Physical Activity Measurement in Patients with Schizophrenia

• Main Authors: Ruei-Yi Lin, 林芮怡
• Other Authors: Mei-Wun Tsai
• Format: Others
• Language: zh-TW
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/62054247928913689828

碩士 === 國立陽明大學 === 物理治療暨輔助科技學系 === 101 === Background: Schizophrenic patients with antipsychotic treatment have been found to have the side-effect of obesity and/or metabolic abnormalities. Physical activity was recommended as an intervention on patients with schizophrenia to reduce the risk of chronic comorbidity. Previous studies have used self-reported questionnaire in assessing physical activity of patients with schizophrenia, and found the low validity and great variability. Whether the psychotic characteristics influence the accuracy of physical activity assessing remains unknown. Purposes: This study aimed to assess the daily physical activity using self-reported questionnaire and accelerator, and to investigate the influencing factors on correlation between both measurements. Methods: We recruited 29 adult schizophrenic patients (34.48% female, age 44.54 ± 6.63 years, BMI 24.18 ± 3.51 kg/m2 and 44.83% overweight or obese) from the rehabilitation ward of a psychiatric hospital of Taipei. Basic data and psychotic characteristics (age of onset, psychotic symptoms and medication) were recorded by chart review. Mini-mental state examination (MMSE) and trail making test (TMT) were selected to evaluate cognitive and psychomotor function. The daily activity was assessed by International Physical Activity Questionnaire (IPAQ) and by 2-weekdays tri-axis accelerator record. To define the activity intensity of accelerator recordings, participants also completed the vector magnitude threshold test. The threshold was established using linear regression model with heart rate and vector magnitude of different walking speed. Statistics: Descriptive statistic was used to investigate the data distribution of physical activity. Subjects were stratified with psychotic characteristics, and then Spearman rank correlation was used to analyses the correlation between IPAQ and accelerator. The significant level was set at 0.05. Results: 13 (48.15%) subjects engaged in moderate activity for more than 10 minutes in a week from IPAQ, and the median (Q1 - Q3) time was 0 (0 - 135) minute/week. The time in walking from IPAQ was 90 (20 - 210) minutes/week. Only 8 (27.59%) subjects met the current recommendation of physical activity for general population. Daily activities derived from accelerator were 0.83 (0.19 - 3.18) minutes/day in vigorous activity, 69.67 (23.08 - 108.75) minutes/day in moderate activity, and 205.67 (97.29 - 261.13) minutes/day in light activity. The sedentary time was 9.17 (8.05 - 11.01) hours/day. The correlation coefficient of activity time between IPAQ-reported and accelerator-derived was 0.07 (p = 0.73) in moderate activity, 0.32 (p = 0.09) in walking/light activity, and 0.29 (p = 0.12) in sitting/sedentary. When stratifying subjects with different characteristics, the greater inconsistent correlation coefficients were found in time of moderate activity between IPAQ-reported and accelerator-derived. The influenced factors included gender (Spearman’s ρ: female 0.39 vs male -0.05 ), age (ρ: ＞45 years 0.36 vs younger -0.03), weight (ρ: normal 0.13 vs overweight/obese -0.05), duration of diagnoses (ρ: ＞21.35 years 0.46 vs shorter -0.18), psychotic symptoms (ρ: only positive 0.61 vs negative -0.55 vs combined -0.09), psychomotor function (ρ: TMT-A≦37 sec 0.12 vs longer 0.01) and anti-EPS prescription (ρ: not prescribed 0.64 vs prescribed -0.38). Conclusions: Patients with schizophrenia spent less time on physical activity and tended to live a sedentary lifestyle. The most common physical activity is low intensity walking exercise. This survey found the correlation of daily activity time was low to fair degree between self-reported questionnaire and accelerator and the degree of correlation became lower in patients with negative symptoms, poor psychomotor function and side-effect of antipsychotics (obese or EPS). Our findings evidenced the physical activity measurement was affected by psychotic characteristics. Using both subjective and objective tools was suggested to accurately evaluate physical activity in applications. Otherwise, a modified version or disease-specific questionnaire to assess physical activity may be needed in patients with schizophrenia.