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      Neuropsychiatric Disease and Treatment (submit here)

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      Soccer practice as an add-on treatment in the management of individuals with a diagnosis of schizophrenia

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          Abstract

          Physical activity is an important aspect of good health for everyone; it is even more important for psychiatric patients who usually live an unhealthy lifestyle. In recent years, there has been growing focus on the use of soccer as a vehicle to improve the health of subjects with severe mental illness. The aim of this study was to investigate the effects of soccer practice on the self-reported health quality of life (SRHQL) and sports performance (SP) in psychotic subjects. Eighteen male patients with diagnosis of schizophrenia were randomized into either a trained (TG) or a control group (CG). The TG was trained for 12 weeks using two soccer training sessions per week. The CG did not perform any regular sports activity during the experimental period. Anthropometric measurements, SRHQL, personal time records in a 30 meter sprint test and slalom test running with a ball were evaluated before and after the experimental period. SRHQL was assessed using Short Form-12 questionnaire measuring physical and mental component summary scores. After the training period, the TG showed a relevant decrease by 4.6% in bodyweight (BW) and body mass index compared to baseline. Conversely, the CG showed an increased BW and body mass index by 1.8% from baseline to posttest. Moreover, after 12 weeks we found that control patients increased their BW significantly when compared to trained patients (Δ = 5.4%; P < 0.05). After the training period, comparing the baseline TG’s Short Form-12-scores to posttest results, we found an improvement of 10.5% and 10.8% in physical component summary and mental component summary, respectively. In addition, performances on the 30 meter sprint test and slalom test running with a ball in the TG improved significantly ( P < 0.01) from baseline to posttest when compared to CG. Soccer practice appears able to improve psychophysical health in individuals with diagnosis of schizophrenia. Indeed, our study demonstrated that programmed soccer physical activity could reduce antipsychotic medication-related weight gain and improve SRHQL and sports performance in psychotic subjects.

          Most cited references83

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          Physiology of soccer: an update.

          Soccer is the most popular sport in the world and is performed by men and women, children and adults with different levels of expertise. Soccer performance depends upon a myriad of factors such as technical/biomechanical, tactical, mental and physiological areas. One of the reasons that soccer is so popular worldwide is that players may not need to have an extraordinary capacity within any of these performance areas, but possess a reasonable level within all areas. However, there are trends towards more systematic training and selection influencing the anthropometric profiles of players who compete at the highest level. As with other activities, soccer is not a science, but science may help improve performance. Efforts to improve soccer performance often focus on technique and tactics at the expense of physical fitness. During a 90-minute game, elite-level players run about 10 km at an average intensity close to the anaerobic threshold (80-90% of maximal heart rate). Within this endurance context, numerous explosive bursts of activity are required, including jumping, kicking, tackling, turning, sprinting, changing pace, and sustaining forceful contractions to maintain balance and control of the ball against defensive pressure. The best teams continue to increase their physical capacities, whilst the less well ranked have similar values as reported 30 years ago. Whether this is a result of fewer assessments and training resources, selling the best players, and/or knowledge of how to perform effective exercise training regimens in less well ranked teams, is not known. As there do exist teams from lower divisions with as high aerobic capacity as professional teams, the latter factor probably plays an important role. This article provides an update on the physiology of soccer players and referees, and relevant physiological tests. It also gives examples of effective strength- and endurance-training programmes to improve on-field performance. The cited literature has been accumulated by computer searching of relevant databases and a review of the authors' extensive files. From a total of 9893 papers covering topics discussed in this article, 843 were selected for closer scrutiny, excluding studies where information was redundant, insufficient or the experimental design was inadequate. In this article, 181 were selected and discussed. The information may have important implications for the safety and success of soccer players and hopefully it should be understood and acted upon by coaches and individual soccer players.
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            Exercise and pharmacotherapy in the treatment of major depressive disorder.

            To assess whether patients receiving aerobic exercise training performed either at home or in a supervised group setting achieve reductions in depression comparable to standard antidepressant medication (sertraline) and greater reductions in depression compared to placebo controls. Between October 2000 and November 2005, we performed a prospective, randomized controlled trial (SMILE study) with allocation concealment and blinded outcome assessment in a tertiary care teaching hospital. A total of 202 adults (153 women; 49 men) diagnosed with major depression were assigned randomly to one of four conditions: supervised exercise in a group setting; home-based exercise; antidepressant medication (sertraline, 50-200 mg daily); or placebo pill for 16 weeks. Patients underwent the structured clinical interview for depression and completed the Hamilton Depression Rating Scale (HAM-D). After 4 months of treatment, 41% of the participants achieved remission, defined as no longer meeting the criteria for major depressive disorder (MDD) and a HAM-D score of <8. Patients receiving active treatments tended to have higher remission rates than the placebo controls: supervised exercise = 45%; home-based exercise = 40%; medication = 47%; placebo = 31% (p = .057). All treatment groups had lower HAM-D scores after treatment; scores for the active treatment groups were not significantly different from the placebo group (p = .23). The efficacy of exercise in patients seems generally comparable with patients receiving antidepressant medication and both tend to be better than the placebo in patients with MDD. Placebo response rates were high, suggesting that a considerable portion of the therapeutic response is determined by patient expectations, ongoing symptom monitoring, attention, and other nonspecific factors.
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              Brain volume in first-episode schizophrenia: systematic review and meta-analysis of magnetic resonance imaging studies.

              Studies of people with schizophrenia assessed using magnetic resonance imaging (MRI) usually include patients with first-episode and chronic disease, yet brain abnormalities may be limited to those with chronic schizophrenia. To determine whether patients with a first episode of schizophrenia have characteristic brain abnormalities. Systematic review and meta-analysis of 66 papers comparing brain volume in patients with a first psychotic episode with volume in healthy controls. A total of 52 cross-sectional studies included 1424 patients with a first psychotic episode; 16 longitudinal studies included 465 such patients. Meta-analysis suggests that whole brain and hippocampal volume are reduced (both P<0.0001) and that ventricular volume is increased (P<0.0001) in these patients relative to healthy controls. Average volumetric changes are close to the limit of detection by MRI methods. It remains to be determined whether schizophrenia is a neurodegenerative process that begins at about the time of symptom onset, or whether it is better characterised as a neurodevelopmental process that produces abnormal brain volumes at an early age.
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                Author and article information

                Journal
                Neuropsychiatr Dis Treat
                Neuropsychiatr Dis Treat
                Neuropsychiatric Disease and Treatment
                Neuropsychiatric Disease and Treatment
                Dove Medical Press
                1176-6328
                1178-2021
                2013
                2013
                03 May 2013
                : 9
                : 595-603
                Affiliations
                [1 ]Department of Law, Social and Sport Science, University of Palermo, Palermo, Italy;
                [2 ]Department of Psychology, University of Palermo, Palermo Italy;
                [3 ]Regional Sports School of CONI Sicilia, Sicily, Italy;
                [4 ]Local Health of Palermo, Palermo, Italy
                Author notes
                Correspondence: Giuseppe Battaglia, Department of Law, Social and Sport Science, University of Palermo, Via, Eleonora Duse 2, Palermo, Italy, 90146, Tel +39 091 2389 9616, Fax +39 091 2386 0894, Email giuseppe.battaglia@ 123456unipa.it
                Article
                ndt-9-595
                10.2147/NDT.S44066
                3647379
                23662058
                94e6fd70-d720-4325-92b1-ee7b1a4d402b
                © 2013 Battaglia et al, publisher and licensee Dove Medical Press Ltd

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                History
                : 02 May 2013
                Categories
                Original Research

                Neurology
                schizophrenia,mental illness,psychotic subjects,sport,exercise,soccer
                Neurology
                schizophrenia, mental illness, psychotic subjects, sport, exercise, soccer

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