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Effects of Physical Activity in Psychosis (EPHAPS)

16 april 2018 bijgewerkt door: John Abel Engh, Sykehuset i Vestfold HF

Effects of Aerobic High Intensity Training on Symptoms, Cognition, Cortical Structure, Substance Use and Metabolic Indices in Patients With Schizophrenia Spectrum Disorder

Physical health problems are common in schizophrenia with a two- to three-fold increased morbidity and mortality rate, resulting in a 20 years reduction in life expectancy. A genetic vulnerability for developing cardiovascular disease has been documented in these patients, and many lifestyle factors also negatively influence physical health. Patients with schizophrenia are likely to smoke, are physically inactive and overweight, suffer from malnutrition due to unhealthy diet, and have reduced cardiorespiratory fitness. Moreover, these patients have increased risk of developing diabetes mellitus type II and metabolic syndrome. These aspects demonstrate the need for multi-disciplinary treatments of patients with schizophrenia and underline the need for addressing their physical health.

Poor physical fitness seems to be associated with exacerbated negative symptoms and increased cognitive dysfunction in patients with schizophrenia. However, evidence on physical activity and its consequences in schizophrenia is scarce. In this randomized controlled trial we investigate the effects of high intensity training in outpatients with schizophrenia on psychotic symptoms and well-being, cognition and cortical structure, tobacco smoking and substance use, in addition to metabolic indices.

Studie Overzicht

Gedetailleerde beschrijving

Outpatients in treatment will be recruited in this randomized controlled trial (RCT). The patients will be randomized to either a Computer gaming Skills Group (CSG) or to a physical Exercise Group (EG). The groups are identically organized in two locations. The interventions last for 12 weeks, and treatment as usual will be continued for all patients. Patients will be assessed when entering the study (after randomization and allocation to one of the clinical groups), as well as post-treatment and 4 months post-treatment. Thus, the planned study is prospective with a longitudinal design. It is single blind in the sense that the assessment of psychiatric symptom level and neurocognitive function will be performed by research staff blind for group membership. The physiological testing will be performed by staff involved in training and will not be blinded.

EG participants will perform aerobic high intensity training (HIT) consisting of supervised walking/running on a treadmill 2 times a week for 12 weeks. Each session will have the following structure; eight-minute warm-up, followed by four times four minutes intervals with 85-95% of maximum heart rate, with active pauses of three minutes of walking at 70% of maximum heart rate. The exercise session will end with a five minute cool-down period. HIT performed as 4 x 4 intervals has been proven feasible and safe among patients with schizophrenia and in other clinical populations.

Participants in the CSG take part in sessions in the clinic playing computer games (Nintendo Wii Sports). The time spent with activities in the clinic will be the same in both groups. When absent from scheduled physical exercise/playing computer games the subjects will be offered to participate on a following day. If absent for a whole week, the training period/computer games playing period will be prolonged accordingly.

In this randomized controlled trial we investigate the effects of HIT in outpatients with schizophrenia on symptoms and well-being, cognition and brain structure, smoking habits and substance use, as well as metabolic indices.

The participating outpatient clinics are catchment area based and cover a population of 200 000 persons with more than 250 patients in the diagnostic group in treatment at one time.

Studietype

Ingrijpend

Inschrijving (Verwacht)

126

Fase

  • Niet toepasbaar

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar tot 67 jaar (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  • verified (Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, SCID) diagnosis of schizophrenia spectrum disorder
  • outpatient in treatment
  • written informed consent
  • fluent in a Scandinavian language

Exclusion Criteria:

  • chest pain during exercise
  • unstable angina pectoris
  • suspicion of recent myocardial infarction
  • uncontrollable arrhythmia
  • acute infection with lymphadenopathy
  • malignant hypertension
  • neurological disorder
  • severe physical disability
  • medical condition incompatible with particiption
  • comorbid diagnosis of mild mental retardation
  • pregnancy

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Enkel

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Physical activity
Aerobic High Intensity Training (HIT)
Aerobic High Intensity Training (HIT)
Actieve vergelijker: Computer game skills training
Playing Nintendo Wii Sports
Playing Nintendo Wii Sports

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Tijdsspanne
Change from Baseline in Cognitive Function after 12 Weeks and 28 Weeks
Tijdsspanne: Baseline, 12 Weeks, 28 Weeks and Up to 5 Years Post-Treatment
Baseline, 12 Weeks, 28 Weeks and Up to 5 Years Post-Treatment

Secundaire uitkomstmaten

Uitkomstmaat
Tijdsspanne
Change from Baseline in Symptom load after 12 Weeks and 28 Weeks
Tijdsspanne: Baseline, 12 Weeks, 28 Weeks and Up to 5 Years Post-Treatment
Baseline, 12 Weeks, 28 Weeks and Up to 5 Years Post-Treatment
Change from Baseline in Peak oxygen uptake after 12 Weeks and 28 Weeks
Tijdsspanne: Baseline, 12 Weeks, 28 Weeks and Up to 5 Years Post-Treatment
Baseline, 12 Weeks, 28 Weeks and Up to 5 Years Post-Treatment
Change from Baseline in Metabolic Indices after 12 Weeks and 28 Weeks
Tijdsspanne: Baseline, 12 Weeks, 28 Weeks and Up to 5 Years Post-Treatment
Baseline, 12 Weeks, 28 Weeks and Up to 5 Years Post-Treatment

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Onderzoekers

  • Hoofdonderzoeker: John A Engh, MD, PhD, Division of Mental Health & Addiction, Vestfold Hospital Trust, Tønsberg, Norway

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Algemene publicaties

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

1 augustus 2014

Primaire voltooiing (Werkelijk)

1 oktober 2017

Studie voltooiing (Verwacht)

1 december 2019

Studieregistratiedata

Eerst ingediend

29 juli 2014

Eerst ingediend dat voldeed aan de QC-criteria

29 juli 2014

Eerst geplaatst (Schatting)

31 juli 2014

Updates van studierecords

Laatste update geplaatst (Werkelijk)

17 april 2018

Laatste update ingediend die voldeed aan QC-criteria

16 april 2018

Laatst geverifieerd

1 april 2018

Meer informatie

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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