A systematic review of the benefits of physical therapy within a multidisciplinary care approach for people with schizophrenia: An update

• The Physical Therapist is valuable component of the multidisciplinary treatment of people with schizophrenia.
• The physical therapy can help improve the psychiatric, physical and quality of life of this persons.
• Aerobic and strength exercises and yoga reduce psychiatric symptoms while improving health-related quality of life.
• More recents studies confirm that progressive muscle relaxation reduces state anxiety and psychological distress.
• There is preliminary evidence available to use Tai-chi exercises as a treatment modality.

This systematic review summarizes the most recent evidence from randomized controlled trials (RCTs) considering the effectiveness of physical therapy interventions (aerobic exercises, strength exercises, relaxation training, basic body awareness exercises, or a combination of these) within the multidisciplinary management of schizophrenia. Two authors searched PubMed, PsycINFO, EMBASE, Web of Science, Physiotherapy Evidence Database (PEDro), and the Cochrane Library considering RCTs published from July 1, 2011–October 1, 2014. Thirteen RCTs representing 549 participants met the inclusion criteria. Overall, the results demonstrate that aerobic exercise significantly reduces psychiatric symptoms, potentially improves mental and physical quality of life and reduces metabolic risk and weight. Specifically, yoga reduces psychiatric symptoms, whilst Tai-chi and progressive muscle relaxation may also have benefits to patients. Two RCTs reported on adverse events. No adverse event was observed supporting the notion that physical therapy is safe in people with schizophrenia. There was considerable heterogeneity in the design, implementation and outcomes in the included studies precluding a meaningful meta-analysis. In general, the quality of physical therapy RCTS is improving and current research demonstrates that physical therapy approaches are valuable interventions and can help improve the psychiatric, physical and quality of life of people with schizophrenia.