The long-lasting impact of high-intensity training via collaborative care in patients with schizophrenia: A 5-year follow-up study.

Unlabelled: Although exercise is medicine for outpatients with schizophrenia, it is unclear if one-year adherence-supported exercise leads to a "tipping point", at which the exercise becomes a routine manifested as life-long training in the patient group.

Methods: Forty-eight outpatients (28 men/20 women: 35 ± 11 (mean ± SD) years) with schizophrenia (ICD-10: F20-29) were randomised to: 1) collaborative care group (TG), performing aerobic interval (AIT; 4 × 4-min treadmill walking/running at ∼90 % peak heart rate) and leg press maximal strength training (MST; 4 × 4 repetitions at ∼90 % maximal strength [1RM]) 2d·wk. for 1-year, supported by transportation and training supervision; or 2) control group (CG). Peak oxygen uptake (V̇O) and walking work efficiency were measured directly along with scaled 1RM/power, anthropometry, blood pressure, and blood samples at inclusion, 1-year, and 5-years post-intervention.

Results: The TG increased V̇O (11 %, p < .01), scaled 1RM (40 %, p < .001), and power (26 %, p < .001) compared to CG after 1-year. At follow-up, no intergroup differences in these factors were observed (all p > .05). Both groups improved walking work efficiency (TG: 11 %; CG: 18 %; both p < .05) after 1-year (no intergroup difference, p > .05), but not at follow-up (both p > .05). At follow-up, HDL (high-density lipoprotein)-cholesterol (-15 %, p < .01) and glucose (26 %, p < .01) decreased/increased(respectively) more in the TG than CG. No other intergroup differences were observed in anthropometry or blood samples.

Conclusion: 1-year adherence-supported high-intensity training improves V̇O, 1RM, and power in outpatients with schizophrenia. However, the improvements in these factors key to longevity are not maintained after 5 years. These findings highlight the importance of long-lasting cost-efficient adherence support, ultimately affecting the population's prognosis.