in PANSS positive (-0.23, 95% CI -0.53 to 0.07), negative (-0.38, 95% CI -0.65 to -0.10), general (-0.42, 95% CI -0.71 to -0.13) and overall scores (-0.25, 95% CI -0.52 to 0.03). Yoga when compared to usual care had no difference in PANSS subscale and overall scores. We found no difference on relapsing of psychiatric symptoms or somatic hospitalization when we compared aerobic or yoga to usual care (Risk Ratio, 1.12 95% CI 0.44-2.81).
Aerobic activity as an exercise modality in a hospital setting can be effective in decreasing negative and general psychosis symptom severity scores compared to usual care, however, it was uncertain if the effects were clinically important. More trials are needed to confirm the clinically benefit of aerobic exercise.
[https://www.crd.york.ac.uk/prospero/], identifier [CRD42021224997].
精神病的治疗通常侧重于药物治疗，但其中一些药物可能会产生意外的副作用，而运动对整体健康有益，且副作用极小。本系统评价和荟萃分析的目的是研究在医院环境中，与常规护理相比，运动和体育活动对精神病患者精神病症状的有效性和安全性。
2022年6月在PubMed、Scopus和PsychINFO上对文献进行了无日期限制的系统电子检索。我们纳入了在医院环境中接受运动干预的精神病患者的随机试验（RCT）。主要关注的结局是阳性和阴性症状严重程度量表（PANSS）总分。次要结局是不良或严重不良事件。
本系统评价共纳入24项试验，荟萃分析纳入9项试验，包括1426名参与者。与常规护理相比，有氧运动对PANSS阳性（-0.23，95%CI -0.53至0.07）、阴性（-0.38，95%CI -0.65至-0.10）、一般（-0.42，95%CI -0.71至-0.13）和总分（-0.25，95%CI -0.52至0.03）的影响更为显著。与常规护理相比，瑜伽在PANSS子量表和总分方面没有差异。当我们将有氧运动或瑜伽与常规护理进行比较时，我们发现精神病症状复发或躯体住院方面没有差异（风险比，1.12 95%CI 0.44-2.81）。
在医院环境中，有氧运动作为一种运动方式，与常规护理相比，可有效降低阴性和一般性精神病症状严重程度评分，然而，这些效果是否具有临床重要性尚不确定。需要更多试验来证实有氧运动的临床益处。
