Systematic Review of the Benefits of Physical Therapy Within a Multidisciplinary Care Approach for People With Schizophrenia
Abstract
Background: Although schizophrenia is the fifth leading cause of disability-adjusted life years worldwide in people aged 15 to 44 years, the clinical evidence of physical therapy as a complementary treatment remains largely unknown. Purpose: The purpose of this study was to systematically review randomized controlled trials (RCTs) evaluating the effectiveness of physical therapy for people with schizophrenia. Data Sources: EMBASE, PsycINFO, PubMed, ISI Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), and the Cochrane Library were searched from their inception until July 1, 2011, for relevant RCTs. In addition, manual search strategies were used. Study Selection: Two reviewers independently determined study eligibility on the basis of inclusion criteria. Data Extraction: Reviewers rated study quality and extracted information about study methods, design, intervention, and results. Data Synthesis: Ten RCTs met all selection criteria; 6 of these studies addressed the use of aerobic and strength exercises. In 2 of these studies, yoga techniques also were investigated. Four studies addressed the use of progressive muscle relaxation. There is evidence that aerobic and strength exercises and yoga reduce psychiatric symptoms, state anxiety, and psychological distress and improve health-related quality of life, that aerobic exercise improves short-term memory, and that progressive muscle relaxation reduces state anxiety and psychological distress. Limitations: The heterogeneity of the interventions and the small sample sizes of the included studies limit overall conclusions and highlight the need for further research. Conclusions: Physical therapy offers added value in the multidisciplinary care of people with schizophrenia.
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In mental health conditions, physical activity has wider benefits including improved quality of life, less psychological distress and improved physical health.
“In such mental health conditions, PA has been shown to have wider benefits to peoples’ wellbeing, including an improved quality of life, less psychological distress and, importantly, improved physical health [28, 29, 38–43].”
From Moving to Beat Anxiety: Epidemiology and Therapeutic Issues with Physical Activity for Anxiety (2018) · cites this paper as [42]
Physical activity in the general population has established efficacy in preventing and managing cardiovascular disease and improving wellbeing.
“PA in the general population has established efficacy in preventing and managing cardiovascular disease and improving wellbeing.”
From Moving to Beat Anxiety: Epidemiology and Therapeutic Issues with Physical Activity for Anxiety (2018) · cites this paper as [42]
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Cites
Assessing the quality of reports of randomized clinical trials: Is blinding necessary?
Jadad, A. R., Moore, R. A., Carroll, D., Jenkinson, C., Reynolds, D. J. M., Gavaghan, D. J., & McQuay, H. J. (1996) · Controlled Clinical Trials · doi:10.1016/0197-2456(95)00134-4 · Cited by 17,582 · see citing works
DE HERT, M., CORRELL, C. U., BOBES, J., CETKOVICH‐BAKMAS, M., COHEN, D., ASAI, I., DETRAUX, J., GAUTAM, S., MÖLLER, H., NDETEI, D. M., et al. (2011) · World Psychiatry · doi:10.1002/j.2051-5545.2011.tb00014.x · Cited by 2,488 · see citing works
Self-citationSchizophrenia: A Concise Overview of Incidence, Prevalence, and Mortality
McGrath, J., Saha, S., Chant, D., & Welham, J. (2008) · Epidemiologic Reviews · doi:10.1093/epirev/mxn001 · Cited by 2,280 · see citing works
Systematic Reviews: Identifying relevant studies for systematic reviews
Dickersin, K., Scherer, R. W., & Lefebvre, C. (1994) · BMJ · doi:10.1136/bmj.309.6964.1286 · Cited by 2,255 · see citing works
Saha, S., Chant, D., & McGrath, J. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.10.1123 · Cited by 2,065 · see citing works
van Os, J., & Kapur, S. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60995-8 · Cited by 1,971 · see citing works
Tiihonen, J., Lönnqvist, J., Wahlbeck, K., Klaukka, T., Niskanen, L., Tanskanen, A., & Haukka, J. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60742-x · Cited by 1,354 · see citing works
Moher, D., Jadad, A. R., Nichol, G., Penman, M., Tugwell, P., & Walsh, S. (1995) · Controlled Clinical Trials · doi:10.1016/0197-2456(94)00031-w · Cited by 1,308 · see citing works
(2006) · Europe PMC (PubMed Central) · Cited by 1,299 · see citing works
Causes of the excess mortality of schizophrenia
Brown, S., Inskip, H., & Barraclough, B. (2000) · British Journal of Psychiatry · doi:10.1192/bjp.177.3.212 · Cited by 1,087 · see citing works
Size of burden of schizophrenia and psychotic disorders
Wulf Rössler, A., Salize, H. J., van Os, J., & Riecher‐Rössler, A. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.04.009 · Cited by 746 · see citing works
Mortality and causes of death in schizophrenia in Stockholm County, Sweden
Ösby, U., Correia, N., Brandt, L., Ekbom, A., & Sparén, P. (2000) · Schizophrenia Research · doi:10.1016/s0920-9964(99)00191-7 · Cited by 679 · see citing works
Metabolic syndrome in people with schizophrenia: a review
DE HERT, M., SCHREURS, V., VANCAMPFORT, D., & VAN WINKEL, R. (2009) · World Psychiatry · doi:10.1002/j.2051-5545.2009.tb00199.x · Cited by 634 · see citing works
Self-citationHippocampal Plasticity in Response to Exercise in Schizophrenia
Pajonk, F.-G., Wobrock, T., Gruber, O., Scherk, H., Berner, D., Kaizl, I., Kierer, A., Müller, S., Oest, M., Meyer, T., et al. (2010) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2009.193 · Cited by 592 · see citing works
van Winkel, R., Stefanis, N. C., & Myin-Germeys, I. (2008) · Schizophrenia Bulletin · doi:10.1093/schbul/sbn101 · Cited by 489 · see citing works
Schizophrenia, “Just the Facts”: What we know in 2008
Tandon, R., Keshavan, M. S., & Nasrallah, H. A. (2008) · Schizophrenia Research · doi:10.1016/j.schres.2008.01.022 · Cited by 412 · see citing works
Schizophrenia, “Just the Facts” 5. Treatment and prevention Past, present, and future
Tandon, R., Nasrallah, H. A., & Keshavan, M. S. (2010) · Schizophrenia Research · doi:10.1016/j.schres.2010.05.025 · Cited by 385 · see citing works
McNeely, M. L., Armijo Olivo, S., & Magee, D. J. (2006) · Physical Therapy · doi:10.1093/ptj/86.5.710 · Cited by 380 · see citing works
Schizophrenia, “just the facts”: What we know in 2008Part 3: Neurobiology
Keshavan, M. S., TANDON, R., Boutros, N. N., & Nasrallah, H. A. (2008) · Schizophrenia Research · doi:10.1016/j.schres.2008.07.020 · Cited by 345 · see citing works
Boutron, I., Tubach, F., Giraudeau, B., & Ravaud, P. (2004) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2003.12.010 · Cited by 300 · see citing works
Exercise Therapy for Schizophrenia
Gorczynski, P., & Faulkner, G. (2010) · Schizophrenia Bulletin · doi:10.1093/schbul/sbq049 · Cited by 285 · see citing works
Duraiswamy, G., Thirthalli, J., Nagendra, H. R., & Gangadhar, B. N. (2007) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2007.01032.x · Cited by 274 · see citing works
Psychosocial Treatments to Promote Functional Recovery in Schizophrenia
Kern, R. S., Glynn, S. M., Horan, W. P., & Marder, S. R. (2009) · Schizophrenia Bulletin · doi:10.1093/schbul/sbn177 · Cited by 267 · see citing works
EFFECTS OF EXERCISE ON MENTAL AND PHYSICAL HEALTH PARAMETERS OF PERSONS WITH SCHIZOPHRENIA
Beebe, L. H., Tian, L., Morris, N., Goodwin, A., Allen, S. S., & Kuldau, J. (2005) · Issues in Mental Health Nursing · doi:10.1080/01612840590959551 · Cited by 259 · see citing works
Systematic Reviews in Health Care
Loo, L. K. (2002) · Annals of Internal Medicine · doi:10.7326/0003-4819-137-7-200210010-00035 · Cited by 254 · see citing works
Validation of a physical activity assessment tool for individuals with schizophrenia
Faulkner, G., Cohn, T. A., & Remington, G. J. (2005) · Schizophrenia Research · doi:10.1016/j.schres.2005.10.020 · Cited by 251 · see citing works
Why do patients with schizophrenia smoke?
Winterer, G. (2010) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e3283366643 · Cited by 238 · see citing works
Capasso, R., Lineberry, T. W., Bostwick, J. M., Decker, P. A., & Sauver, J. L. S. (2007) · Schizophrenia Research · doi:10.1016/j.schres.2007.10.005 · Cited by 201 · see citing works
Negative symptoms of schizophrenia: a problem that will not go away
Stahl, S. M., & Buckley, P. F. (2007) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2006.00947.x · Cited by 195 · see citing works
Behere, R. V., Arasappa, R., Jagannathan, A., Varambally, S. S., Venkatasubramanian, G., Thirthalli, J., Subbakrishna, D. K., Nagendra, H., & Gangadhar, B. N. (2010) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2010.01605.x · Cited by 159 · see citing works
Assessment of physical activity in middle-aged and older adults with schizophrenia
Lindamer, L. A., McKibbin, C. L., Norman, G. J., Jordan, L. S., Harrison, K. A., Abeyesinhe, S., & Patrick, K. (2008) · Schizophrenia Research · doi:10.1016/j.schres.2008.04.040 · Cited by 145 · see citing works
Systematic Reviews on the Basis of Methodological Criteria
de Vet, H. C. W., de Bie, R. A., van der Heijden, G. J. M. G., Verhagen, A. P., Sijpkes, P., & Knipschild, P. G. (1997) · Physiotherapy · doi:10.1016/s0031-9406(05)66175-5 · Cited by 141 · see citing works
Vancampfort, D., Probst, M., Sweers, K., Maurissen, K., Knapen, J., & Hert, M. A. F. D. (2011) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2010.01666.x · Cited by 139 · see citing works
Self-citationThe Ghost in the Machine: Disembodiment in Schizophrenia – Two Case Studies
de Haan, S., & Fuchs, T. A. E. (2010) · Psychopathology · doi:10.1159/000319402 · Cited by 133 · see citing works
Marzolini, S., Jensen, B., & Melville, P. (2008) · Mental health and physical activity · doi:10.1016/j.mhpa.2008.11.001 · Cited by 133 · see citing works
Vancampfort, D., Knapen, J., Probst, M., van Winkel, R., Deckx, S., Maurissen, K., Peuskens, J., & Binder, M. D. (2010) · Psychiatry Research · doi:10.1016/j.psychres.2010.03.011 · Cited by 129 · see citing works
Self-citationExercise as an adjunct treatment for schizophrenia: A review of the literature
Biddle, S. (1999) · Journal of Mental Health · doi:10.1080/09638239917157 · Cited by 125 · see citing works
Vancampfort, D., De Hert, M., Knapen, J., Wampers, M., Demunter, H., Deckx, S., Maurissen, K., & Probst, M. (2011) · Disability and Rehabilitation · doi:10.3109/09638288.2010.509458 · Cited by 123 · see citing works
Self-citationPhillips, L., Francey, S. M., Edwards, J., & McMurray, N. E. (2009) · Anxiety Stress & Coping · doi:10.1080/10615800902811065 · Cited by 117 · see citing works
Exercise, Health and Mental Health: Emerging Relationships
Faulkner, G., & Taylor, A. H. (2006) · Sport & Exercise Psychology Review · doi:10.53841/bpssepr.2006.2.2.58 · Cited by 116 · see citing works
Holley, J., Crone, D., Tyson, P. J., & Lovell, G. P. (2010) · British Journal of Clinical Psychology · doi:10.1348/014466510x496220 · Cited by 111 · see citing works
Psychomotor Therapy and Psychiatry: What’s in a Name?
Probst, M. (2010) · The Open Complementary Medicine Journal · doi:10.2174/1876391x010020010105 · Cited by 90 · see citing works
Self-citationChen, W.-C., Chu, H., Lu, R., Chou, Y.-H., Chen, C.-H., Chang, Y.-C., O'Brien, A., & Chou, K.-R. (2009) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2008.02773.x · Cited by 86 · see citing works
Skjærven, L. H., Kristoffersen, K., & Gard, G. E. (2010) · Physical Therapy · doi:10.2522/ptj.20090059 · Cited by 85 · see citing works
Vancampfort, D., Binder, M. D., Knapen, J., Maurissen, K., Raepsaet, J., Deckx, S., Remans, S., & Probst, M. (2011) · Clinical Rehabilitation · doi:10.1177/0269215510395633 · Cited by 82 · see citing works
Self-citationA systematic review of physiotherapy for spondylolysis and spondylolisthesis
McNeely, M. L., Torrance, G. W., & Magee, D. J. (2003) · Manual Therapy · doi:10.1016/s1356-689x(02)00066-8 · Cited by 81 · see citing works
Exercise interventions as an adjunct therapy for psychosis: A critical review
Ellis, N., Crone, D., Davey, R., & Grogan, S. (2006) · British Journal of Clinical Psychology · doi:10.1348/014466506x122995 · Cited by 78 · see citing works
Faulkner, G., & Carless, D. (2006) · Psychiatric Rehabilitation Journal · doi:10.2975/29.2006.258.266 · Cited by 78 · see citing works
Exercise, Health and Mental Health
(2005) · Routledge eBooks · doi:10.4324/9780203415016 · Cited by 73 · see citing works
The experiences of basic body awareness therapy in patients with schizophrenia
Hedlund, L., & Gyllensten, A. L. (2009) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2009.03.002 · Cited by 62 · see citing works
Cardiometabolic effects of physical activity interventions for people with schizophrenia
Vancampfort, D., Knapen, J., Binder, M. D., van Winkel, R., Deckx, S., Maurissen, K., Peuskens, J., Simons, J., & Probst, M. (2009) · Physical Therapy Reviews · doi:10.1179/108331909x12540993898053 · Cited by 61 · see citing works
Self-citationKindes, M. V. (2006) · Cited by 54 · see citing works
Patient experiences of basic body awareness therapy and the relationship with the physiotherapist
Gyllensten, A. L., Hansson, L. I., & Ekdahl, C. S. (2003) · Journal of Bodywork and Movement Therapies · doi:10.1016/s1360-8592(02)00068-2 · Cited by 49 · see citing works
Exercise and quality of life in cancer survivors
Courneya, K. S. (2010) · Taylor & Francis eBooks · doi:10.4324/9780203415016_chapter_7 · Cited by 46 · see citing works
Anxiety Reduction in Hospitalized Schizophrenics through Thermal Biofeedback and Relaxation Training
Hawkins, R. C., Doell, S. R., Lindseth, P. D., et al. (1980) · Perceptual and Motor Skills · doi:10.2466/pms.1980.51.2.475 · Cited by 28 · see citing works
The use and utility of EMG biofeedback with chronic schizophrenic patients
Pharr, O. M., & Coursey, R. D. (1989) · Applied Psychophysiology and Biofeedback · doi:10.1007/bf01000096 · Cited by 17 · see citing works
Flagged first, then by citations
Research works printed but not linked: 6
- Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Arling- ton, VA: American Psychiatric Association; 1994.
- Physiotherapy in Psychiatry and Mental Health Special Interest Group for Schizo- phrenia. Patients with schizophrenia and physiotherapy in psychiatry and mental health: what are our experiences? Round table discussion held at: Third Interna- tional Conference for Physiotherapy in Psychiatry and Mental Health; February 4, 2010; Lund, Sweden.
- Saha S, Chant D, McGrath J. A systematic review of mortality in schizophrenia. Arch Gen Psychiatry. 2007;64:1123-1131.
- Gorczynski P, Faulkner G. Exercise ther- apy for schizophrenia. Schizophr Bull. 2010;36:665-666.
- Vancampfort D, De Hert M, Skjaerven LH, et al. Organization of Physical Ther- apy in Mental Health consensus on phys- ical activity for minimizing cardiometa- bolic risk in patients with schizophrenia. Disabil Rehabil. In press.
- Mutrie N, Faulkner G. Physical activity and mental health. In: Everett T, Donaghy M, Fever S, eds. Physiotherapy and Occupa- tional Therapy in Mental Health: An Evi- dence Based Approach. London, United Kingdom: Routledge; 2003:82-97.
Cited by
Sorted by citations
Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases
Pedersen, B. K., & Saltin, B. (2015) · Scandinavian Journal of Medicine & Science in Sports · doi:10.1111/sms.12581 · Cited by 3,514 · see citing works
Dauwan, M., Begemann, M. J. H., Heringa, S. M., & Sommer, I. E. (2016) · Schizophrenia Bulletin · doi:10.1093/schbul/sbv164 · Cited by 393 · see citing works
Moving to Beat Anxiety: Epidemiology and Therapeutic Issues with Physical Activity for Anxiety
Kandola, A., Vancampfort, D., Herring, M., Rebar, A., Hallgren, M., Firth, J., & Stubbs, B. (2018) · Current Psychiatry Reports · doi:10.1007/s11920-018-0923-x · Cited by 291 · see citing works
Self-citationLutgens, D., Gariepy, G., & Malla, A. (2017) · British Journal of Psychiatry · doi:10.1192/bjp.bp.116.197103 · Cited by 181 · see citing works
Kandola, A., Hendrikse, J., Lucassen, P. J., & Yücel, M. (2016) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2016.00373 · Cited by 155 · see citing works
“In both cases, AE has been demonstrated to be effective in reducing both positive and negative symptoms of schizophrenia (Vancampfort et al., 2012; Firth et al., 2015; Rimes et al., 2015) and affective symptoms in MDD (Cooney et al., 2012), in some cases just as effectively as antidepressants…”
Svatkova, A., Mandl, R. C. W., Scheewe, T. W., Cahn, W., Kahn, R. S., & Hulshoff Pol, H. E. (2015) · Schizophrenia Bulletin · doi:10.1093/schbul/sbv033 · Cited by 120 · see citing works
Aerobic exercise and yoga improve neurocognitive function in women with early psychosis.
Lin, J., Chan, S. K., Lee, E. H., Chang, W. C., Tse, M., Su, W. W., Sham, P., Hui, C. L., Joe, G., Chan, C. L., et al. (2015) · npj Schizophrenia · doi:10.1038/npjschz.2015.47 · Cited by 118 · see citing works
“Systematic reviews demonstrated that aerobic exercise can reduce primary symptoms in patients with schizophrenia, and attenuate secondary symptoms such as depression, self-depreciation and social withdrawal.(5) However, the benefit of physical exercise for neurocognitive impairment in schizophrenia has not received co…”
BackgroundNeurobiological effects of physical exercise in schizophrenia: a systematic review.
Vancampfort, D., Probst, M., De Hert, M., Soundy, A., Stubbs, B., Stroobants, M., & De Herdt, A. (2014) · Disability and Rehabilitation · doi:10.3109/09638288.2013.874505 · Cited by 80 · see citing works
Diabetes, physical activity participation and exercise capacity in patients with schizophrenia
Vancampfort, D., De Hert, M., Sweers, K., De Herdt, A., Detraux, J., & Probst, M. (2013) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.12077 · Cited by 34 · see citing works
Self-citationMindfulness and Acceptance–Based Interventions in Physical Therapist Practice: The Time Is Now
Tatta, J., Willgens, A. M., & Palombaro, K. M. (2022) · Physical Therapy · doi:10.1093/ptj/pzab293 · Cited by 30 · see citing works
Yin, J., Sun, Y., Zhu, Y., Alifujiang, H., Wang, Y., An, S., Huang, H., Fu, X., Deng, H., & Chen, Y. (2024) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2024.103959 · Cited by 15 · see citing works
- Authors
- Vancampfort, D., Probst, M., Helvik Skjaerven, L., Catalán-Matamoros, D., Lundvik-Gyllensten, A., Gómez-Conesa, A., Ijntema, R., & De Hert, M.
- Affiliations
- KU Leuven (BE)
- L. Helvik Skjaerven, PT, MSc, Department of Physical Therapy, Faculty of Health and Sciences, Bergen University College, Bergen, Norway.
- University of Almería (ES)
- A. Lundvik-Gyllensten, PT, PhD, Division of Physical Therapy, Faculty of Health Sciences, Lund University, Lund, Sweden.
- A. Gómez-Conesa, PT, PhD, Department of Physical Therapy, University of Murcia, Murcia, Spain.
- University of Applied Sciences Utrecht (NL)
- M. De Hert, MD, PhD, University Psychiatric Centre, Catholic University Leuven, Campus Kortenberg, and Faculty of Medicine, Catholic University Leuven.
- Corresponding author
- Vancampfort, Davy
- Venue
- Physical Therapy
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-01-01
- Volume
- 92
- Issue
- 1
- Pages
- 11-23
- ISSN
- 0031-9023 (ISSN-L)
- 1538-6724
- OpenAlex
- W2128995640
- Cited by
- 141
- References
- 56
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 6 · 2023: 7 · 2022: 5 · 2021: 9 · 2020: 6 · 2019: 5 · 2018: 13 · 2017: 11 · 2016: 10 · 2015: 19 · 2014: 18 · 2013: 18 · 2012: 8
- FWCI
- 1.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Physical Therapy (publishedVersion)
- PubMed (publishedVersion)
- Lirias (submittedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Diversity and Impact of Dance
- Keywords
- schizophrenia, multidisciplinary care, aerobic exercise, resistance training, yoga, progressive muscle relaxation, psychiatric symptoms, state anxiety, psychological distress, health-related quality of life, short-term memory, complementary therapy
- MeSH terms
- Exercise Therapy, Humans, Schizophrenia, Randomized Controlled Trials as Topic, Delivery of Health Care, Integrated, Physical Therapy Modalities
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