A Walking Program for Outpatients in Psychiatric Rehabilitation: Pilot Study

Department of Public Health, Mental Health, and Administrative Nursing, University of Illinois at Chicago College of Nursing, Chicago, IL 60612, USA.
Biological Research for Nursing (Impact Factor: 1.43). 11/2005; 7(2):87-97. DOI: 10.1177/1099800405278116
Source: PubMed


The purposes of this quasi-experimental pilot study were to determine adherence to a 12-week group-based moderate-intensity walking program for sedentary adult outpatients with serious and persistent mental illness and to examine change from baseline to after the walking program in health status (mental and physical health, mood, and psychosocial functioning) and exercise motivation (exercise outcomes expectancies, exercise decisional balance). The 15 volunteers in this study were aged 21 to 65 years and enrolled in psychosocial rehabilitation; they participated in a 12-week walking program meeting three times per week for 1 hr, supplemented with four health information workshops delivered at the beginning of the study. Participants received individual exercise prescriptions determined by preprogram fitness testing and used heart rate monitors during walking sessions. Thirteen participants (87%) completed the study and attended 76% of the walking sessions. Overall, they walked at lower intensity than prescribed, with pulses within target heart rate ranges 35% of the time during Weeks 1 through 4, 26% of the time during Weeks 5 through 8, and 22% of the time during Weeks 9 through 12. However, mood improved (Profile of Mood States, t = -2.51, two-tailed, df = 12, p = .02), as did psychosocial functioning (Multnomah Community Ability Scale, two-tailed, df = 12, t = 2.49, p = .02). The findings indicate a walking group may be feasible for rehabilitation programs. In addition to the known cardiovascular risk-reduction benefits of regular walking, walking may improve mood and psychosocial functioning in adults with serious and persistent mental illness.

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    • "Poulin et al. (2007), Bradshaw et al. (2010), Attux et al. (2011), Methapatara and Srisurapanont (2011) and Goldberg et al. (2013) promoted counseling programs focusing on nutrition, healthy lifestyle and PA. Besides this, other authors promoted intervention programs, mainly based on walking and gym activities (e.g., stationary bicycle, indoor rowing, treadmill, and resistance exercises) (Beebe et al., 2005; Chen et al., 2009; Daumit et al., 2011; Dodd, Duffy, Stewart, Impey, & Taylor, 2011; Marzolini, Jensen, & Melville, 2009; McDevitt, 2005; Vittaca, Paneroni, Comini, & Bianchi, 2013). "
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    ABSTRACT: Purpose The purpose of this study was to evaluate the effects of a 16-week group physical activity (PA) program on physical fitness and quality of life in outpatients with schizophrenia. Methods Nineteen outpatients with schizophrenia were divided into experimental (EG) (n=8; mean age 39±7 years) and control (CG) (n=11; mean age 40±6 years) groups. The EG underwent twice a week sessions of a group PA program for a period of 16-weeks. The participants completed a battery of tests at baseline and after 16-weeks, which included the assessment of body composition (dual-energy X-ray absorptiometry), functional exercise capacity (6MWT), physical activity levels (accelerometers), quality of life (WHOQOL-Brief), and anthropometric measures. During the program different strategies were implemented to ensure the participants’ adherence. Results The attendance to the program was 79.7%. In the EG a significant decrease was observed in hip circumference (p = 0.02); a significant increase occurred in moderate to vigorous physical activity (p = 0.05) and in the environment domain (WHOQOL-Brief) (p = 0.02). The improvement in environment domain scores was also associated with a decrease in sedentary behavior (r = -0.82, p = 0.01) in the EG. Conclusions The strategies used during the program promoted a high rate of attendance. PA may have a positive impact on the participants’ ability to perform activities of daily living. This study showed that a group PA program can be successfully implemented for outpatients with schizophrenia and can influence their quality of life and PA levels.
    Full-text · Article · Jul 2014 · Mental Health and Physical Activity
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    • "A further study reported significant pre–post improvements in the intervention groups for aerobic capacity (Blumenthal et al. 1999), but two studies found no significant differences between groups, and did not report further pre–post analyses (Daley et al. 2008; Skrinar et al. 2005). For the remaining two studies that utilized a one-group study design, significant improvements in vigorous physical activity (McDevitt et al. 2005), submaximal exercise test scores (Pelletier et al. 2005), and distance walked (Pelletier et al. 2005) were observed. "
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    ABSTRACT: Individuals diagnosed with mental illness experience high rates of morbidity and mortality as a result of poor physical health and unhealthy lifestyle behaviours. The aim of this paper is to systematically review the literature on health behaviour interventions to improve the physical health of individuals diagnosed with a mental illness. A systematic search strategy was undertaken using four of the major electronic databases. Identified articles were screened for inclusion, included articles were coded, and data were extracted and critically reviewed. A total of 42 articles were identified for inclusion. The most commonly targeted physical health behaviour was weight management. The majority of studies reported improvements in health behaviours following interventions. The findings provide evidence for the positive effect of health behaviour interventions in improving the physical health of individuals diagnosed with a serious mental illness. A focus on health behaviour interventions within the mental health nursing profession might lead to improvements in health behaviours and general health in consumers of mental health services.
    Full-text · Article · Jun 2012 · International journal of mental health nursing
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    • "Few studies have addressed accurately measuring PA or intervening to improve PA in persons with schizophrenia. Although weight control programs have been tested in this population, few experimentally evaluate PA interventions, and many only address diet and nutrition (McDevitt et al., 2005; Littrell et al., 2003; McCreadie et al., 2005; Evans et al., 2005; Menza et al., 2004). When PA is addressed, studies typically measure it using simple self-reports of time engaged in PA, usually walking (Vreeland et al., 2003). "
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    ABSTRACT: Regular physical activity (PA) decreases morbidity in the general population; yet, information about the amount and effects of PA in persons with schizophrenia is scant. To develop interventions to increase PA and to assess its potential benefits in this group, accurate measurement of PA is needed. The purpose of this study was to characterize PA and determine the test-retest reliability and concurrent validity of the Yale Physical Activity Scale (YPAS), a self-report measure, in persons with schizophrenia. PA was assessed with the YPAS, a scale of motivational readiness for PA, and accelerometry in middle-aged and older persons with a diagnosis of schizophrenia (n=54) and in a comparison group with no known psychiatric diagnosis (n=27). On the YPAS measures, persons with schizophrenia reported on average 11 h per week of PA, whereas the non-psychiatric comparison group reported about 32 h per week. Only about 30% of schizophrenia subjects were classified as being regularly active relative to 62% of the comparison group on PA motivational stages of readiness. On the accelerometry measures, the schizophrenia group had lower levels of light activity than the comparison group, but there were no differences in moderate and vigorous activity or sedentary behavior. Only in the comparison group were there significant associations between YPAS and accelerometer variables. Several YPAS scores demonstrated high test-retest reliability in both groups, and concurrent validity was supported between the YPAS and PA motivational stages of readiness. We found that the YPAS is a reliable measure of PA in schizophrenia for some indices. Although the YPAS demonstrated concurrent validity with other self-report measures, it did not demonstrate concurrent validity when compared to PA measured by accelerometry in persons with schizophrenia. Use of multiple measures, both subjective and objective, is recommended when assessing PA in schizophrenia.
    Full-text · Article · Jul 2008 · Schizophrenia Research
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