scholarly journals Aerobic exercise in severe mental illness: requirements from the perspective of sports medicine

2021 ◽  
Author(s):  
Peter Falkai ◽  
Andrea Schmitt ◽  
Christian P. Rosenbeiger ◽  
Isabel Maurus ◽  
Lisa Hattenkofer ◽  
...  
Keyword(s):  
Mental Illness ◽  
Depressive Symptoms ◽  
Aerobic Exercise ◽  
Severe Mental Illness ◽  
Cardiorespiratory Fitness ◽  
Sports Medicine ◽  
Mental Illnesses ◽  
Moderate Intensity ◽  
Global Functioning ◽  
Exercise Interventions

AbstractMajor depression, bipolar disorder, and schizophrenia are severe mental illnesses. Despite receiving psychopharmacological and psychosocial treatments, about half of patients develop a chronic course with residual cognitive and negative symptoms and have a high risk for cardiovascular disease and reduced life expectancy. Therefore, add-on innovative treatment approaches are needed to improve outcome. Aerobic exercise interventions have been shown to improve global functioning, cognition, and negative and depressive symptoms in these patients. The basic mechanism of these exercise-related changes has been reported to be improved brain plasticity, e.g., increased volume of disease-related brain regions such as the hippocampus. The optimal type, duration, and frequency of exercise have not yet been determined and need to be addressed in supervised physical exercise studies. Because of the low physical activity levels, lack of drive related to negative and depressive symptoms, and high prevalence of cardiovascular comorbidities in patients with severe mental illness, besides aiming to improve symptoms of mental illness, exercise interventions should also aim to increase cardiorespiratory fitness, which they should comprehensively assess by direct measurements of maximal oxygen uptake. Based on the recommendations for developing cardiorespiratory fitness by the American College of Sports Medicine, 150 min moderate-intensity training per week or vigorous-intensity exercise training for 75 min per week are appropriate. Most studies have had relatively short intervention periods, so future studies should focus on long-term adherence to exercise by implementing motivational strategies supported by telemedicine and by identifying and targeting typical barriers to exercise in this patient population.

Effective e-health design for those with, and without, mental health disorders: shallow navigation, concentrated contents, modest number of links, one screen area for links. (Preprint)

2018 ◽  
Author(s):  
Armando Rotondi ◽  
Jonathan Grady ◽  
Barbara H. Hanusa ◽  
Michael R. Spring ◽  
Kaleab Z. Abebe ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Success Rate ◽  
Fractional Factorial ◽  
Mental Illnesses ◽  
Schizophrenia Spectrum Disorders ◽  
Design Elements ◽  
Website Usability ◽  
Schizophrenia Spectrum ◽  
Health Applications

BACKGROUND E-health applications are an avenue to improve service responsiveness, convenience, and appeal, and tailor treatments to improve relevance, engagement, and use. It is critical to user engagement that the designs of e-health applications are intuitive to navigate. Limited research exists on designs that work for those with a severe mental illness, many of whom infrequently seek treatment, and tend to discontinuation medications and psychosocial treatments. OBJECTIVE The purpose of this study was to evaluate the influence of 12 design elements (e.g., website depth, reading level, use of navigational lists) on the usability of e-health application websites for those with, and without, mental health disorders (including severe mental illness). METHODS A 212-4 fractional factorial experimental design was used to specify the designs of 256 e-health websites, which systematically varied the 12 design elements. The final destination contents of all websites were identical, only the navigational pages varied. Three subgroups of participants comprising 226 individuals, were used to test these websites (those with schizophrenia-spectrum disorders, other mental illnesses, and no mental illness). Unique to this study was that the 12 design elements were manipulated systematically to allow assessment of combinations of design elements rather than only one element at a time. RESULTS The best and worst designs were identified for each of the three subgroups, and the sample overall. The depth of a website’s navigation, that is, the number of screens/pages users needed to navigate to find desired content, had the strongest influence on usability (ability to find information). The worst performing design for those with schizophrenia-spectrum disorders had an 8.6% success rate (ability to find information), the best had a 53.2% success rate. The navigational design made a 45% difference in usability. For the subgroup with other mental illnesses the design made a 52% difference, and for those with no mental illness a 50% difference in success rate. The websites with the highest usability all had several key similarities, as did the websites with the poorest usability. A unique finding is that the influences on usability of some design elements are variable. For these design elements, whether they had a positive or negative effect, and the size of its effect, could be influenced by the rest of the design environment, that is, the other elements in the design. This was not the case for navigational depth, a shallower hierarchy is better than a deeper hierarchy. CONCLUSIONS It is possible to identify evidence-based strategies for designing e-health applications that result in a high level of usability. Even for those with schizophrenia, or other severe mental illnesses, there are designs that are highly effective. The best designs have key similarities, but can also vary in some respects. Key words: schizophrenia, severe mental illness, e-health, design, website, usability, website design, website usability, fractional factorial design.

scholarly journals Changes in the Gut Bacteria Composition of Healthy Men with the Same Nutritional Profile Undergoing 10-Week Aerobic Exercise Training: A Randomized Controlled Trial

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2839
Author(s):  
Ayane S. Resende ◽  
Geovana S. F. Leite ◽  
Antonio H. Lancha Junior
Keyword(s):  
Body Composition ◽  
Aerobic Exercise ◽  
Cardiorespiratory Fitness ◽  
Gut Bacteria ◽  
Moderate Intensity ◽  
Daily Routine ◽  
Nutritional Profile ◽  
Α Diversity ◽  
Pearson's R ◽  
Pearson’S R

Nutrient consumption and body mass index (BMI) are closely related to the gut microbiota, and exercise effects on gut bacteria composition may be related to those variables. Thus, we aimed to investigate the effect of 10-week moderate aerobic exercise on the cardiorespiratory fitness and gut bacteria composition of non-obese men with the same nutritional profile. Twenty-four previously sedentary men (age 25.18 [SD 4.66] years, BMI 24.5 [SD 3.72] kg/m2) were randomly assigned into Control (CG; n = 12) or Exercise Groups (EG; n = 12). Body composition, cardiorespiratory parameters, blood markers, dietary habits and gut bacteria composition were evaluated. EG performed 150 min per week of supervised moderate (60–65% of VO2peak) aerobic exercise, while CG maintained their daily routine. The V4 16S rRNA gene was sequenced and treated using QIIME software. Only EG demonstrated marked improvements in cardiorespiratory fitness (VO2peak, p < 0.05; Effect Size = 0.971) without changes in other gut bacteria-affecting variables. Exercise did not promote clustering based on diversity indices (p > 0.05), although significant variations in an unclassified genus from Clostridiales order and in Streptococcus genus were observed (p < 0.05). Moreover, α-diversity was correlated with VO2peak (Pearson’s R: 0.47; R2 0.23: 95%CI: 0.09 to 0.74, p = 0.02) and BMI (Pearson’s R: −0.50; R2 0.25: 95%CI: −0.75 to −0.12, p = 0.01). Roseburia, Sutterella and Odoribacter genera were associated with VO2peak, while Desulfovibrio and Faecalibacterium genera were associated with body composition (p < 0.05). Our study indicates that aerobic exercise at moderate intensity improved VO2peak and affected gut bacteria composition of non-obese men who maintained a balanced consumption of nutrients.

scholarly journals High-intensity exercise to promote accelerated improvements in cardiorespiratory fitness (HI-PACE): Study protocol for a randomized controlled trial

2019 ◽  
Author(s):  
Joshua E. McGee ◽  
Savanna G. Barefoot ◽  
Nicole R. Gniewek ◽  
Patricia M. Brophy ◽  
Angela Clark ◽  
...  
Keyword(s):  
Public Health ◽  
Type 2 Diabetes ◽  
African Americans ◽  
Aerobic Exercise ◽  
Cardiorespiratory Fitness ◽  
High Intensity ◽  
Controlled Trial ◽  
High Intensity Exercise ◽  
Moderate Intensity

Abstract Background African Americans have a disproportionate prevalence and incidence of type 2 diabetes compared to Caucasians. Recent evidence indicates low cardiorespiratory fitness (CRF) level, an independent risk factor for type 2 diabetes, is also more prevalent in African Americans than Caucasians. Numerous studies in Caucasian populations suggest vigorous exercise intensity may promote greater improvements in CRF and other type 2 diabetes risk factors (e.g. reduction of glucose/insulin levels, pulse wave velocity, body fat, etc.) than moderate intensity. However, current evidence comparing health benefits of different aerobic exercise intensities on type 2 diabetes risk factors in African Americans is negligible. This is clinically important as African Americans have a greater risk for type 2 diabetes and are less likely to meet public health recommendations for physical activity than Caucasians. The purpose of the High-Intensity exercise to Promote Accelerated improvements in CardiorEspiratory fitness (HI-PACE) study is to evaluate whether high-intensity aerobic exercise elicits greater improvements in CRF, insulin action, and arterial stiffness than moderate-intensity exercise in African Americans. Methods/Design­ A randomized controlled trial will be performed on overweight and obese (body mass index: 25-45 kg/m2) African Americans (35-65 years) (n=60). Participants will be randomized to moderate-intensity (MOD-INT) or high-intensity (HIGH-INT) aerobic exercise training, or a non-exercise control group (CON) for 24 weeks. Supervised exercise will be performed at a heart rate associated with 45-55% and 70-80% of VO2 max in the MOD-INT and the HIGH-INT groups, respectively, for an exercise dose of 600 MET-minutes/week (consistent with public health recommendations). The primary outcome is change in CRF. Secondary outcomes include change in insulin sensitivity (measured via an intravenous glucose tolerance test), skeletal muscle mitochondrial oxidative capacity (via near infrared spectroscopy), skeletal muscle measurements (i.e. citrate synthase, COX IV, GLUT-4, CPT-1, PGC1-α), arterial stiffness (via carotid-femoral pulse wave velocity), body fat, C-reactive protein, and psychological outcomes (quality of life/exercise enjoyment). Discussion The anticipated results of the HI-PACE study will provide vital information on the health effects of high-intensity exercise in African Americans. This study will advance health disparity research and has the potential to influence future public health guidelines for physical activity. Trial Registration ClinicalTrials.gov ID: NCT02892331. Registered on 8 September 2016, https://clinicaltrials.gov/ct2/show/NCT02892331

scholarly journals COGNITIVE PERFORMANCE, EXERCISE, AND AMYLOID BURDEN: A RANDOMIZED CONTROLLED TRIAL

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S610-S610
Author(s):  
Amber Watts ◽  
Eric Vidoni ◽  
Jill Morris ◽  
Mark Perry ◽  
David Johnson ◽  
...  
Keyword(s):  
Older Adults ◽  
Aerobic Exercise ◽  
Cognitive Performance ◽  
Cardiorespiratory Fitness ◽  
Pet Imaging ◽  
Verbal Memory ◽  
Controlled Trial ◽  
Control Group ◽  
Digit Symbol Substitution Test ◽  
Exercise Interventions

Abstract Exercise is a promising strategy for prevention of Alzheimer’s disease (AD). Amyloid neuroimaging can identify individuals at risk of developing AD prior to displaying symptoms. We screened adults (65+) with Florbetapir PET imaging and a comprehensive cognitive battery. We randomized 117 participants with normal cognition into a 52-week aerobic exercise program to examine the effects of aerobic exercise on cognitive performance. We compared an intensive exercise treatment group to a standard of care control group. Cognition was assessed at baseline, 26 weeks, and 52 weeks in the domains of verbal memory, visuospatial processing, attention, and executive function. Interim results on 87 participants show cardiorespiratory fitness improved in the exercise group vs. control group (t=3.66(81), p&lt; .001). The degree of change in cardiorespiratory fitness did not differ between those with and without elevated amyloid (t=-0.37(81), p=.710). Greater improvements in cardiorespiratory fitness predicted better performance on cognitive tests including trailmaking test, Stroop test, and digit symbol substitution test, which did not differ by amyloid status. Elevated amyloid levels predicted lower cognitive scores in logical memory, space relations, and identical pictures test. Our findings suggest PET imaging is a valid marker of cognitive performance in non-impaired older adults, and that this pre-clinical amyloid status did not reduce the cognitive benefits of exercise for those who improved in cardiorespiratory fitness. Exercise interventions hold promise for cognitive maintenance among pre-symptomatic older adults with elevated amyloid levels. Finally, results highlight the importance of evaluating multiple cognitive domains which are associated differently with exercise and amyloid status.

scholarly journals A Qualitative Study Exploring the Lived Experience of Unemployment Among People with Severe Mental Illness

2020 ◽  
Vol 42 (5) ◽  
pp. 435-444
Author(s):  
Reema Samuel ◽  
Abirame S. ◽  
K. S. Jacob
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Lived Experience ◽  
Health Care Professionals ◽  
Bipolar Affective Disorder ◽  
Community Support ◽  
Role Expectations ◽  
Mental Illnesses ◽  
Economic Productivity ◽  
Barriers To Employment

Background: Severe mental illnesses lead to deterioration in the life skills of the patient, resulting in socio-occupational dysfunction and low rates of employment. The purpose of this study was to explore attitudes, knowledge, and barriers to employment as experienced by patients and their caregivers in India. Method: Patients with schizophrenia or bipolar affective disorder, aged between 18 and 60 and undergoing inpatient treatment and their caregivers, were approached for written informed consent and recruited for focus group discussions. A total of eight focus groups were conducted until saturation of themes was seen to have been achieved. The data were transcribed, coded, synthesized, and organized into major findings and implications for practice. Results: Role expectations based on gender were seen to influence the decision to work. The possible recurrence of illness due to excess stress and unsupportive working environments was cited as the most common problem that could arise related to employment. Stigma and faulty attributions related to the illness were the most cited barriers to employment. Most participants felt that psychosocial rehabilitation and family and community support were essential for facilitating work. Most participants did not consider mental illness as a disability and were unaware of government schemes for the mentally ill. Conclusion: Considering gender-based role expectations, avenues for self/family employment and improving the awareness of benefits for mental illness both among consumers and health care professionals are essential to enhance economic productivity in people with severe mental illness.

scholarly journals An Overview of Cognitive Remediation Therapy for People with Severe Mental Illness

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Cherrie Galletly ◽  
Ashlee Rigby
Keyword(s):  
Mental Illness ◽  
Cognitive Function ◽  
Mental Disorders ◽  
Severe Mental Illness ◽  
Cognitive Deficits ◽  
Cognitive Remediation ◽  
Mental Illnesses ◽  
Cognitive Remediation Therapy ◽  
Severe Mental Disorders ◽  
Varying Length

Cognitive remediation refers to nonpharmacological methods of improving cognitive function in people with severe mental disorders. Cognitive remediation therapy (CRT) can be delivered via computerised programs, of varying length and complexity, or can be undertaken one-on-one by a trained clinician. There has been a considerable interest in cognitive remediation, driven by recognition that cognitive deficits are a major determinant of outcome in people with severe, chronic mental illnesses. CRT has been shown to be effective, especially if combined with vocational rehabilitation.

scholarly journals Metabolic phenotyping reveals a potential link between elevated faecal amino acids, diet and symptom severity in individuals with severe mental illness

2021 ◽  
Author(s):  
Jack Jansma ◽  
Rogier van Essen ◽  
Bartholomeus C.M. Haarman ◽  
Anastasia Chrysovalantou Chatziioannou ◽  
Jenny Borkent ◽  
...  
Keyword(s):  
Amino Acids ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Symptom Severity ◽  
Psychiatric Symptoms ◽  
Mental Illnesses ◽  
Therapeutic Interventions ◽  
Schizophrenia Spectrum Disorders ◽  
Potential Link ◽  
The Brain

The brain-gut axis is increasingly recognized as an important contributing factor in the onset and progression of severe mental illnesses such as schizophrenia spectrum disorders and bipolar disorder. This study investigates associations between levels of faecal metabolites identified using 1H-NMR, clinical parameters, and dietary components of forty-two individuals diagnosed in a transdiagnostic approach to have severe mental illness. Faecal levels of the amino acids; alanine, leucine, and valine showed a significant positive correlation with psychiatric symptom severity as well as with dairy intake. Overall, this study proposes a diet-induced link between the brain-gut axis and the severity of psychiatric symptoms, which could be valuable in the design of novel dietary or therapeutic interventions to improve psychiatric symptoms.

scholarly journals Functional disability and associated factors among patients with severe mental illness attending psychiatry outpatient unit at Ayder comprehensive specialized hospital, Mekelle, Ethiopia: a cross-sectional study.

2020 ◽  
Author(s):  
Tesfalem Amare ◽  
Natnael Seifu ◽  
Mirkat Shewangzaw
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Functional Disability ◽  
Social Supports ◽  
Cross Sectional Study ◽  
Mental Illnesses ◽  
Sectional Study ◽  
Cross Sectional ◽  
Duration Of Illness ◽  
Functional Disabilities

Abstract Background According to the World Health Organization (WHO), functional disability associated with severe mental illnesses was pervasive, affecting everyday life, and has a significant contribution to the global functional disability. The severe mental illnesses (schizophrenia, major depressive disorder, and bipolar disorder) were among the top ten leading causes of functional disability as indicated by years lived with a functional disability. These illnesses hurt the academic, occupational, social and family functioning of the patients. Despite this fact, functional disabilities and its contributing factors among severe mental illness were not clear. Therefore this study will assess the prevalence and associated factors of functional disabilities among patients with severe mental illnesses. Methods Institutional based cross-sectional study was conducted from Feb 03 to March 10, 2020, with a total of 423 participants in Mekelle, Ethiopia. A stratified random sampling method was included in the study. Functional disabilities were measured by WHO functional disability assessment schedule version two (WHODAS 2.0). Bivariate and multiple logistic regression analyses were performed to determine the association between independent and dependent variables. Results The prevalence of functional disability among severe mental ill patients was 88.1% (51.3% mild, 27.5% moderate & 9.3% sever functional disabilities). This study revealed that, being jobless [AOR=4.01, 95% CI (1.77, 12.35)], duration of illness ≥11 years [AOR=2.99, 95% CI(1.17,7.64)], those who had poor treatment adherence [AOR= 2.79, 95% CI (1.06, 7.35)], drug adverse effects [AOR= 4.61, 95% CI (1.79, 11.84)], poor social supports [AOR=6.58, 95% CI (2.01, 21.56)], and moderate social supports [AOR=4.16, 95% CI (1.88,9.20)] were significantly associated with functional disabilities. Conclusion The prevalence of functional disability was found to be high. Being jobless, duration of illness ≥11 years, medication non-adherent, having drug side effects and having poor or moderate social support were significantly associated with functional disabilities. Therefore, when treating patients with severe mental illness giving especial attention the bio-psycho-social aspect of treatment is essential.

Sign in / Sign up

Export Citation Format

Share Document