运动方式对精神分裂症负面症状的比较影响:32个RCT的系统审查和网络元分析
Zixia Wang1, Jihai Li2, Li Wang3
1Department of Physical Education and Health Teaching and Research, Hunan Applied Technology University, Changde, Hunan 415000, China.
Psychiatry research
|August 14, 2025
概括
和抵抗运动显著改善精神分裂症患者的负面症状,提供有效的非药物治疗选择. 这些发现表明,个性化的运动处方可能会改善结果.
科学领域:
- 精神病学和心理健康 精神病学和心理健康
- 运动科学 运动科学
- 康复医学 康复医学 康复医学
背景情况:
- 精神分裂症的负面症状显著损害生活质量,并且对标准抗精神病治疗有抗性.
- 非药物干预措施,如运动,正在被探索作为精神分裂症管理的辅助疗法.
- 不同的运动方式对负面症状的比较有效性仍然不够理解.
研究的目的:
- 系统地比较各种运动类型的有效性:有氧运动 (AE),阻力运动 (RE),联合AE+RE,心身运动 (MBE) 和在改善精神分裂症的负面症状方面.
- 通过网络元分析和积累性排名 (SUCRA) 下的表面分析,对这些干预措施的有效性进行排名.
主要方法:
- 在五个数据库中进行了全面的搜索,直到2024年9月,对成年精神分裂症患者的随机对照试验 (RCT) 进行了全面搜索.
- 研究将结构化炼干预与对照组或其他炼方式进行比较,以负症状得分 (PANSS-负,SANS,BNSS) 为主要结果.
- 进行了随机效应网络元分析,以汇集标准化平均差异 (SMD) 和置信区间 (CI),并使用GRADE评估偏差风险和证据确定性.
主要成果:
- 包括32个与1773名参与者的RCT,干预时间从4周到24周不等.
- 与对照人群相比,所有运动类型都显示了负面症状的改善. (SMD = -1.14) 和抵抗运动 (SMD = -1.15) 显示出最大的影响.
- 在SUCRA排名中, (87.1%) 和阻力运动 (82.1%) 是最有效的. 在31-40岁的参与者和在亚洲进行的研究中,益处更大. 证据的确定性主要为低至中等.
结论:
- 和抵抗运动似乎是改善精神分裂症负面症状的最有效的运动方式.
- 患者年龄和地理位置等因素可能会影响治疗结果,突出了对个性化炼策略的潜在需求.
- 建议进一步进行高质量的RCT来验证这些发现,并完善对精神分裂症的运动处方.
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