Schizophrenia and Exercise Therapy
Posted: 18 May 2020
Schizophrenia is a mental health disorder that is classified under a spectrum of psychotic disorder; affecting how an individual thinks, feels and behaves. Symptoms are seen in both negative (reduced behaviors) and positive (increased behaviors) symptoms, as well as additions to daily behaviors including hallucinations and delusions.
Traditionally, research on exercise and mental health conditions such as Schizophrenia has been largely focused on endurance exercise and aerobic training. This form of training has shown benefits in improving negative symptoms and general symptom severity, improving cognition, quality of life and global functioning in patients with Schizophrenia (Vakhrusheva, Marino, Stroup & Kimhy, 2016).
The beneficial adaptations of aerobic training come from improvements in cortical thickening within the brain and an increase in hippocampal volume, which is responsible for the declarative memory and executive functioning. Another key aspect within the brain that has been linked with Schizophrenia is the brain-derived neurotropic factor (BDNF). The BDNF is the most prevalent neurotrophin and is involved in neuronal growth, maintenance of cortical processes and neural development.
Recently, research has shifted the beneficial use of resistance training in the management of Schizophrenia for global functioning. Resistance exercise has numerous benefits for both physical and cognitive improvements. Developments in cognition are noted through positive changes to task-related working memory, improved cognitive attention on task and the neuroplasticity effect similarly seen with aerobic exercise (Maurus et al., 2020).
Everyone knows that exercise is needed to keep us healthy, and the guidelines are not so different for individuals with Schizophrenia. The recommendations of exercise for psychotic disorders and behaviours are:
- 2-3 days of aerobic exercise (approx. 100min)
- 2 days of strength training at 50-85% 1RM intensity.
The guidelines for strength training can vary depending on functionality of the individual. For example, a high functioning individual with psychotic behaviours may be able to complete higher intensities of strength training, and lower functioning individuals may still benefit from a lower intensity strength routine (Martin, et al., 2017).
Guidance on exercise intensity and training types should be provided by exercise specialist such as Accredited Exercise Physiologists under the referral of a GP. However self-referrals ae also accepted for individuals with Schizophrenia and similar psychotic disorders.
Martin, H., Beard, S., Clissold, N., Andraos, K. & Currey, L. (2017) Combined Aerobic and Resistance Exercise Interventions for Individuals with Schizophrenia: A Systematic Review, Mental Health and Physical Activity.
Maurus, I., et al. (2020) Resistance Training in Patients with Schizophrenia: Concept and Proof of Principle Trial, Journal of Psychiatric Research
Vakhrusheva, J., Marino, B., Stroup, S.T. & Kimhy, D. (2016) Aerobic Exercise in People with Schizophrenia: Neural and Neurocognitive Benefits, Current Behavioral Neuroscience Reports