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运动对精神分裂症患者认知和临床症状的影响:一项随机对照试验的系统评价。

The effect of exercise on cognition and clinical symptoms of patients with schizophrenia: A systematic review of randomized controlled trial.

机构信息

International Doctoral Program in Principles and Implications of Mind Science, National Cheng Kung University, Tainan, Taiwan.

Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan; The Innovative and Translational Research Center for Brain Consciousness, Taipei Medical University, Taipei, Taiwan.

出版信息

Prog Brain Res. 2024;283:255-304. doi: 10.1016/bs.pbr.2024.01.002. Epub 2024 Feb 1.

Abstract

Physical activity has been viewed as a potential non-pharmacological therapeutic strategy to improve the clinical symptoms and neurocognitive deficits in patients with schizophrenia. However, there are various types of physical activities, and different exercise prescriptions might produce inconsistent benefits. Thus, this study aimed to conduct a systematic review of exercise interventions for patients with schizophrenia, clarifying the benefits of these interventions on cognitive function and clinical symptoms. This review encompasses six electronic databases, with inclusion criteria including randomized controlled trial designs, participants with schizophrenia, and a comprehensive exercise intervention program. Twenty-seven studies met the inclusion criteria, incorporating data from 1549 patients with schizophrenia. The results highlight that when comparing the exercise intervention group to the non-intervention control group, patients with schizophrenia showed significant improvement in negative symptoms. Structured exercise interventions can help improve the negative symptoms of schizophrenia, filling the gaps where medication falls short. Regarding functional outcomes, exercise interventions aid in enhancing the overall functionality (psychological, social, occupational) of individuals with schizophrenia. The improvement is largely tied to the boost in physical fitness that exercise provides. Based on current findings, exercise interventions assist in enhancing cognitive function in patients with schizophrenia. Notably, significant improvements are observed in higher-order cognitive functions, including processing speed, attention, and working memory. It is recommended to engage in moderate-intensity exercises at least three times a week, with each session lasting a minimum of 30min. Well-structured exercise interventions contribute to enhancing the negative symptoms and cognitive functions in patients with schizophrenia.

摘要

身体活动被视为改善精神分裂症患者临床症状和神经认知缺陷的一种潜在非药物治疗策略。然而,身体活动有多种类型,不同的运动处方可能产生不一致的益处。因此,本研究旨在对精神分裂症患者的运动干预进行系统评价,阐明这些干预措施对认知功能和临床症状的益处。本综述涵盖了六个电子数据库,纳入标准包括随机对照试验设计、精神分裂症患者和全面的运动干预方案。27 项研究符合纳入标准,纳入了 1549 名精神分裂症患者的数据。结果表明,与非干预对照组相比,运动干预组的精神分裂症患者的阴性症状有显著改善。结构化运动干预可以帮助改善精神分裂症的阴性症状,弥补药物治疗的不足。关于功能结果,运动干预有助于提高精神分裂症患者的整体功能(心理、社会、职业)。这种改善主要归因于运动提供的身体健康的提高。根据目前的研究结果,运动干预有助于改善精神分裂症患者的认知功能。值得注意的是,在较高阶的认知功能,包括处理速度、注意力和工作记忆方面,观察到了显著的改善。建议每周至少进行三次中等强度的运动,每次至少 30 分钟。结构化的运动干预有助于改善精神分裂症患者的阴性症状和认知功能。

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