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Open Access Research article

An impaired health related muscular fitness contributes to a reduced walking capacity in patients with schizophrenia: a cross-sectional study

Davy Vancampfort1*, Michel Probst12, Amber De Herdt2, Rui Manuel Nunes Corredeira3, Attilio Carraro4, Dirk De Wachter1 and Marc De Hert1

Author Affiliations

1 University Psychiatric Centre Catholic University Leuven, Campus Kortenberg, Kortenberg, Belgium

2 Faculty of Kinesiology and Rehabilitation Sciences, Catholic University Leuven, Leuven, Belgium

3 CIAFEL - Centre for Research on Physical Activity, Health and Leisure, University of Porto, Porto, Portugal

4 Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padua, Padova, Italy

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BMC Psychiatry 2013, 13:5  doi:10.1186/1471-244X-13-5

Published: 3 January 2013

Abstract

Background

Patients with schizophrenia report muscle weakness. The relation of this muscle weakness with performing daily life activities such as walking is however not yet studied. The aim of this study was to quantify walking capacity and health related muscular fitness in patients with schizophrenia compared with age-, gender and body mass index (BMI)-matched healthy controls. Secondly, we identified variables that could explain the variability in walking capacity and in health related muscular fitness in patients with schizophrenia.

Methods

A total of 100 patients with schizophrenia and 40 healthy volunteers were initially screened. Eighty patients with schizophrenia (36.8±10.0 years) and the 40 age-, gender- and body mass index (BMI)-matched healthy volunteers (37.1±10.3 years) were finally included. All participants performed a standing broad jump test (SBJ) and a six-minute walk test (6MWT) and filled out the International Physical Activity Questionnaire. Patients additionally had a fasting metabolic laboratory screening and were assessed for psychiatric symptoms.

Results

Patients with schizophrenia did have lower 6MWT (17.9%, p<0.001) [effect size (ES)=−1.01] and SBJ (14.1%, p<0.001) (ES=−0.57) scores. Patients were also less physically active (1291.0±1201.8 metabolic equivalent-minutes/week versus 2463.1±1365.3, p<0.001) (ES=−0.91) than controls. Schizophrenia patients with metabolic syndrome (MetS) (35%) had a 23.9% lower (p<0.001) SBJ-score and 22.4% (p<0.001) lower 6MWT-score than those without MetS. In multiple regression analysis, 71.8% of the variance in 6MWT was explained by muscular fitness, BMI, presence of MetS and physical activity participation, while 53.9% of the variance in SBJ-score was explained by age, illness duration, BMI and physical activity participation.

Conclusions

The walking capacity and health-related muscular fitness are impaired in patients with schizophrenia and both should be a major focus in daily clinical practice and future research.

Keywords:
Muscle weakness; Fitness; Physical activity; Metabolic syndrome; Walking; Schizophrenia