Rationale, design and baseline data for the Activating Consumers to Exercise through Peer Support (ACE trial): A randomized controlled trial to increase fitness among adults with mental illness

BackgroundThe benefits of regular physical activity are particularly salient to persons with serious mental illness (SMI) who have increased prevalence of obesity, diabetes, and earlier mortality from cardiovascular disease.MethodsThe Activating Consumers to Exercise through Peer Support (ACE) trial will examine the effectiveness of peer support on adherence to a 4-month pilot exercise program for adults with SMI. Design, rationale and baseline data are reported. Baseline measures included: graded treadmill test; six-minute walk; height, weight and blood pressure; body composition; fasting blood; and self-reported psychiatric symptoms. Fitness levels were compared with national data and relationships among fitness parameters, psychological factors and cardiovascular disease risk factors were examined.ResultsThere were 93 participants and 18 peer leaders recruited from community psychiatry programs with an average age of 47 years (SD 10). There were no differences in demographics (76% female, 72% African American) or mental health symptoms between participants and peer leaders. Ninety-five percent of the sample had below average fitness levels for their age and sex with average MET levels of 5.9 (SD 2.2) for participants and 6.2 (SD 2.3) for peer leaders. Fitness evaluated during the treadmill test and the six-minute-walk were associated (rs = 0.36, p < 0.001). Lower MET levels were associated with a higher BMI (rs = −0.35, p < 0.001) and percent body fat (rs = −0.36, p < 0.001).ConclusionThe uniformly low baseline cardiovascular fitness and the association of fitness with BMI and adiposity underscore the importance of suitably tailored programs to increase physical activity among adults with SMI.

► We provide rationale and design for a pilot exercise study among adults with serious mental illness.
► Adults with serious mental illness had uniformly low cardiovascular fitness.
► Among adults with serious mental illness, cardiovascular fitness correlated with BMI.