Synergy Between Physical Activity and Outdoor Green Environments to Reduce the Intensity of Negative Symptoms in Schizophrenia.

Centre Hospitalier Universitaire de Saint Etienne45 enrolled

Overview

Physical activity appears to be a novel and original adjunctive therapeutic approach in the management of patients with schizophrenia. It may help reduce schizophrenic symptoms, act as a pro-cognitive therapy, improve quality of life, and reduce cardiovascular comorbidities. Moreover, some evidence suggests that physical activity practiced in a natural environment has even more positive effects on mental health compared to physical activity carried out indoors or in urban settings. Indeed, greater exposure to greenery is associated with a better perception of general health and with reduced levels of cortisol, anxiety, and depression. No study has yet attempted to examine the impact of physical activity in green (outdoor) spaces compared to indoor physical activity on the negative symptoms of patients suffering from schizophrenia. The aim of this study is therefore to test this hypothesis.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

NONE

Enrollment

Conditions

Schizoaffective Disorder

Interventions

EXT group will perform aerobic and resistance exercises with a coach in adapted physical activities on a green environment in a parc. Sessions will be typically composed as follows: * Warm-up (20 min) * Aerobic exercise (30 min) at RPE 4 to 7 on the Borg scale * Muscular strengthening (25 min) at RPE 4 to 7 on the Borg scale * Cool-down, stretching and balance (15 min) EXR group will train for 8 weeks, twice a week for 1h30, following WHO recommendation.

8-week indoor physical activity programOTHER

INT group will perform aerobic and resistance exercises with a coach in adapted physical activities, inside a conventional gym. Sessions will be typically composed as follows: * Warm-up (20 min) * Aerobic exercise (30 min) at RPE 4 to 7 on the Borg scale * Muscular strengthening (25 min) at RPE 4 to 7 on the Borg scale * Cool-down, stretching and balance (15 min) INT group will train for 8 weeks, twice a week for 1h30, following WHO recommendation.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 55 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients with schizophrenia, aged 18 to 55 years * Having persistent negative symptoms (SNS), negative symptoms self-assessment scale \> 7 * Regularly monitored in the psychiatry department. * Have no medical contraindications to physical activity * Subject affiliated with or entitled to a social security system. * Subject having received informed information about the study and having co-signed, with the investigator, consent to participate in the study. * Male or female. Exclusion Criteria: * Patient unsuitable for study in the opinion of the investigator * Any subject with chronic joint pathologies (example: repeated sprains, patellar or ligament problems) or cardiac pathologies. * Any subject presenting chronic or central neurological pathologies. * Any subject deprived of liberty or subject to legal protection * Excessive consumption of alcohol (\> 14 glasses per week) or caffeinated drinks (\> 400 mg of coffee per day). * Pregnant women. * Subject unable to understand the purpose and conditions of the study, unable to give consent.

Outcomes

Primary Outcomes

Self-evaluation of negative symptoms (SNS) questionnaire

The primary outcome will be the evolution of negative symtoms, assessed using the Self-evaluation of negative symptoms (SNS) questionnaire. The total SNS score ranges from 0 to 40, where higher scores indicate greater severity of negative symptoms.

Time frame: Weeks 2, 10 and 22

Secondary Outcomes

Clinical global Impression (CGI) scale

The patient's overall symptomatology and functioning will be assessed by the Clinical global Impression (CGI) scale. The CGI scale is assessed on a 7-point scale, with the severity of illness rated from 1 (normal) to 7 (very seriously ill). CGI scores range from 1 (much improved) to 7 (much worse).

Time frame: Weeks 2, 10 and 22

Personal and social performance (PSP) scale

The patient's overall symptomatology and functioning will be assessed by the Personal and social performance (PSP) scale. Higher scores indicate higher levels of perceived stress.

Time frame: Weeks 2, 10 and 22

Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS)

Cognitive disorders reported will be assessed using the French version of the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS). The total score (range 0-84) is calculated as the sum of all items, with higher scores reflecting a greater Self-Appraisals of Cognitive Deficits.