Long-term maintenance and effects of exercise in early psychosis:a six-month follow up to an intervention study

Aim: To examine if people with first-episode psychosis (FEP) are able to continue adhering to exercise after a supervised intervention, and to explore if the benefits of exercise can be sustained. Methods: Twenty-eight people with FEP took part in a 10-week exercise intervention that provided each participant with twice-weekly accompaniment to exercise activities of their own choice. 20 were re-assessed 6 months after the intervention. Long-term adherence to exercise was assessed, and measures of psychiatric symptoms, physical health, neurocognition and social functioning were administered at baseline, post-intervention and 6-months follow-up.Results: During the supervised intervention, participants achieved 124.4 minutes of moderate-to-vigorous exercise per week. After 6 months, physical activity levels had decreased significantly (p=0.025) and only 55% of participants had continued to exercise weekly. Repeated-Measures ANOVA found that the significant improvements in psychiatric symptoms and social functioning observed immediately after the intervention were maintained at 6-months (p=0.001). However, post-hoc analyses showed that symptomatic reductions were only maintained for those who continued to exercise, whereas symptom scores increased among those who had ceased exercising. Previously-observed improvements in waist circumference and verbal memory were lost by 6 months.Conclusion: Long-term exercise participation is associated with significant benefits for symptoms, cognition and social functioning in FEP. However, adherence to unsupervised exercise is low. Future research should explore the effectiveness of ‘step-down’ support following supervised interventions, and aim to establish sustainable methods for maintaining regular exercise in order to facilitate functional recovery and maintain physical health.