Systematic Review of the Benefits of Physical Therapy Within a Multidisciplinary Care Approach for People With Schizophrenia

Background. Although schizophrenia is the fifth leading cause of disability-adjusted life years worldwide in people aged 15 to 44 years, the clinical evidence of physical therapy as a complementary treatment remains largely unknown. Purpose. The purpose of this study was to systematically review randomized controlled trials (RCTs) evaluating the effectiveness of physical therapy for people with schizophrenia. Data Sources. EMBASE, PsycINFO, PubMed, ISI Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), and the Cochrane Library were searched from their inception until July 1, 2011, for relevant RCTs. In addition, manual search strategies were used. Study Selection. Two reviewers independently determined study eligibility on the basis of inclusion criteria. Data Extraction. Reviewers rated study quality and extracted information about study methods, design, intervention, and results. Data Synthesis. Ten RCTs met all selection criteria; 6 of these studies addressed the use of aerobic and strength exercises. In 2 of these studies, yoga techniques also were investigated. Four studies addressed the use of progressive muscle relaxation. There is evidence that aerobic and strength exercises and yoga reduce psychiatric symptoms, state anxiety, and psychological distress and improve health-related quality of life, that aerobic exercise improves short-term memory, and that progressive muscle relaxation reduces state anxiety and psychological distress. Limitations. The heterogeneity of the interventions and the small sample sizes of the included studies limit overall conclusions and highlight the need for further research. Conclusions. Physical therapy offers added value in the multidisciplinary care of people with schizophrenia.