Presently, there is limited evidence for significant procognitive effects for antipsychotics and other pharmacologic approaches. (1) Therefore, treatment of cognitive impairment in schizophrenia represents a tremendous area of unmet need.
There has been significant research on the effects of exercise on brain structure and functional performance. (2) A meta-analysis found that aerobic exercise exerted a positive effect on global cognition and some, but not all, cognitive domains in patients with schizophrenia. Unfortunately, findings are limited by small samples, as well as variable types and intensity of exercise and study designs. (3)
Exploring the Research
To further elucidate this issue, Huang and colleagues performed a 12-week randomized controlled trial of the effects of aerobic walking on cognitive function in patients with schizophrenia. (4) The goal was to determine if the intensity of aerobic walking is associated with changes in cognition. Patients were randomized 1:1 based on age and sex to usual treatment with antipsychotics with or without aerobic walking. Inclusion criteria were 20 to 60 years, DSM-5 diagnosis of schizophrenia, stable antipsychotic dose for at least 1 month, Positive and Negative Syndrome Scale (PANSS) total score < 95, no history of major physical illness, and no physical disability that caused difficulty walking.
The Aerobic Protocol
The program comprised 150 minutes/week of outdoor walking, typically divided over 3 to 5...