Motivating factors and barriers towards exercise in severe mental illness: a systematic review and meta-analysis
Open accessAbstract
Exercise can improve clinical outcomes in people with severe mental illness (SMI). However, this population typically engages in low levels of physical activity with poor adherence to exercise interventions. Understanding the motivating factors and barriers towards exercise for people with SMI would help to maximize exercise participation. A search of major electronic databases was conducted from inception until May 2016. Quantitative studies providing proportional data on the motivating factors and/or barriers towards exercise among patients with SMI were eligible. Random-effects meta-analyses were undertaken to calculate proportional data and 95% confidence intervals (CI) for motivating factors and barriers toward exercise. From 1468 studies, 12 independent studies of 6431 psychiatric patients were eligible for inclusion. Meta-analyses showed that 91% of people with SMI endorsed ‘improving health’ as a reason for exercise ( N = 6, n = 790, 95% CI 80–94). Among specific aspects of health and well-being, the most common motivations were ‘losing weight’ (83% of patients), ‘improving mood’ (81%) and ‘reducing stress’ (78%). However, low mood and stress were also identified as the most prevalent barriers towards exercise (61% of patients), followed by ‘lack of support’ (50%). Many of the desirable outcomes of exercise for people with SMI, such as mood improvement, stress reduction and increased energy, are inversely related to the barriers of depression, stress and fatigue which frequently restrict their participation in exercise. Providing patients with professional support to identify and achieve their exercise goals may enable them to overcome psychological barriers, and maintain motivation towards regular physical activity.
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People with severe mental illness experience a range of barriers to engaging in physical activity and exercise, such as high levels of perceived stress, somatic comorbidities, low mood, and a lack of self-confidence and of social support.
“However, people with severe mental illness experience a range of barriers to engaging in physical activity and exercise, such as high levels of perceived stress, somatic comorbidities, low mood, and a lack of self-confidence and of social support 7-11 .”
Lack of support is one of the largest barriers toward exercise in patients with serious mental illness.
“The intervention holds tremendous promise as lack of support is one of the largest barriers toward exercise in patients with serious mental illness (Firth et al., 2016) and it is now possible to use social media to counter such.”
From Social Media and Mental Health: Benefits, Risks, and Opportunities for Research and Practice (2020) · cites this paper as Firth et al., 2016
There is emerging evidence that online peer-support platforms, smartphone apps, and fitness trackers can successfully increase walking and physical activity in people with severe mental illness.
“Although there are very few evaluations of mHealth for physical health in mental illness, there is emerging evidence that online peer-support platforms, smartphone apps and fitness trackers can successfully increase walking and physical activity in people with SMI.257,341,342”
From The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness (2019) · cites this paper as [341]
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“The intervention holds tremendous promise as lack of support is one of the largest barriers towards exercise in patients with serious mental illness (Firth et al. 2016), and it is now possible to use social media to counter such.”
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Carneiro, L., Silva, F., Vasoncelos-Raposo, J., Mota, M. P., Vieira-Coelho, M. A., Deslandes, A., Marinho, H., Amaral, G., & Monteiro-Júnior, R. (2020) · doi:10.21203/rs.3.rs-24600/v1 · Cited by 3 · see citing works
- Authors
- Firth, J., Rosenbaum, S., Stubbs, B., Gorczynski, P., Yung, A. R., & Vancampfort, D.
- Affiliations
- University of Manchester (GB)
- UNSW Sydney (AU)
- King's College London (GB)
- University of Portsmouth (GB)
- The University of Melbourne (AU)
- KU Leuven (BE)
- Corresponding author
- Firth, J.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2016-08-09
- Volume
- 46
- Issue
- 14
- Pages
- 2869-2881
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC5080671
- OpenAlex
- W2513004262
- Cited by
- 577
- References
- 57
- Citations by year
- 2026: 59 · 2025: 58 · 2024: 77 · 2023: 73 · 2022: 61 · 2021: 66 · 2020: 54 · 2019: 48 · 2018: 47 · 2017: 29 · 2016: 5
- FWCI
- 5.04
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Psychological Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, cc-by)
- Lirias (KU Leuven) (submittedVersion, other-oa)
- Figshare (submittedVersion, cc-by)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Funders
- Medical Research Council
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Social Psychology › Motivation and Self-Concept in Sports
- Keywords
- exercise motivation, barriers to exercise, severe mental illness, physical activity, exercise adherence, weight loss, mood improvement, stress reduction, depression, fatigue, social support, exercise intervention
- MeSH terms
- Mental Disorders, Humans, Motivation, Exercise
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