Ausdauertraining bei Schizophreniepatienten: Eine kontrollierte Studie zu den Wirkungen von Ausdauertraining in der Kombination mit kognitivem Training auf Ausdauerleistungsfähigkeit, Funktionsniveau und Hippocampusvolumen
Endurance training with schizophrenia patients: A controlled study about the effects of endurance training in combination with cognitive training on endurance capacity, psychosocial functioning and hippocampal volumes
by Katriona Keller
Date of Examination:2014-11-17
Date of issue:2014-11-18
Advisor:Prof. Dr. Dr. Andree Niklas
Referee:Prof. Dr. Dr. Andree Niklas
Referee:Prof. Dr. Peter Falkai
Referee:Prof. Dr. Arnd Krüger
Files in this item
Name:Dissertation_Katriona_Keller.pdf
Size:69.6Mb
Format:PDF
Abstract
English
The aim of the study is the investigation of endurance training for future implementation into the therapy plan of schizophrenia patients. In healthy controls and animals, several beneficial effects of endurance training are known that may counteract pathological changes in schizophrenia, or contribute to counteract the consequences of the disorder. Previous studies reported positive effects of training on symptom severity, but changes in endurance capacity and cerebral changes have seldom been investigated and with contradictory findings. The controlled interventional study “Exercise II” addresses the question whether adaptations to endurance training in combination with cognitive training have a positive impact on schizophrenia. 25 schizophrenia patients and 27 healthy controls participated in 12 weeks endurance training. 25 schizophrenia patients formed a second group of patients playing table soccer as another control condition. Three sessions per week with durations of 30 minutes each were offered in all groups. In the second half this was combined with two weekly sessions of cognitive training. Endurance training was conducted on bicycle ergometers with predominantly aerobic metabolism employing the continuous method. Before the beginning of the training, after the first half, after the cessation of the intervention, as well as three and nine months later, anamnestic interviews, incremental ergometries, doctor-patients discussions, and neuropsychological tests were conducted. From magnet resonance imaging data hippocampal volumes were calculated by means of semiautomatic segmentation. 22 patients and 23 healthy controls completed the endurance training with 92% attendance and 21 patients completed the table soccer intervention with 93% attendance on average. The training was feasible with the projected parameters and was positively judged by the participants. Despite of the interest in participation in future sports programs, only 2 patients were able to sustain the training independently and systematically after cessation of the intervention. The endurance capacity increased in both endurance groups in comparison of pre and post measurements. This became evident in significant increases of Physical Working Capacity and maximal power by 9 to 16% in patients and 6 to 12% in healthy controls on average (p≤0.015). Adaptation in patients and healthy controls were comparable although patients showed a lower level of endurance capacity. Significant changes in parameters of energy metabolism were only detectable in healthy controls (p≤0,019). Global psychosocial functioning improved in the endurance group but not in the table soccer group (p=0,003). Expected changes in hippocampal volume were measurable in neither group and differences between groups did not reach statistically significance. The improvements in endurance performance and functioning, the confirmed feasibility and the positive subjective reactions of the patients indicate that a further investigation of a long term sports therapy concept implementing training in daily care of schizophrenia patients should be conducted.
Keywords: endurance training; schizophrenia