Brobakken Mathias Forsberg, Nygård Mona, Güzey Ismail Cüneyt, Morken Gunnar, Wang Eivind
Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway; Department of Psychosis and Rehabilitation, Psychiatry Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
Department of Psychosis and Rehabilitation, Psychiatry Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Schizophr Res. 2025 Jan;275:156-165. doi: 10.1016/j.schres.2024.12.012. Epub 2024 Dec 27.
Although exercise is medicine for outpatients with schizophrenia, it is unclear if one-year adherence-supported exercise leads to a "tipping point", at which the exercise becomes a routine manifested as life-long training in the patient group.
Forty-eight outpatients (28 men/20 women: 35 ± 11 (mean ± SD) years) with schizophrenia (ICD-10: F20-29) were randomised to: 1) collaborative care group (TG), performing aerobic interval (AIT; 4 × 4-min treadmill walking/running at ∼90 % peak heart rate) and leg press maximal strength training (MST; 4 × 4 repetitions at ∼90 % maximal strength [1RM]) 2d·wk. for 1-year, supported by transportation and training supervision; or 2) control group (CG). Peak oxygen uptake (V̇O) and walking work efficiency were measured directly along with scaled 1RM/power, anthropometry, blood pressure, and blood samples at inclusion, 1-year, and 5-years post-intervention.
The TG increased V̇O (11 %, p < .01), scaled 1RM (40 %, p < .001), and power (26 %, p < .001) compared to CG after 1-year. At follow-up, no intergroup differences in these factors were observed (all p > .05). Both groups improved walking work efficiency (TG: 11 %; CG: 18 %; both p < .05) after 1-year (no intergroup difference, p > .05), but not at follow-up (both p > .05). At follow-up, HDL (high-density lipoprotein)-cholesterol (-15 %, p < .01) and glucose (26 %, p < .01) decreased/increased(respectively) more in the TG than CG. No other intergroup differences were observed in anthropometry or blood samples.
1-year adherence-supported high-intensity training improves V̇O, 1RM, and power in outpatients with schizophrenia. However, the improvements in these factors key to longevity are not maintained after 5 years. These findings highlight the importance of long-lasting cost-efficient adherence support, ultimately affecting the population's prognosis.
尽管运动对精神分裂症门诊患者来说是一种“药物”，但尚不清楚为期一年的有依从性支持的运动是否会导致一个“临界点”，在这个临界点上运动成为一种常规行为，表现为患者群体的终身训练。
48例精神分裂症门诊患者（28名男性/20名女性：35±11（平均±标准差）岁，国际疾病分类第10版：F20 - 29）被随机分为：1）协作照护组（TG），进行有氧间歇训练（AIT；4×4分钟跑步机快走/跑步，心率达到峰值心率的约90%）和腿部推举最大力量训练（MST；4×4次重复，强度达到最大力量[1RM]的约90%），每周2天，持续1年，由交通和训练监督提供支持；或2）对照组（CG）。在入组时、干预后1年和5年，直接测量峰值摄氧量（V̇O）和步行工作效率，同时测量标准化的1RM/功率、人体测量指标、血压和血液样本。
与CG组相比，TG组在1年后V̇O增加了11%（p <.01），标准化1RM增加了40%（p <.001），功率增加了26%（p <.001）。在随访时，这些因素在两组间未观察到差异（所有p >.05）。两组在1年后步行工作效率均有所提高（TG组：11%；CG组：18%；均p <.05）（组间无差异，p >.05），但在随访时未提高（均p >.05）。在随访时，TG组高密度脂蛋白（HDL）胆固醇降低（-15%，p <.01），血糖升高（26%，p <.01），变化幅度大于CG组。在人体测量指标或血液样本方面未观察到其他组间差异。
为期1年的有依从性支持的高强度训练可改善精神分裂症门诊患者的V̇O、1RM和功率。然而，这些对长寿至关重要的因素在5年后并未维持改善。这些发现凸显了长期有效依从性支持的重要性，最终会影响该人群的预后。
