The effectiveness of structured exercise programmes on psychological and physiological outcomes for patients with psychotic disorders: A systematic review and meta-analysis

Abstract

Structured exercise has been utilised as complementary therapy for patients with psychotic disorders. This review aims to determine the efficacy of structured exercise on both psychological and physiological variables. Applying PRISMA guidelines and keyword search terms, studies were systematically searched in CINAHL, EMBASE, Medline, PsychInfo, SportDiscus and Web of Science databases from earliest record to December 2017. Eligibility criteria included studies who examined adolescents and adult populations with psychotic disorders, and who implemented modalities of structured exercise. 23 studies were included. Aerobic, resistance and combination interventions led to favourable changes in psychological/physiological outcomes relative to controls. Meta-analysis of ten combinable studies examining psychotic symptom severity using the PANSS identified a pooled mean difference estimate of −0.54 (95%CI = −0.83 to –0.25); Z = −3.65, p > .001) in favour of structured exercise interventions. Inspection of the funnel plot suggested publication bias was present (Egger test intercept = −2.13, SE = 0.83, p = .03), and an adjusted estimate = −0.34 (95%CI = −0.66 to −0.01). Systematic review results suggest structured exercise can improve psychological and physiological indices, though with likely variable effect magnitudes based on multiple factors. Meta-analytical findings identified that structured exercise interventions can reduce symptom severity indices associated with diagnosed psychotic disorders.

Keywords:

• psychotic disorders
• structured exercise
• mental health
• SMI
• aerobic exercise

Acknowledgements

The research team would like to thank Kanchana Ekanayake Aalia (Faculty Liaison Librarian) at The University of Sydney for her expertise while conducting this systematic literature review.

ORCID

Caitlin Inez Taylor http://orcid.org/0000-0001-7431-9872

Ross Sanders http://orcid.org/0000-0003-0489-3048

Stephen Cobley http://orcid.org/0000-0001-6099-392X