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Open Access Research article

Therapeutic effects of maximal strength training on walking efficiency in patients with schizophrenia – a pilot study

Jørn Heggelund123*, Gunnar Morken13, Jan Helgerud456, Geir E Nilsberg3 and Jan Hoff47

Author Affiliations

1 Faculty of Medicine, Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway

2 Division of Psychiatry, Department of Research and Development (AFFU), St. Olavs University Hospital, Trondheim, Norway

3 Division of Psychiatry, Department of Østmarka, St. Olavs University Hospital, Trondheim, Norway

4 Faculty of Medicine, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway

5 Hokksund Medical Rehabilitation Centre, Hokksund, Norway

6 Department of Sports and Outdoor Life Studies, Telemark University College, Bø, Norway

7 Department of Physical Medicine and Rehabilitation, St.Olavs University Hospital, Trondheim, Norway

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BMC Research Notes 2012, 5:344  doi:10.1186/1756-0500-5-344

Published: 3 July 2012

Abstract

Background

Patients with schizophrenia frequently have disabling gait deficits. The net mechanical efficiency of walking (ϵnet) is an accurate measure often used to evaluate walking performance. Patients with gait deficits have a reduced ϵnet with excessive energy expenditure during sub-maximal walking. Maximal strength training (MST) improves ϵnet in healthy individuals and is associated with reduced risk of mortality. The aim of this study was to investigate whether MST improves ϵnet in patients with schizophrenia.

Methods

Patients (ICD-10 schizophrenia, schizotypal or delusional disorders (F20-F29)) were included in a non-randomized trial. Patients were assigned to one of two groups: 1) MST consisting of 4x4 repetitions at 85-90% one repetition maximum (1RM) performed in a leg press apparatus or 2) playing computer games (CG). Both groups carried out their activity three days per week for eight weeks. 1RM, ϵnet at 60 watt walking, peak oxygen uptake (VO2peak), the Positive and Negative Syndrome Scale (PANSS) and the 36-items short form (SF-36) were measured pre and post intervention.

Results

The baseline ϵnet was 17.3 ± 1.2% and 19.4 ± 3.0% in the MST (n = 6) and CG groups (n = 7), respectively, which is categorized as mechanical inefficiency. The MST group improved 1RM by 79 kg (p = 0.006) and ϵnet by 3.4% (p = 0.046) more than the CG group. The MST group improved 1RM and ϵnet, by a mean of 83 kg (p = 0.028) and 3.4% (p = 0.028), respectively. VO2peak at baseline was 34.2 ± 10.2 and 38.3 ± 9.8 ml·kg-1·min-1 in the MST and CG groups, respectively, and did not change (p > 0.05). No change was observed in PANSS or SF-36 (p > 0.05).

Conclusions

MST improves 1RM and ϵnet in patients with schizophrenia. MST could be used as a therapeutic intervention for patients with schizophrenia to normalize their reduced ϵnet.

Keywords:
Exercise; Gait disturbances; Walking efficiency; Schizophrenia