***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Previous qualitative studies have found that exercise may facilitate symptomatic and functional recovery in people with long-term schizophrenia . This study examined the perceived effects of exercise as experienced by people in the early stages of psychosis , and explored which aspects of an exercise intervention facilitated or hindered their engagement . Methods Nineteen semi-structured interviews were conducted with early intervention service users who had participated in a 10-week exercise intervention .  Interviews discussed people ’s incentives and barriers to exercise , short- and long-term effects , and opinions on optimal interventions . A thematic analysis was applied to determine the prevailing themes . Results The intervention was perceived as beneficial and engaging for participants . The main themes were ( a )  exercise alleviating psychiatric symptoms , ( b ) improved self-perceptions following exercise  , and ( c ) factors determining exercise participation , with three respective sub-themes for each . Conclusions Participants explained how exercise had improved their mental health , improved their confidence and given them a sense of achievement . Autonomy and social support were identified as critical factors for effectively engaging people with first-episode psychosis in moderate-to-vigorous exercise . Implementing such programs in early intervention services may lead to better physical health , symptom management and social functioning among service users . Trial registration Current Controlled Trials IS RCT N09150095 . Registered 10 December 2013 Objective : To examine a 1-year follow-up of a 4-month , controlled clinical trial of exercise and antidepressant medication in patients with major depressive disorder ( MDD ) . Methods : In the original study , 202 sedentary adults with MDD were r and omized to : a ) supervised exercise ; b ) home-based exercise ; c ) sertraline ; or d ) placebo pill . We examined two outcomes measured at 1-year follow-up ( i.e. , 16 months post r and omization ) : 1 ) continuous Hamilton Depression Rating Scale score ; and 2 ) MDD status ( depressed ; partial remission ; full remission ) in 172 available participants ( 85 % of the original cohort ) . Regression analyses were performed to examine the effects of treatment group assignment , as well as follow-up antidepressant medication use and self-reported exercise ( Godin Leisure-Time Exercise Question naire ) , on the two outcomes . Results : In the original study , patients receiving exercise achieved similar benefits compared with those receiving sertraline . At the time of the 1-year follow-up , rates of MDD remission increased from 46 % at post treatment to 66 % for participants available for follow-up . Neither initial treatment group assignment nor antidepressant medication use during the follow-up period were significant predictors of MDD remission at 1 year . However , regular exercise during the follow-up period predicted both Hamilton Depression Rating Scale scores and MDD diagnosis at 1 year . This relationship was curvilinear , with the association concentrated between 0 minute and 180 minutes of weekly exercise . Conclusion : The effects of aerobic exercise on MDD remission seem to be similar to sertraline after 4 months of treatment ; exercise during the follow-up period seems to extend the short-term benefits of exercise and may augment the benefits of antidepressant use . Trial Registration : clinical trials.gov Identifier : NCT00331305 . MDD = major depressive disorder ; HAM-D = Hamilton Depression Rating Scale ; SCID = Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition Axis I Disorders ; PSSS = Perceived Social Support Scale OBJECTIVE The aim of this study was to examine both single and joint associations of physical activity and conventional cardiovascular risk factors with total and cardiovascular mortality among patients with diabetes . RESEARCH DESIGN AND METHODS We prospect ively followed 3,708 Finnish patients with type 2 diabetes aged 25 - 74 years .  Physical activity , smoking status , blood pressure , height , weight , and serum cholesterol level were determined at baseline . Cox proportional hazard models were used to estimate single and joint effects of physical activity and other cardiovascular risk factors on the risk of mortality . RESULTS During a mean follow-up of 18.7 years , 1,423 deaths were recorded , 906 of which were due to cardiovascular disease . Moderate or high levels of physical activity were associated with decreased total and cardiovascular mortality , whereas higher levels of BMI and blood pressure and current smoking were associated with increased total and cardiovascular mortality . High serum cholesterol levels also increased cardiovascular mortality . The protective effect of physical activity was consistent in diabetic patients with any levels of BMI , blood pressure , total cholesterol , and smoking . CONCLUSIONS A moderate or high level of physical activity was associated with a reduced risk of total and cardiovascular mortality among patients with type 2 diabetes . The favorable association of physical activity with longevity was observed regardless of the levels of BMI , blood pressure , total cholesterol , and smoking The objective of this multicenter r and omised clinical trial was to examine the effect of  exercise versus occupational therapy on mental and physical health in schizophrenia patients Background : Increasingly alarmed by the health risks ( that is , weight gain , elevated lipids , and poor glucose tolerance ) posed by novel antipsychotic medications , clinicians who treat schizophrenia are attempting to help patients improve lifestyle factors . Unfortunately , schizophrenia research has neglected exercise as a legitimate adjunctive treatment for schizophrenia . Objective : To assess the extent to which stable patients with schizophrenia would adhere to an exercise program if offered access to a fitness facility . Methods : Ten of 20 stable patients with schizophrenia or schizoaffective disorder who were treated with olanzapine for at least 4 weeks had the opportunity to receive access to a Young Men 's Christian Association ( YMCA ) fitness facility , based on r and om allocation . The intervention included a free membership to the YMCA for 6 months , with access to all the fitness amenities and equipment . The mean dosage of olanzapine was 11.5 mg daily for the YMCA group . Results : Of the 10 subjects , 2 did not attend at all . One subject met criteria for full attendance for each of the 6 months and lost 15 kg . Dropout rates were as follows : 90 % at 6 months , 70 % at 5 months , and 40 % at 4 months . The main reason they gave for poor attendance was lack of motivation . The mean weight gain was 2 kg in the YMCA group . Conclusion : Most subjects did not regularly exercise or attend . They cited poor motivation as the main reason . The subject who exercised regularly lost a significant amount of weight AIM Initiating antipsychotic medication frequently induces rapid , clinical ly significant weight gain . We aim ed to evaluate the effectiveness of a lifestyle and life skills intervention , delivered within 4 weeks of antipsychotic medication initiation , in attenuating weight gain in youth aged 14 - 25 years with first-episode psychosis ( FEP ) . METHODS We undertook a prospect i ve , controlled study in two early psychosis community services . Intervention participants ( n = 16 ) received a 12-week individualized intervention delivered by specialist clinical staff ( nurse , dietician and exercise physiologist ) and youth peer wellness coaches , in addition to st and ard care . A comparison group was recruited from a similar service and received st and ard care  ( n = 12 ) . RESULTS The intervention group experienced significantly less weight gain at 12 weeks compared to st and ard care ( 1.8 kg , 95 % CI -0.4 to 2.8 vs. 7.8 kg , 4.8 - 10.7 , P < 0.001 ) . Thirteen per cent ( 2/16 ) of the intervention group experienced clinical ly significant weight gain ( greater than 7 % of baseline weight ) , while 75 % ( 9/12 ) of the st and ard care group experienced this level of weight gain . Similar positive effects of the intervention were observed for waist circumference . CONCLUSIONS A lifestyle and life skills intervention delivered as part of st and ard care attenuated antipsychotic-induced weight gain in young people with FEP . The intervention was acceptable to the young people referred to the service . Such interventions may prevent the seeding of future disease risk and in the long-term help reduce the life expectancy gap for people living with serious mental illness The purpose of this prospect i ve and observational design study was to assess the feasibility of using a pedometer and step log to explore  level of physical activity ( PA )  and to assess motivation to be physically active in adults with schizophrenia . Descriptive statistics were used to analyse data of 7 male and 5 female subjects . Pedometer data indicated that subjects walked an average of 4731.03 ( ±3318.19 ) steps and 5002.58 ( ±3041.03 ) during the first week and second week of the study , respectively . A minimum 30-min walk was recorded on an average of 3.67 ( ±1.82 ) days ( week one ) and 4.5 ( ±1.88 ) days ( week two ) . Step logs , inconsistently maintained by subjects , were not able to be analysed . Examination of the Motives for Physical Activity Measure-Revised ( MPAM-R ) at baseline indicates that exercise fitness and body appearance were subjects ' primary motives for PA participation . Study findings indicate that it is feasible to use a pedometer to monitor the level of PA  . However , maintenance of a concurrent step log requires further consideration to determine realistic outcomes . Extrinsically focused motivations for PA in this study sample may predict low PA adherence Individuals with schizophrenia display substantial neurocognitive deficits for which available treatments offer only limited benefits . Yet , findings from studies of animals , clinical and non clinical population s have linked neurocognitive improvements to increases in  aerobic fitness  ( AF ) via aerobic exercise training ( AE ) . Such improvements have been attributed to up-regulation of brain-derived neurotrophic factor ( BDNF ) . However , the impact of AE on neurocognition , and the putative role of BDNF , have not been investigated in schizophrenia . Employing a proof-of-concept , single-blind , r and omized clinical trial design , 33 individuals with schizophrenia were r and omized to receive st and ard psychiatric treatment ( n = 17 ; " treatment as usual " ; TAU ) or attend a 12-week AE program ( n = 16 ) utilizing active-play video games ( Xbox 360 Kinect ) and traditional AE equipment . Participants completed assessment s of AF ( indexed by VO2 peak ml/kg/min ) , neurocognition ( MATRICS Consensus Cognitive Battery ) , and serum-BDNF before and after and 12-week period . Twenty-six participants ( 79 % ) completed the study . At follow-up , the AE participants improved their AF by 18.0 % vs a -0.5 % decline in the TAU group ( P = .002 ) and improved their neurocognition by 15.1 % vs -2.0 % decline in the TAU group ( P = .031 ) . Hierarchical multiple regression analyses indicated that enhancement in AF and increases in BDNF predicted 25.4 % and 14.6 % of the neurocognitive improvement variance , respectively . The results indicate AE is effective in enhancing neurocognitive functioning in people with schizophrenia and provide preliminary support for the impact of AE-related BDNF up-regulation on neurocognition in this population . Poor AF represents a modifiable risk factor for neurocognitive dysfunction in schizophrenia for which AE training offer a safe , nonstigmatizing , and side-effect-free intervention OBJECTIVE The objective of this study was to evaluate the effectiveness of a fitness health mentor program ( In SHAPE ) in improving physical fitness and weight loss among overweight and obese adults with serious mental illness . METHODS A r and omized controlled trial was conducted with 133 persons with serious mental illness and a body mass index ( BMI ) > 25 who were assigned either to the In SHAPE program ( one year of weekly sessions with a fitness trainer plus a fitness club membership ) or to one year of fitness club membership and education . Assessment s were conducted at baseline and three , six , nine , and 12 months later . RESULTS Participants had a mean baseline weight of 231.8±54.8 pounds and a mean BMI of 37.6±8.2 . At 12-month follow-up , In SHAPE ( N=67 ) compared with fitness club membership and education ( N=66 ) was associated with three times greater fitness club attendance , twice as much participation in physical exercise , greater engagement in vigorous physical activity , and improvement in diet . Twice the proportion of participants ( 40 % versus 20 % ) achieved clinical ly significant improvement in cardiorespiratory fitness ( > 50 m on the six-minute walk test ) . Weight loss and BMI did not differ between groups . Among In SHAPE participants , 49 % achieved either clinical ly significant increased fitness or weight loss ( 5 % or greater ) , and 24 % achieved both clinical ly significant improved fitness and weight loss . CONCLUSIONS The In SHAPE program achieved clinical ly significant reduction in cardiovascular risk for almost one-half of participants at 12 months . Although the intervention showed promise in improving fitness , optimizing weight loss may require additional intensive , multicomponent dietary interventions 
    Output:
    
Many of the desirable outcomes of exercise for people with SMI , such as mood improvement , stress reduction and increased energy , are inversely related to the barriers of depression , stress and fatigue which frequently restrict their participation in exercise .
Providing patients with professional support to identify and achieve their exercise goals may enable them to overcome psychological barriers , and maintain motivation towards regular physical activity