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Exercise Therapy In Adults With Serious Mental Illness

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Exercise therapy in adults with serious mental illness: a systematic review and meta-analysis

Background:
Individuals with serious mental illness are at a higher risk of physical ill health. Mortality rates are at least twice those of the general population  with higher levels of cardiovascular disease, metabolic disease, diabetes, and respiratory illness. Although genetics may have a role in the  physical health problems of these patients, lifestyle and environmental factors such as levels of smoking, obesity, poor diet, and low levels of  physical activity also play a prominent part.
Methods:
We conducted a systematic review and meta-analysis of randomised controlled trials comparing the effect of exercise interventions on individ uals with serious mental illness. Searches were made in Ovid MEDLINE, Embase, CINAHL, PsycINFO, Biological Abstracts on Ovid, and The  Cochrane Library (January 2009, repeated January 2013) through to February 2013.
Results:
Eight RCTs were identified in the systematic search . Six compared exercise versus usual care. One study assessed the effect of a cycling  programme versus muscle strengthening and toning exercises. The final study compared the effect of adding specific exercise advice and  motivational skills to a simple walking programme. The review found that exercise improved levels of exercise activity (n = 13, standard mean  difference [SMD] 1.81, CI 0.44 to 3.18, p = 0.01). No beneficial effect was found on negative (n = 84, SMD =−0.54, CI−1.79 to 0.71, p = 0.40) or positive symptoms of schizophrenia (n = 84, SMD =−1.66, CI−3.78 to 0.45, p = 0.12). No change was found on body mass index compared with  usual care (n = 151, SMD =−0.24, CI−0.56 to 0.08, p = 0.14), or body weight (n = 77, SMD = 0.13,CI−0.32 to 0.58, p = 0.57). No beneficial  effect was found on anxiety and depressive symptoms (n = 94, SMD =−0.26,CI−0.91 to 0.39, p = 0.43), or quality of life in respect of physical  and mental domains.
Conclusions:
This systematic review showed that exercise therapies can lead to a modest increase in levels of exercise activity but overall there was no notice able change for symptoms of mental health, body mass index, and body weight.

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