Group Exercise for Psychiatric Hospitalization

Overseen By Matthew E Peters, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Johns Hopkins University

Disqualifiers: Non-English speakers, Physical conditions, Safety concerns, others

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to assess how regular exercise influences activity levels, mood, anxiety, energy, and sleep in individuals hospitalized for psychiatric issues. Participants will initially follow their usual treatment, then join exercise sessions led by an occupational therapist (OT-led Exercise Group). These sessions include activities such as cardio, strength training, and yoga. Individuals admitted to the Johns Hopkins psychiatric unit who are stable enough to participate safely might be suitable candidates. As an unphased trial, this study provides a unique opportunity to explore the benefits of exercise on mental health in a supportive environment.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that exercise can enhance both mental and physical health for individuals in psychiatric hospitals. A review of eight studies found that exercise reduces depression in hospitalized patients. Exercise is generally safe and well-tolerated, with few negative effects reported.

In this trial, an occupational therapist will lead exercise sessions. These sessions will include activities such as warm-ups, cardio (heart-pumping workouts), strength exercises, kickboxing, cool-downs, yoga, and group discussions.

Structured exercise programs like this have been used in similar settings with positive results, and no major safety concerns have been reported. In summary, exercise programs like this one are both safe and beneficial for mental health in a hospital setting. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the OT-led exercise group for psychiatric hospitalization because it combines physical activity with mental health care in a novel way. Unlike traditional treatments that often focus solely on medication or talk therapy, this approach integrates high-intensity interval training, kickboxing, and yoga, all led by an occupational therapist. This method not only aims to improve mental health through physical exercise but also incorporates educational discussions, potentially offering a holistic approach to recovery. The unique blend of physical and educational components could provide faster and more comprehensive benefits for patients, making it a promising avenue to explore in psychiatric care.

What evidence suggests that the OT-led Exercise Group is effective for psychiatric inpatients?

Research shows that exercise can positively impact people with mental health issues. A review of eight studies found that exercise improved symptoms for patients with depression in hospitals. In this trial, participants in the OT-led Exercise Group will engage in structured exercise sessions, including education, warm-up, high-intensity interval training cardio, strength, kickboxing, cool-down, yoga, and discussion. Group exercise sessions have helped with pain and movement in mental health settings. Patients reported feeling better mentally and managing their symptoms more effectively after participating in exercise programs. Overall, exercise seems to boost motivation and interest, aiding mental health recovery. ^{2 6 7 8 9}

Who Is on the Research Team?

Matthew E Peters, MD

Principal Investigator

Johns Hopkins School of Medicine

Are You a Good Fit for This Trial?

This trial is for adult psychiatric inpatients at Johns Hopkins Bayview who can consent to participate and are stable enough to safely do exercise. It includes those using mobility aids but excludes non-English speakers, patients with certain physical or neurological conditions, or those whose behavior poses a safety risk.

Inclusion Criteria

Able to give informed consent and understand the tasks involved

My doctor thinks I am stable enough to safely do the exercise program.

I use a mobility aid but can do exercises in different positions.

Exclusion Criteria

My behavior is considered safe for group settings by my healthcare team.

English is not my primary language.

A patient can be excluded if in the opinion of the treatment team on the unit, participation in the study would have a negative impact on the patient's mental health or treatment plan.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment as Usual (TAU)

Participants receive treatment as usual, including daily educational sessions led by an occupational therapist

3 months

Daily sessions

Exercise Intervention (EXI)

Participants engage in an OT-led exercise group including education, warm-up, high intensity interval training, cardio, strength, kickboxing, cool-down, yoga, and discussion

3 months

Daily sessions

Follow-up

Participants are monitored for changes in sleep, depression, and anxiety using standardized questionnaires

up to 6 months

What Are the Treatments Tested in This Trial?

Interventions

• OT-led Exercise Group
• Treatment as Usual - OT Groups

Trial Overview The study compares the usual treatment groups with added exercise sessions led by occupational therapists. The goal is to see if regular exercise improves mood, anxiety levels, energy, and sleep among these patients over two three-month periods.

How Is the Trial Designed?

Group I: OT-led Exercise Group on Inpatient Psychiatry Unit Experimental Treatment 1 Intervention

Occupational therapist (OT) led group. Group includes education, warm-up, high intensity interval training cardio, strength, kick boxing, cool-down, yoga, and discussion. This group also receives the Treatment as Usual groups.

Group II: Treatment As Usual - OT Groups on Inpatient Psychiatry Unit Placebo Group 1 Intervention

An occupational therapist (OT) will begin daily educational session about the topic of choice for that day.

Who Is Running the Clinical Trial?

Johns Hopkins University

Lead Sponsor

Trials

2,366

Recruited

15,160,000+

Published Research Related to This Trial

Exercise interventions have shown positive health outcomes for hospitalized patients with depression, based on a systematic review of eight studies, indicating that exercise can be beneficial in acute mental health settings.

However, the evidence for the effectiveness of exercise in hospitalized patients with schizophrenia, bipolar disorder, or anxiety disorders is limited, highlighting a need for more research to determine the best exercise approaches for these populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise for mental illness: a systematic review of inpatient studies. Stanton, R., Happell, B.[2018]

Exercise interventions in inpatient mental health settings significantly improved depression symptoms, with a moderate effect size (Standardized mean difference = -0.416) across 15 studies, indicating their potential therapeutic benefits.

No serious adverse events were reported from exercise, and most participants found the interventions enjoyable, with over 80% attendance; however, only five trials provided post-discharge support for continued exercise, highlighting a need for better systems to maintain engagement after leaving the hospital.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The efficacy of exercise interventions for all types of inpatients across mental health settings: A systematic review and meta-analysis of 47 studies. Martland, R., Korman, N., Firth, J., et al.[2023]

An exercise program for individuals with serious mental illness was found to be feasible, with regular attendance from participants who self-selected to join the exercise group, which met three times a week for 50 minutes.

Both the exercise group (N=38) and the control group (N=28) showed similar improvements in symptoms and psychological well-being, indicating that exercise can be an effective adjunct treatment, although demographic factors influenced participation rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An adjunct exercise program for serious mental illness: who chooses to participate and is it feasible? Sylvia, LG., Kopeski, L., Brown, C., et al.[2021]

A physical fitness training program for inpatients with psychiatric disorders, consisting of group exercise sessions three times a week for six weeks, can improve self-esteem and body image among these patients.

The study highlights the need for physical therapy practices to expand their focus to include the unique needs of individuals with mental health issues, recognizing the close relationship between physical and psychological health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical fitness program for patients with psychiatric disorders. A clinical report. Chastain, PB., Shapiro, GE.[2019]

A 24-week aerobic exercise program for adults with severe chronic schizophrenia was found to be feasible and safe, with participants attending an average of 73% of sessions and experiencing no adverse events.

The program led to a significant reduction in body weight (2.4%) and body mass index (2.2%), indicating potential benefits for physical health in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A small group aerobic exercise programme that reduces body weight is feasible in adults with severe chronic schizophrenia: a pilot study. Dodd, KJ., Duffy, S., Stewart, JA., et al.[2011]

Citations

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Examining the Effectiveness of a Group Occupational Therapy ... Conclusion: The study's findings suggest that occupation-focused group interventions may enhance motivation, specifically, interest in ...

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Group physical therapy improves outcomes for patients on ... Group physical therapy, as part of an inpatient psychiatric pain management team, assists with improving patient outcomes of pain and mobility.

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Experiences of exercise services for individuals with ... Exercise engagement was perceived to improve acute and sustained mental health effects, and behavioural replacement. Patients reported better symptom management ...

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Group Exercise for Psychiatric Hospitalization Exercise interventions have shown positive health outcomes for hospitalized patients with depression, based on a systematic review of eight studies, indicating ...

5. encompass.eku.edu encompass.eku.edu/cgi/viewcontent.cgi?article=2086&context=honors_theses

Occupational Therapy in Psychiatry - encompass . eku.edu Despite the field's roots in mental health, there is limited historical evidence on the effectiveness of OT treatment for treating mental ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10619065/

Physical activity interventions for inpatients in secure ... Physical activity (PA) has been identified as an appropriate intervention to help improve the psychological and physical health of inpatients.

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Occupational Therapy in Psychiatric Short-Term ... The growth of occupational therapy in in Psychiatric-Short-Term-Hospitalization-Units is emphasized, with an increase in qualitative studies.

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Impact of Exercise Groups on Patient Mental Health and ... A placebo-controlled study with measures of activity, mood, anxiety, energy, and sleep as primary outcomes in 50 psychiatric inpatients at Johns Hopkins ...

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Staff perspectives on the barriers and facilitators to ... This study aimed to explore staff views on role for exercise for people with SMI and the barriers and facilitators to exercise implementation in inpatient ...