EXERCISE INTERVENTIONS FOR POSTURAL STABILITY IN PATIENTS WITH SCHIZOPHRENIA: A SYSTEMATIC REVIEW AND META-ANALYSIS
Notice bibliographique
Résumé
Abstract Background Patients with schizophrenia generally need long-term antipsychotic treatment for relapse prevention. On the other hand, antipsychotic drugs cause postural instability, resulting in an increased risk of falls. Therefore, potential interventions that could enhance postural stability have long been desired for this population. While exercise reportedly improves positive and negative symptoms, cardiopulmonary function, and cognitive functions in patients with schizophrenia, its impact on the postural sway remains unclear in schizophrenia. Aims & Objectives This systematic review and meta-analysis aimed to investigate whether exercise improves postural sway in schizophrenia. Method We conducted comprehensive literature searches in multiple electronic bibliographic databases using terms related to physical activity interventions, combined with keywords such as "schizophrenia," "exercise," and "postural sway" according to the PRISMA statement (RPOSPERO-ID: CRD42023425865). We included studies investigating the postural stability in patients aged 18 and over with schizophrenia who underwent any exercise intervention in addition to their pharmacotherapy. The primary outcome measure was the postural sway, as indicated by pre- and post-intervention scores. A standardized data collection tool extracted statistical information from the primary studies. For each included trial, treatment effects measured by continuous variables were calculated using standardized mean differences (SMD) along with 95% confidence intervals (CI) using EZR statistical software. We assessed the data for risk of bias, heterogeneity, reporting bias, and quality of evidence. Results Out of the 328 articles initially identified, a total of nine studies were selected for inclusion, involving 317 participants with a mean age of 46.3 years (including 151 men). There were five randomized controlled trials (55.6%), following two experimental studies (22.2%), a longitudinal study (11.1%) and one pilot study (11.1%). The duration of the intervention ranged from six weeks to 14 months, with sessions lasting 20 to 90 minutes (mean 56.1 minutes) and occurring 1 to 3 times per week. Most interventions incorporated body-mind interventions (55.6%), such as yoga therapy and Pilates. Despite the variation in evaluation methods, seven studies (77.8%) demonstrated a significant improvement in postural instability following each intervention. Meta-analysis of any exercise interventions revealed lack of significant improvement in postural sway (N=7, n=265, SMD=-0.19, 95% CI: -0.81 to 0.43, p=0.54, I2=78%, p<0.01). However, in a subgroup analysis, both yoga therapy (N=4, n=158, SMD=-0.42, 95% CI: -0.74 to -0.11, p=0.009, I2=0%, p=0.48) and Pilates (N=2, n=40, SMD=-0.81, 95% CI: -1.47 to -0.15, p=0.015, I2=1%, p=0.32) significantly improved the postural instability. In addition, each study exhibited ineligible bias in randomization, and the overall study quality was not high. Discussion & Conclusion While the meta-analysis of all exercise types combined found no significant improvements in postural sway, subgroup analyses focusing on Pilates and yoga therapy significantly enhanced postural stability. Exercises targeting core muscles and relaxation elements may reduce postural instability in schizophrenia. Since this review is limited by the scarcity of exercise types, further exercise interventions in addition to pharmacotherapy are warranted.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,009 | 0,023 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,001 |
| Méta-épidémiologie (sens large) | 0,017 | 0,031 |
| Bibliométrie | 0,006 | 0,006 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».