The feasibility of resistance training versus aerobic exercise in a rehabilitation setting for people living with psychotic disorders: A randomised controlled trial

OBJECTIVES: People with psychotic disorders face significant functional impairments, high levels of disability, multimorbidity and physical health challenges. Despite unique health benefits, resistance training remains underexplored in this population and rarely implemented in real-world mental health settings.

METHODS: This randomised controlled trial comparing resistance training with aerobic interval training in people with psychotic disorders accessing psychiatric rehabilitation. Supervised exercise sessions by exercise physiologists were conducted 3 times per week over 8 weeks. Primary outcomes were feasibility, acceptability and adverse events. Secondary outcomes were psychiatric symptoms, global and physical functioning and the effect of randomisation to exercise type on participation rates.

RESULTS: In total, 54 participants (median age 31 years, 71.6% male, 75% diagnosed with schizophrenia/schizoaffective disorder, 55.5% with ⩾3 health conditions) were enrolled. Resistance training met predetermined feasibility and acceptability thresholds and showed comparable results to aerobic interval training with no significant exercise-related adverse events. Within-group analysis revealed significant increases in muscle strength following resistance training. Post-intervention, resistance training participants reported more total weekly minutes of physical activity compared to aerobic interval training, though no other significant between-group differences were observed. Randomisation to exercise type did not influence participation.

CONCLUSION: In conclusion, resistance training was feasible and acceptable to people with psychotic disorders, with no serious adverse events and comparable to aerobic interval training. Resistance training was successfully implemented in rehabilitation settings with promising improvements in muscle strength and self-reported physical activity. In future, larger longer-term trials comparing resistance training with aerobic interval training, and in comparison with other psychosocial therapies are warranted. Further exploration of participant preference for exercise type on outcomes is recommended.