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

60 Participants Needed

Trial Summary

What is the purpose of this trial?

More research is needed to elucidate the impacts of physical activity interventions on short- and long-term activity and neuropsychiatric symptoms (NPS) in psychiatric inpatients and to support its advantageousness when compared to current standards of care. To investigate the impact of regular exercise on activity level, NPS, and sleep in an inpatient psychiatry unit, the investigators propose a placebo-controlled study with measures of activity, mood, anxiety, energy, and sleep as primary outcomes in 50 psychiatric inpatients at Johns Hopkins Hospital. Given the challenges of maintaining blinded assignment to treatment arm, the investigators will compare patients during two time periods (3 months each): the first is treatment as usual (TAU), the second adds exercise intervention (EXI).

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.

What data supports the effectiveness of the treatment OT-led Exercise Group for psychiatric hospitalization?

Research shows that exercise can help improve mental health symptoms, such as depression, in people with various mental illnesses. Exercise interventions in mental health settings have been found to be enjoyable and beneficial, with no serious side effects, suggesting that group exercise could be a helpful part of psychiatric care. ^{1 2 3 4 5}

Is group exercise safe for people in psychiatric hospitals?

Research shows that exercise in psychiatric hospitals is generally safe, with no serious exercise-related adverse events reported. Most participants found the exercise enjoyable and useful. ^{2 3 4 5 6}

How does the OT-led Exercise Group treatment differ from other treatments for psychiatric hospitalization?

The OT-led Exercise Group treatment is unique because it involves structured group exercise sessions led by occupational therapists, specifically designed for patients hospitalized with mental illness. Unlike traditional treatments that may focus solely on medication or therapy, this approach emphasizes physical activity to improve both physical and psychological health, potentially enhancing self-esteem and body image. ^{3 6 7 8 9}

Research Team

Matthew E Peters, MD

Principal Investigator

Johns Hopkins School of Medicine

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

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]

References

1. England pubmed.ncbi.nlm.nih.gov

Challenges in implementing an exercise intervention within residential psychiatric care: A mixed methods study. [2022]

2. England 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. [2023]

3. Australia pubmed.ncbi.nlm.nih.gov

Exercise for mental illness: a systematic review of inpatient studies. [2018]

4. England 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. [2011]

5. United States pubmed.ncbi.nlm.nih.gov

Aerobic exercise improves gastrointestinal motility in psychiatric inpatients. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

An adjunct exercise program for serious mental illness: who chooses to participate and is it feasible? [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Participation in and Satisfaction With an Exercise Program for Inpatient Mental Health Consumers. [2018]

8. United States pubmed.ncbi.nlm.nih.gov

Physical fitness program for patients with psychiatric disorders. A clinical report. [2019]

9. Australia pubmed.ncbi.nlm.nih.gov

An evaluation of the need of the long-stay psychiatric patient for organised exercise. [2014]