The current study aims to compare the effects of physical activity and Virtual Reality training on physical function, cognition and quality of life in patients with Schizophrenia. It is hypothesized in the literature that both physical activity and VR may have positive effects on the symptoms of PwS. Still, which modality may be more effective has yet to be discovered. By comparing the effects of physical activity and VR training on the symptoms of PwS, this study may provide valuable insights into the potential benefits of these interventions and inform the development of effective treatment strategies for PwS. Our study will discuss this relationship, and the results will be presented.
1 INTRODUCTION AND PURPOSE Schizophrenia is a debilitating mental disorder characterized by disruptions in thinking, perception, emotions, and social functioning (1). Patients with schizophrenia (PwS) often experience impairments in physical function, cognition, and quality of life, which can significantly impact their overall well-being. As part of the pursuit to enhance treatment outcomes, researchers, including physical therapists, have explored various adjunctive therapies that can potentially alleviate these impairments. In this study, we aim to compare the effects of physical activity (PA) and virtual reality (VR) training on physical function, cognition, and quality of life in Patients with schizophrenia (PwS), compared to a control group that undergoes regular occupational therapy. 1.1 Background Physical activity has been recognized as a beneficial intervention for individuals with mental disorders, including schizophrenia (2). Engaging in regular physical activity has been associated with improved physical fitness, cardiovascular health, and muscle strength. Furthermore, studies have shown that physical activity can positively influence cognitive function, including attention, memory, and executive functions, in individuals with schizophrenia (2, 3). These improvements in physical and cognitive domains can potentially lead to enhanced quality of life for these individuals. Virtual reality training, on the other hand, is an emerging therapeutic approach that provides immersive and interactive experiences through computer-generated simulations. While the benefits of physical activity have been extensively studied in schizophrenia, research investigating the specific effects of virtual reality training in this population is limited (4). There is a need to explore the potential benefits of VR in improving physical function, cognition, and quality of life in individuals with schizophrenia to expand our understanding of its therapeutic value. 1.2 Significance Understanding the comparative effects of physical activity and virtual reality training on physical function, cognition, and quality of life in Patients with schizophrenia (PwS), in comparison to the control group undergoing regular occupational therapy, holds significant importance. By comparing these interventions, we can identify their relative effectiveness and potential benefits in addressing the impairments associated with schizophrenia. This knowledge can inform clinicians, researchers, and healthcare professionals, including physical therapists, in making evidence-based decisions regarding the use of these interventions in clinical practice. Additionally, it may contribute to the development of personalized treatment approaches that optimize outcomes and improve the overall well-being of individuals with schizophrenia. 1.3 Overview This study describes a comparative analysis of three groups: a physical activity intervention group, a virtual reality training intervention group, and a control group that undergoes regular occupational therapy at the center. The study will recruit a sample of individuals diagnosed with schizophrenia and randomly assign them to one of the three groups. Assessments of physical function, cognitive performance, and quality of life will be conducted before and after the interventions to evaluate the effectiveness of each approach. The findings of this study will contribute to the existing literature and inform the development of evidence-based interventions for individuals with schizophrenia, particularly in the context of physical therapy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
45
Participants will engage in the VR gaming intervention three times a week for 12 weeks. Each session will last approximately 45 minutes, providing ample gameplay, instruction, and debriefing time.
The intervention includes a 5-minute warm-up, 10 minutes of strengthening exercises (lunges and squats), 20 minutes of balance and cardiovascular endurance activities (HIIT exercises), 20 minutes of aerobic exercises (stationary bike and dancing), and a 5-minute cool-down with breathing control. Participants also continue with personalized occupational therapy to enhance their functional abilities.
the group will undergo their normal occupational therapy activities that include drawing, coloring, mathematical problems as well as solving mazes
Kartal Dr Lutfi Kirdar City Hospital
Istanbul, Turkey (Türkiye)
Simple Physical Activity Questionnaire
The SIMPAQ is a five-point evaluation tool designed to assess physical activity and sedentary behavior in individuals with common mental disorders.
Time frame: 12 weeks
Six minute walking test
The 6-Minute Walk Test (6MWT) is a standardized physical performance test that measures the distance an individual can walk on a flat, hard surface in six minutes. It provides an objective assessment of functional exercise capacity, endurance, and overall mobility in daily life activities.
Time frame: 12 weeks
The Mini-Mental State Examination
The Mini-Mental State Examination (MMSE) is commonly used as a screening tool to assess cognitive function and detect cognitive impairments. While the MMSE is not specifically designed to evaluate cognitive deficits associated with schizophrenia, it can still provide some insights into general cognitive functioning in individuals with schizophrenia. In schizophrenia, cognitive impairments are frequently observed across various cognitive domains, including attention, working memory, executive function, verbal fluency, and processing speed. These cognitive deficits can significantly impact daily functioning, quality of life, and overall outcomes for individuals with schizophrenia.
Time frame: 12 weeks
SF-36
It is a widely used self-report questionnaire that assesses health-related quality of life (HRQoL)
Time frame: 12 weeks
Berg Balance Scale
Berg Balance Scale (BBS) is a standardized clinical test used to evaluate static and dynamic balance. It consists of 14 functional tasks, such as standing, reaching, and turning, each scored on a 5-point scale. The total score provides an objective measure of balance performance and fall risk in individuals.
Time frame: 12 weeks
Time Up and Go Test
The Timed Up and Go Test (TUG) is a standardized assessment that measures functional mobility. Participants are asked to stand up from a seated position, walk three meters, turn around, walk back, and sit down. The time taken to complete the task is recorded, providing an objective measure of mobility, balance, walking ability, and fall risk
Time frame: 12 weeks
Sit to Stand test
"The Sit-to-Stand Test is a functional performance measure used to assess lower limb strength, endurance, and mobility. Participants are asked to rise from a seated position to a full stand and return to sitting, repeated either for a set number of repetitions (e.g., five times) or within a fixed time period (e.g., 30 seconds). The total time or number of repetitions provides an objective indicator of lower body function and fall risk.
Time frame: 12 weeks
Grip strength
he Grip Strength Test is a standardized assessment of hand and forearm muscle strength. Participants are instructed to squeeze a calibrated hand dynamometer with maximum effort, usually in a seated position with the elbow at 90 degrees. The highest value from repeated trials is recorded, providing an objective measure of upper extremity strength and overall functional capacity
Time frame: 12 weeks
Calgary Depression Scale
The Calgary Depression Scale was developed by Addington et al. (1994) as a tool to measure the presence and severity of depressive symptoms in patients with schizophrenia.
Time frame: 12 weeks
Katz Activities of Daily Living Scale
The Katz Index of Independence in ADLs (Katz Index) is a widely used tool to assess basic activities of daily living (ADLs) such as bathing, dressing, toileting, transferring, continence, and feeding.
Time frame: 12 weeks
Lawton Brody Instrumental Activities of Daily Living Scale
IADL is a commonly used tool to assess the level of independence in instrumental activities of daily living in older adults.
Time frame: 12 weeks
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