Aerobic Exercise Improves Cognitive Functioning in People With Schizophrenia: A Systematic Review and Meta-Analysis.
Aerobic Exercise Improves Cognitive Functioning in People With Schizophrenia: A Systematic Review and Meta-Analysis.
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DOI：
10.1093/schbul/sbw115
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发表时间：
2017-05-01
影响因子：
6.6
通讯作者：
Yung AR
中科院分区：
文献类型：
--
作者：
Firth J;Stubbs B;Rosenbaum S;Vancampfort D;Malchow B;Schuch F;Elliott R;Nuechterlein KH;Yung AR
认知缺陷在精神分裂症患者中普遍存在，治疗选择有限。人们对运动对神经认知的益处越来越感兴趣，但到目前为止，还缺乏对研究的全面评估。因此，我们对所有对照试验进行了荟萃分析，调查了运动干预对精神分裂症患者的认知结果。这些研究是通过对主要电子数据库进行系统搜索而确定的，从最初到2016年4月。Meta分析用于计算合并效应大小(Hedge G)和95%的Cis。我们为385名精神分裂症患者确定了10项具有认知结果数据的合格试验。运动显著改善整体认知(g=0.33，95%CI=0.13-0.53，P=.001)，无统计学异质性(I2=0%)。7项随机对照试验的效应量为g=0.43(P<；.001)。Meta回归分析表明，运动量越大，全球认知能力的改善越大(β=0.005，P=0.065)。由体力活动专业人员监督的干预也更有效(g=0.47，P<；.001)。运动显著改善了工作记忆(g=0.39，P=.024，N=7，n=282)、社会认知(g=0.71，P=.002，N=3，n=81)和注意力/警觉性(g=0.66，P=.005，N=3，n=104)的认知领域。对加工速度、言语记忆、视觉记忆、推理和问题解决的影响不显著。这一荟萃分析提供了证据，表明锻炼可以改善精神分裂症患者的认知功能，特别是通过使用更高剂量的锻炼进行干预。考虑到在改善认知方面的挑战，以及锻炼对健康的更广泛好处，有必要更多地关注为精神分裂症患者提供有监督的锻炼。
Cognitive deficits are pervasive among people with schizophrenia and treatment options are limited. There has been an increased interest in the neurocognitive benefits of exercise, but a comprehensive evaluation of studies to date is lacking. We therefore conducted a meta-analysis of all controlled trials investigating the cognitive outcomes of exercise interventions in schizophrenia. Studies were identified from a systematic search across major electronic databases from inception to April 2016. Meta-analyses were used to calculate pooled effect sizes (Hedges g) and 95% CIs. We identified 10 eligible trials with cognitive outcome data for 385 patients with schizophrenia. Exercise significantly improved global cognition (g = 0.33, 95% CI = 0.13–0.53, P = .001) with no statistical heterogeneity (I2 = 0%). The effect size in the 7 studies which were randomized controlled trials was g = 0.43 (P < .001). Meta-regression analyses indicated that greater amounts of exercise are associated with larger improvements in global cognition (β = .005, P = .065). Interventions which were supervised by physical activity professionals were also more effective (g = 0.47, P < .001). Exercise significantly improved the cognitive domains of working memory (g = 0.39, P = .024, N = 7, n = 282), social cognition (g = 0.71, P = .002, N = 3, n = 81), and attention/vigilance (g = 0.66, P = .005, N = 3, n = 104). Effects on processing speed, verbal memory, visual memory and reasoning and problem solving were not significant. This meta-analysis provides evidence that exercise can improve cognitive functioning among people with schizophrenia, particularly from interventions using higher dosages of exercise. Given the challenges in improving cognition, and the wider health benefits of exercise, a greater focus on providing supervised exercise to people with schizophrenia is needed.