Active-Play Video Games May Boost Fitness in Schizophrenia

Megan Brooks

November 03, 2015

Active-play video games may help patients with schizophrenia boost activity levels and improve aerobic fitness, new research suggests.

Patients with schizophrenia are much more likely to be sedentary than the general population. Active-play video games have been used to boost physical fitness in various patient populations, but their use among patients with schizophrenia has been limited.

"The rationale for including active-play video games as part of the exercise training was to increase participants' enjoyment and adherence with the aerobic exercise program," lead researcher David Kimhy, PhD, of Columbia University and the New York State Psychiatric Institute, in New York City, told Medscape Medical News.

"The results are consistent with findings in other clinical populations, providing support for the feasibility, acceptability, adherence, and safety of integrating active-play video games into aerobic exercise training for people with schizophrenia," Dr Kimhy said.

The study was published online October 1 in Psychiatric Services.

High Marks From Patients

Sixteen patients with schizophrenia (mean age, 36 years) participated in a 12-week aerobic exercise intervention made up of three 1-hour exercise sessions per week. The sessions were led by an exercise trainer with a Bachelor of Science degree in therapeutic recreation and 4 years of aerobic exercise training experience. During each session, after a 10-minute joint warm-up period, participants exercised individually using the available equipment for about 45 minutes. This was followed by a 5-minute cool-down period.

The aerobic exercise equipment included two Xbox 360 video game consoles with Kinect motion sensing devices for playing an interactive whole-body fitness activity game, along with two treadmill machines, a stationary bike, and an elliptical exercise machine. During the 45 minutes of active aerobic exercise period, participants were free to use any of these four exercise options.

Thirteen of the 16 participants (81%) completed the 12-week program, attending an average of 79% of sessions. The proportion of time spent on the active-play video game (39%) exceeded time spent on any other type of equipment.

The patients reported "high acceptability and enjoyment rates related to use of the exercise video game system, recommended use of such systems to others, and endorsed future plans to use active-play video games," the authors say. "Our results provide preliminary support for the integration of such technologies into AE [aerobic exercise] training programs for this population."

On average, the participants' mean heart rate while using the video game was similar to the mean heart rate when using the treadmill or elliptical machine, the researchers report.

Although previous reports indicate that active-play video games can enhance aerobic fitness in a range of clinical and nonclinical populations, the current study did not address this issue directly, the investigators note.

However, an earlier analysis from the same cohort that focused on clinical outcomes did find that aerobic exercise utilizing active-play video games or traditional equipment can boost aerobic fitness and neurocognition in patients with schizophrenia.

"We are currently developing a multisite study examining the use of such technologies in a larger sample of individuals with schizophrenia," said Dr Kimhy.

Additional Evidence

"Dr Kimhy's study does provide additional evidence that active video games are an ideal way to initiate and sustain activity in people with schizophrenia," Heather Leutwyler, RN, PhD, assistant professor, Department of Physiological Nursing, University of California, San Francisco, told Medscape Medical News.

"In our work, we also found ideal adherence to our program with participants playing a wide variety of games using the Xbox Kinect 360 video game system," said Dr Leutwyler, who was not involved in the study.

She noted that several factors make active video games "an ideal way to help people of all ages with schizophrenia to become more active are. It is easy to incorporate into the daily routine of mental health treatment facilities and simple for staff to facilitate; it allows participants to play novel games in a safe environment (eg, skiing); and it's fun."

The study was supported by the National Institute of Mental Health. The authors and Dr Leutwyler have disclosed no relevant financial relationships.

Psychiatr Serv. Published October 1, 2015. Abstract

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