Efficacy of Exercise Videos to Increase Physical Activity and Fitness in Individuals With Psychiatric Disabilities

SIGNIFICANCE: In comparison to the general population, individuals with schizophrenia and other major mental illnesses are more likely to be overweight and to have a higher incidence of cardiovascular disease and metabolic disorder, with up to decades of potential years of life lost. Clearly, interventions are needed to increase engagement in physical activity. A review of interventions suggests that active interventions with approaches tailored to the specific needs of people with psychiatric disabilities are more effective. Occupational therapists are well suited to design interventions that use active learning approaches and are adapted to the cognitive, sensorimotor, and psychosocial needs of the population.

INNOVATION: This is the first study to use exercise videos as an intervention approach for increasing physical activity for individuals with psychiatric disability. Although exercise videos are frequently used by the general population, commercially available videos may not be well suited for individuals with psychiatric disabilities. Eight professionally produced videos with simplified instruction and optional modifications were developed by the principal investigator and occupational therapy students. Individuals with psychiatric disabilities participate in the videos to serve as role models. The videos are available online to the public.

METHOD: In this study, the research question was as follows: What is the efficacy of exercise videos for increasing fitness and physical activity in individuals with psychiatric disabilities? A randomized waitlist controlled trial is underway to compare individuals who receive instruction and access to exercise videos with a group of individuals who do not receive the videos. After 4 wk, the waitlist control group will receive the videos and instruction. Data are collected at baseline, 5 wk, and 11 wk. Twenty individuals were recruited to participate in the study, with 10 randomly assigned to each group. Measures include physical activity as measured with Fitbit pedometers and a daily log of exercise participation. Fitness measures are based on the President’s Challenge: Adult Fitness Test. Participants in the intervention meet once a week for 4 wk. In each session, they participate in two of the exercise videos. All participants receive the videos on DVD and are encouraged to engage in exercise for at least 30 min a day most or all days of the week. A repeated-measures analysis of variance (ANOVA) will be used to examine differences in outcome measures at the three time points between the two groups. In addition, the groups will be combined for a within-group analysis comparing before and after intervention periods using a within-group (dependent-sample) t test.

RESULTS: This research is in progress, but our baseline results indicate that our sample is in need of increased fitness. Most participants are in the overweight-to-obese category (body mass index [BMI] = 29.8, range = 21.8 to 43.4); on average, they scored within the typical range on the timed walk test (14.9 min) and below average on sit-ups, push-ups, and the sit and reach test.