運動對精神分裂症患者的生理與精神健康有益

作者：Caroline Cassels  
出處：WebMD醫學新聞

　　May 12, 2010 —根據一項新考科藍綜論顯示，罹患精神分裂或類精神分裂疾病患者常規地運動計畫是可行的，且可能協助改善這些病患的精神與生理健康。
　　
　　然而，雖然整體結果是正面的，但這項綜論僅收納3項小型研究，作者們表示，在做出任何確切的結論前，仍需要較大型的隨機分派研究。
　　
　　這篇綜論的主要作者、加拿大安大略多倫多大學生理教育與健康教師Guy Faulkner博士在一項聲明中表示，對於精神分裂患者而言，目前運動的指引在潛在生理與精神健康好處上顯然是可接受的，因此幾天或每天30分鐘的中度程度運動是一個好的目標。
　　
　　根據這項綜論，運動可以改善精神健康是非常清楚的，但是目前為止，對於精神分裂症方面只有非常有限的證據。
　　
　　有越來越多人認為運動可以增進精神健康。作者們寫到，有關於運動對於精神分裂症的影響，對罹患嚴重精神疾病族群，例如精神分裂症，這樣好處的證據有限。
　　
　　為了確認運動或運動計畫對精神分裂患者精神健康的影響，研究團隊進行了一項搜尋，找尋所有比較任何運動或活動為主要或標準照護主要部份，或是其他治療介入的隨機分派研究。
　　
　　這項綜論包括3項最近的小型研究，比較為期12或16週的運動計畫，包括散步、行走、以及肌肉強度訓練，相較於標準照護或瑜珈對於生理與精神健康預後的影響。
　　
　　研究團隊發現，運動計畫可以改善例如焦慮與憂鬱，特別是與標準照護比較時。生理健康預後的改變是可見的，但是整體來說並不顯著。研究人員表示這可能是因為研究時間較短所致。
　　
　　Faulkner博士表示，過去兩項綜論已經發現，運動治療對於精神分裂是有好處的，但是需要更多嚴謹的研究。這項新的綜論代表這樣的呼籲已經開始被重視。
　　
　　但是我們仍然需要更多研究協助我們學習，如何讓更多精神分裂患者熱衷於運動計畫，以及如何在精神健康服務中發展並執行這樣的計畫。他附帶表示，這是此類介入一個最大的挑戰。
　　
　　作者們表示沒有相關資金上的往來。


Exercise Beneficial for Physical and Mental Health Outcomes in Schizophrenia

By Caroline Cassels
Medscape Medical News

May 12, 2010 — Regular physical exercise programs for individuals with schizophrenia and schizophrenia-like illnesses are feasible and may help improve the mental and physical well-being of these patients, the results of a new Cochrane review suggest.

However, although the overall results were positive, the review included only 3 small studies, prompting the authors to point out that larger randomized trials are needed "before any definitive conclusions can be drawn."

"Current guidelines for exercise appear to be just as acceptable to individuals with schizophrenia in terms of potential physical and mental health benefit, so 30 minutes of moderate physical activity on most, or all, days of the week is a good goal to aim for. Start slowly and build up," the review's lead author Guy Faulkner, PhD, Faculty of Physical Education and Health, University of Toronto, Ontario, Canada, said in a statement.

According to the review, it is well documented that exercise can improve mental health, but to date there has been only limited evidence with respect to its impact on schizophrenia.

"There is a growing recognition that physical activity can enhance mental health. With regard to the effects of exercise on schizophrenia, there is limited evidence to suggest that such benefits are also reported in populations characterized by serious mental illness such as schizophrenia," the authors write.

To determine the mental health effects of exercise or physical activity programs for individuals with schizophrenia, the researchers performed a search to find all randomized controlled trials comparing any intervention where physical activity or exercise was considered to be the main or an active component with standard care or other treatments in this patient population.

The review focused on 3 recent, small studies that compared the effects of 12- to 16-week exercise programs, including components such as jogging, walking, and strength training, with standard care or yoga on physical and mental health outcomes.

The researchers found that exercise programs improved mental state for measures such as anxiety and depression, particularly when compared with standard care. Changes in physical health outcomes were seen, but they were not significant overall. However, the researchers suggest this may be due to the short timescale of the trials.

Two previous reviews have found exercise therapy to be beneficial in schizophrenia but called for more rigorous research. "This new review suggests that such calls are starting to be addressed," said Dr. Faulkner.

"But we still need more research that will help us learn how we can get individuals with schizophrenia engaged in exercise programs in the first place and how such programs can be developed and implemented within mental health services. That’s one of the biggest challenges for this type of intervention," he added.

The authors have disclosed no relevant financial relationships.