Systematic Review and Meta-analysis of Exercise Interventions for Psychotic Disorders: The Impact of Exercise Intensity, Mindfulness Components, and Other Moderators on Symptoms, Functioning, and Cardiometabolic Health

Matthias Rißmayer; Joseph Kambeitz; Florian Javelle; Theresa Katharina Lichtenstein

doi:10.1093/schbul/sbae015

Systematic Review and Meta-analysis of Exercise Interventions for Psychotic Disorders: The Impact of Exercise Intensity, Mindfulness Components, and Other Moderators on Symptoms, Functioning, and Cardiometabolic Health

Titel in Übersetzung: Systematic Review und Meta-Analyse von Bewegungsinterventionen bei psychotischen Störungen: Der Einfluss von Trainingsintensität, Achtsamkeitsübungen und anderer Moderatoren auf Symptome, Funktionsfähigkeit und kardiometabolische Gesundheit

Matthias Rißmayer, Joseph Kambeitz, Florian Javelle, Theresa Katharina Lichtenstein

Universitätsklinikum Köln

Publikation: Beitrag in Fachzeitschrift › Zeitschriftenaufsätze › Forschung › Begutachtung

Abstract

Hintergrund und Hypothese: Die Bewegungstherapie hat sich als wirksame ergänzende Behandlung für Patienten mit psychotischen Störungen erwiesen. Die spezifischen Auswirkungen der verschiedenen Trainingsmodalitäten sind jedoch nach wie vor kaum bekannt. Dieser Artikel zielt darauf ab, den moderierenden Einfluss verschiedener Trainingsmodalitäten quantitativ zu überprüfen, wobei die Hypothese aufgestellt wird, dass eine höhere Trainingsintensität sowie die Verwendung von Achtsamkeitsübungen die Interventionsergebnisse verbessern werden.

Studienaufbau: PubMed, Web of Science und PsycINFO wurden von 2010 bis März 2022 nach randomisierten kontrollierten Studien durchsucht, die Bewegungsinterventionen bei Patienten mit psychotischen Störungen untersuchten (Vorregistrierung: https://doi.org/10.17605/OSF.IO/J8QNS). Berücksichtigt wurden positive/negative Symptome, PANSS (Positive and Negative Syndrome Scale) General Psychopathology/Total Scores, depressive Symptome, psychosoziale Funktionsfähigkeit, Lebensqualität, kardiorespiratorische Fitness und Body Mass Index. Separate Meta-Analysen, einschließlich Moderatoren-Analysen, wurden durchgeführt, um den moderierenden Einfluss der verschiedenen Trainingsmodalitäten zu bewerten.

Ergebnisse: Von 6653 Studien wurden 40 (n = 2111 Patienten) in die Meta-Analyse einbezogen. Die Auswirkungen mäßig intensiver Übungen übertrafen die Auswirkungen niedrig intensiver Ansätze für die PANSS-Gesamtwerte (P = .02) und depressive Symptome (P = .04). Die Integration von Achtsamkeitsübungen war mit Verbesserungen bei den Positivsymptomen (P = .04) und den PANSS-Subscores für allgemeine Psychopathologie (P = .04) verbunden, aber auch mit größeren Fehlern innerhalb der Studien größerer und Heterogenität zwischen den Studien. Unsere Analyse zeigt auch eine bessere Wirkung der Intervention auf Depressionen bei jüngeren Patienten (P = .012) und eine Verbesserung der Werte für die psychosoziale Funktionsfähigkeit nach häufigeren Sitzungen (P < .01).

Schlussfolgerungen: Ein Minimum an moderater Intensität sollte in Betracht gezogen werden. Häufigere Trainingssitzungen pro Woche scheinen ebenfalls von Vorteil zu sein. Das Hinzufügen von Achtsamkeitsübungen ist zwar vielversprechend, erhöht aber die Heterogenität und erfordert Vorsicht bei der Verallgemeinerung der Ergebnisse.

Titel in Übersetzung	Systematic Review und Meta-Analyse von Bewegungsinterventionen bei psychotischen Störungen: Der Einfluss von Trainingsintensität, Achtsamkeitsübungen und anderer Moderatoren auf Symptome, Funktionsfähigkeit und kardiometabolische Gesundheit
Originalsprache	Englisch
Zeitschrift	Schizophrenia bulletin
ISSN	0586-7614
DOIs	https://doi.org/10.1093/schbul/sbae015
Publikationsstatus	Veröffentlicht - 23.02.2024

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@article{4a7c016b43914ba6bcac953246776b52,

title = "Systematic Review and Meta-analysis of Exercise Interventions for Psychotic Disorders: The Impact of Exercise Intensity, Mindfulness Components, and Other Moderators on Symptoms, Functioning, and Cardiometabolic Health",

abstract = "Background and HypothesisExercise therapy has been shown to be an effective complementary treatment for patients with psychotic disorders. However, the specific impacts of different training modalities remain poorly understood. This article aims to quantitatively review the moderating influence of different exercise modalities, hypothesizing that higher exercise intensity as well as utilization of mindfulness-based exercise (MBE) components, will improve intervention outcomes.Study DesignPubMed, Web of Science, and PsycINFO were searched from 2010 to March 2022 for randomized controlled trials investigating exercise interventions in patients with psychotic disorders (preregistration: https://doi.org/10.17605/OSF.IO/J8QNS). Outcomes considered were positive/negative symptoms, Positive and Negative Syndrome Scale (PANSS) General Psychopathology/Total scores, depressive symptoms, psychosocial functioning, quality of life, cardiorespiratory fitness, and body mass index. Separate meta-analyses, including moderator analyses, were performed to evaluate the moderating influence of different training modalities.Study ResultsOf 6653 studies, 40 (n = 2111 patients) were included in the meta-analysis. The effects of moderate-intensity exercise exceed low-intensity approaches for PANSS Total scores (P = .02) and depressive symptoms (P = .04). The presence of MBE components was associated with improvements in positive symptoms (P = .04) and PANSS General Psychopathology subscores (P = .04) but also with higher error and between-study heterogeneity. Our analysis also shows improved intervention effects on depression in younger patients (P = .012) and improved psychosocial functioning scores following more frequent sessions (P < .01).ConclusionsA minimum of moderate intensity should be considered. More frequent training sessions per week also seem to be beneficial. While adding mindfulness elements is promising, it increases heterogeneity and requires caution in terms of generalization.",

author = "Matthias Ri{\ss}mayer and Joseph Kambeitz and Florian Javelle and Lichtenstein, {Theresa Katharina}",

year = "2024",

month = feb,

day = "23",

doi = "10.1093/schbul/sbae015",

language = "English",

journal = "Schizophrenia bulletin",

issn = "0586-7614",

publisher = "Oxford University Press",

}

Systematic Review and Meta-analysis of Exercise Interventions for Psychotic Disorders: The Impact of Exercise Intensity, Mindfulness Components, and Other Moderators on Symptoms, Functioning, and Cardiometabolic Health. / Rißmayer, Matthias; Kambeitz, Joseph; Javelle, Florian et al.
in: Schizophrenia bulletin, 23.02.2024.

Publikation: Beitrag in Fachzeitschrift › Zeitschriftenaufsätze › Forschung › Begutachtung

TY - JOUR

T1 - Systematic Review and Meta-analysis of Exercise Interventions for Psychotic Disorders: The Impact of Exercise Intensity, Mindfulness Components, and Other Moderators on Symptoms, Functioning, and Cardiometabolic Health

AU - Rißmayer, Matthias

AU - Kambeitz, Joseph

AU - Javelle, Florian

AU - Lichtenstein, Theresa Katharina

PY - 2024/2/23

Y1 - 2024/2/23

N2 - Background and HypothesisExercise therapy has been shown to be an effective complementary treatment for patients with psychotic disorders. However, the specific impacts of different training modalities remain poorly understood. This article aims to quantitatively review the moderating influence of different exercise modalities, hypothesizing that higher exercise intensity as well as utilization of mindfulness-based exercise (MBE) components, will improve intervention outcomes.Study DesignPubMed, Web of Science, and PsycINFO were searched from 2010 to March 2022 for randomized controlled trials investigating exercise interventions in patients with psychotic disorders (preregistration: https://doi.org/10.17605/OSF.IO/J8QNS). Outcomes considered were positive/negative symptoms, Positive and Negative Syndrome Scale (PANSS) General Psychopathology/Total scores, depressive symptoms, psychosocial functioning, quality of life, cardiorespiratory fitness, and body mass index. Separate meta-analyses, including moderator analyses, were performed to evaluate the moderating influence of different training modalities.Study ResultsOf 6653 studies, 40 (n = 2111 patients) were included in the meta-analysis. The effects of moderate-intensity exercise exceed low-intensity approaches for PANSS Total scores (P = .02) and depressive symptoms (P = .04). The presence of MBE components was associated with improvements in positive symptoms (P = .04) and PANSS General Psychopathology subscores (P = .04) but also with higher error and between-study heterogeneity. Our analysis also shows improved intervention effects on depression in younger patients (P = .012) and improved psychosocial functioning scores following more frequent sessions (P < .01).ConclusionsA minimum of moderate intensity should be considered. More frequent training sessions per week also seem to be beneficial. While adding mindfulness elements is promising, it increases heterogeneity and requires caution in terms of generalization.

AB - Background and HypothesisExercise therapy has been shown to be an effective complementary treatment for patients with psychotic disorders. However, the specific impacts of different training modalities remain poorly understood. This article aims to quantitatively review the moderating influence of different exercise modalities, hypothesizing that higher exercise intensity as well as utilization of mindfulness-based exercise (MBE) components, will improve intervention outcomes.Study DesignPubMed, Web of Science, and PsycINFO were searched from 2010 to March 2022 for randomized controlled trials investigating exercise interventions in patients with psychotic disorders (preregistration: https://doi.org/10.17605/OSF.IO/J8QNS). Outcomes considered were positive/negative symptoms, Positive and Negative Syndrome Scale (PANSS) General Psychopathology/Total scores, depressive symptoms, psychosocial functioning, quality of life, cardiorespiratory fitness, and body mass index. Separate meta-analyses, including moderator analyses, were performed to evaluate the moderating influence of different training modalities.Study ResultsOf 6653 studies, 40 (n = 2111 patients) were included in the meta-analysis. The effects of moderate-intensity exercise exceed low-intensity approaches for PANSS Total scores (P = .02) and depressive symptoms (P = .04). The presence of MBE components was associated with improvements in positive symptoms (P = .04) and PANSS General Psychopathology subscores (P = .04) but also with higher error and between-study heterogeneity. Our analysis also shows improved intervention effects on depression in younger patients (P = .012) and improved psychosocial functioning scores following more frequent sessions (P < .01).ConclusionsA minimum of moderate intensity should be considered. More frequent training sessions per week also seem to be beneficial. While adding mindfulness elements is promising, it increases heterogeneity and requires caution in terms of generalization.

UR - https://doi.org/10.1093/schbul/sbae015

U2 - 10.1093/schbul/sbae015

DO - 10.1093/schbul/sbae015

M3 - Journal articles

SN - 0586-7614

JO - Schizophrenia bulletin

JF - Schizophrenia bulletin

ER -