People with psychotic disorders, such as schizophrenia, often experience significant difficulties in daily functioning, physical health, and quality of life. Long-acting injectable antipsychotics are an important part of treatment, but they can be associated with metabolic side effects and reduced physical fitness. Physical exercise has shown potential benefits for mental and physical health in this population; however, structured exercise programs implemented in real-world psychiatric services are still limited. The purpose of this study is to evaluate the feasibility and clinical impact of a structured, multimodal physical exercise program for adults with psychosis who are receiving long-acting injectable antipsychotic treatment. The study aims to determine whether participation in a supervised exercise program can improve physical functioning, psychological well-being, and selected biological markers related to brain health and metabolism. This study will be conducted in an outpatient psychiatric setting in Portugal and will include adults diagnosed with psychosis who are currently treated with long-acting injectable antipsychotics. Participants will be allocated to either an exercise group or a control group receiving usual care. The exercise program will last 24 weeks and will include aerobic, strength, mobility, and flexibility exercises, with supervised sessions conducted by qualified professionals. Participants will be assessed at baseline, during the intervention, after completion of the program, and at follow-up. Assessments will include measures of physical function, body composition, psychological well-being, quality of life, and blood-based biomarkers such as brain-derived neurotrophic factor, dopamine, serotonin, and metabolic indicators. The main hypothesis of this study is that individuals who participate in the physical exercise program will show improvements in physical function, mood, and overall well-being compared with those receiving usual care alone. The results of this study are expected to provide practical evidence to support the integration of structured physical exercise as an adjunct to routine psychiatric care for people with psychosis.
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Body mass/weight
Timeframe: Baseline, 12 weeks, 24 weeks, 8-week post-intervention follow-up
Body mass index (BMI)
Timeframe: Baseline, 12 weeks, 24 weeks, 8-week post-intervention follow-up
Body fat percentage
Timeframe: Baseline, 12 weeks, 24 weeks, 8-week post-intervention follow-up
Lean body mass
Timeframe: Baseline, 12 weeks, 24 weeks, 8-week post-intervention follow-up
Sit-to-Stand Test _ 30s
Timeframe: Baseline, 12 weeks, 24 weeks, and 8-week post-intervention follow-up
Handgrip Test
Timeframe: Baseline, 12 weeks, 24 weeks, and 8-week post-intervention follow-up
European Health Interview Survey - Quality of Life 8-item Index (EUROHIS-QOL-8)
Timeframe: Baseline, 12 weeks, 24 weeks, and 8-week post-intervention follow-up
Patient Health Questionnaire-9 - PHQ-9
Timeframe: Baseline, 12 weeks, 24 weeks, and 8-week post-intervention follow-up
Positive and Negative Affect Scale (PANAS)
Timeframe: Baseline, 12 weeks, 24 weeks, and 8-week post-intervention follow-up
Serum Brain-Derived Neurotrophic Factor (BDNF) levels
Timeframe: Baseline, 12 weeks, 24 weeks, and 8-week post-intervention follow-up
Serum lipid profile
Timeframe: Baseline, 12 weeks, 24 weeks, and 8-week post-intervention follow-up
Glycemic and metabolic markers
Timeframe: Baseline, 12 weeks, 24 weeks, and 8-week post-intervention follow-up
Serum Serotonin levels
Timeframe: Baseline, 12 weeks, 24 weeks, and 8-week post-intervention follow-up
Serum Dopamine levels
Timeframe: Baseline, 12 weeks, 24 weeks, and 8-week post-intervention follow-up