***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 Recently , there has been an interest in the relative effectiveness of progressive muscle relaxation ( PMR ) within the multidisciplinary treatment of patients with schizophrenia . The present study is aim ed at providing evidence on the efficacy of PMR as means of alleviating the state anxiety and psychological distress and a way to increase subjective well-being in chronic patients with schizophrenia . SUBJECTS AND METHODS Sixty four schizophrenia patients underwent 2 sessions of PMR . On the third session they were r and omly allocated to either the PMR or the reading control condition .  The State Anxiety Inventory ( SAI ) was used to assess state anxiety and the Subjective Exercise Experience Scale ( SEES ) to assess psychological distress and subjective well-being before and after the third session for both groups . RESULTS Our data show a significant time by group interaction for the SAI and SEES ( Wilks λ=0.58 , p<0.001 ) . Effect sizes for PMR were -0.22 ( 95%CI=-0.73 to 0.19 ) for state anxiety , -0.96 ( 95%CI=-0.41 to -1.43 ) for psychological stress , and + 1.01 ( 95%CI=0.45 to 1.54 ) for subjective well-being . CONCLUSION The present study provides scientific evidence for the utility of PMR in the chronic psychiatric setting s for patients with schizophrenia Physical activity is an important aspect of good health for everyone ; it is even more important for psychiatric patients who usually live an unhealthy lifestyle . In recent years , there has been growing focus on the use of soccer as a vehicle to improve the health of subjects with severe mental illness . The aim of this study was to investigate the effects of soccer practice on the self-reported health quality of life ( SRHQL ) and sports performance ( SP ) in psychotic subjects . Eighteen male patients with diagnosis of schizophrenia were r and omized into either a trained ( TG ) or a control group ( CG ) . The TG was trained for 12 weeks using two soccer training sessions per week . The CG did not perform any regular sports activity during the experimental period . Anthropometric measurements , SRHQL , personal time records in a 30 meter sprint test and slalom test running with a ball were evaluated before and after the experimental period . SRHQL was assessed using Short Form-12 question naire measuring physical and mental component summary scores . After the training period , the TG showed a relevant decrease by 4.6 % in bodyweight ( BW ) and body mass index compared to baseline . Conversely , the CG showed an increased BW and body mass index by 1.8 % from baseline to posttest . Moreover , after 12 weeks we found that control patients increased their BW significantly when compared to trained patients ( Δ = 5.4 % ; P < 0.05 ) . After the training period , comparing the baseline TG ’s Short Form-12-scores to posttest results , we found an improvement of 10.5 % and 10.8 % in physical component summary and mental component summary , respectively . In addition , performances on the 30 meter sprint test and slalom test running with a ball in the TG improved significantly ( P < 0.01 ) from baseline to posttest when compared to CG . Soccer practice appears able to improve psychophysical health in individuals with diagnosis of schizophrenia . Indeed , our study demonstrated that programmed soccer physical activity could reduce antipsychotic medication-related weight gain and improve SRHQL and sports performance in psychotic subjects Objective . Patients with schizophrenia residing at institutions often suffer from negative symptoms , motor , and functional impairments more severe than their noninstitutionalized counterparts . Tai-chi emphasizes body relaxation , alertness , and movement coordination with benefits to balance , focus , and stress relief . This pilot study explored the efficacy of Tai-chi on movement coordination , negative symptoms , and functioning disabilities towards schizophrenia . Methods . A r and omized waitlist control design was adopted , where participants were r and omized to receive either the 6-week Tai-chi program and st and ard residential care or only the latter . 30 Chinese patients with schizophrenia were recruited from a rehabilitation residency . All were assessed on movement coordination , negative symptoms , and functional disabilities at baseline , following intervention and 6 weeks after intervention . Results . Tai-chi buffered from deteriorations in movement coordination and interpersonal functioning , the latter with sustained effectiveness 6 weeks after the class was ended . Controls showed marked deteriorations in those areas . The Tai-chi group also experienced fewer disruptions to life activities at the 6-week maintenance . There was no significant improvement in negative symptoms after Tai-chi . Conclusions . This study demonstrated encouraging benefits of Tai-chi in preventing deteriorations in movement coordination and interpersonal functioning for residential patients with schizophrenia . The ease of implementation facilitates promotion at institutional psychiatric services INTRODUCTION Postural instability is a serious concern in patients with schizophrenia-spectrum disorders since it is expected to increase the risk of falls that may lead to fractures . The impact of yoga therapy on postural stability has not been investigated . METHODS In this eight-week single-blind r and omized controlled study with an eight-week follow-up , out patients with schizophrenia or related psychotic disorder ( ICD-10 ) were r and omly assigned to either yoga therapy or a control group . In the yoga therapy group , the subjects received weekly sessions of 60-min yoga therapy for eight weeks in addition to their ongoing treatment . In the control group , the subjects received a weekly regular day-care program . The assessment s that were performed at the baseline and endpoint included the Clinical Stabilometric Platform ( CSP ) , anteflexion in st and ing . RESULTS Forty-nine patients participated in this study ( 32 men ; mean ± SD age , 53.1 ± 12.3 years ) :  yoga therapy group ( n = 25 ) and control group ( n = 24 ) . In the yoga group , significant improvements were observed in a total length of trunk motion , the Romberg ratio , and anteflexion in st and ing at week 8 ( mean ± SD : 63.9 ± 40.7 - 53.4 ± 26.2 cm , 1.6 ± 0.9 - 1.1 ± 0.6 , and -8.7 ± 9.5 to -3.8 ± 12.4 cm , respectively ) while there were no significant changes in the control group . However , those clinical gains returned to the baseline level at week 16 . CONCLUSIONS The results confirmed the beneficial effects of the yoga therapy on postural stability in patients with schizophrenia . However , the therapeutic effects seemed transient , which warrants further investigations on strategies to sustain the improvements Weight gain has been identified as being responsible for increased morbidity and mortality rates of schizophrenia patients . For the management of weight gain , exercise is one of the most acknowledged interventions . At the same time , exercise and sports have been recognized for their positive impact on psychiatric symptoms of schizophrenia . However , the neurobiological basis for this remains poorly understood . We aim ed to examine the effect of sports participation on weight gain , psychiatric symptoms and brain activation during sports observation in schizophrenia patients . Thirteen schizophrenia patients who participated in a 3-month program , including sports participation and 10 control schizophrenia patients were studied . In both groups , body mass index ( BMI ) , Positive and Negative Syndrome Scale ( PANSS ) , and brain activation during observation of sports-related actions measured by functional magnetic resonance imaging were accessed before and after a 3-month interval . BMI and general psychopathology scale of PANSS were significantly reduced in the program group but not in the control group after a 3-month interval . Compared with baseline , activation of the body-selective extrastriate body area ( EBA ) in the posterior temporal-occipital cortex during observation of sports-related actions was increased in the program group . In this group , increase in EBA activation was associated with improvement in the general psychopathology scale of PANSS . Sports participation had a positive effect not only on weight gain but also on psychiatric symptoms in schizophrenia . EBA might mediate these beneficial effects of sports participation . Our findings merit further investigation of neurobiological mechanisms underlying the therapeutic effect of sports for schizophrenia The objective of this study was to examine exercise effects on global brain volume , hippocampal volume , and cortical thickness in schizophrenia patients and healthy controls . Irrespective of diagnosis and intervention , associations between brain changes and cardiorespiratory fitness improvement were examined . Sixty-three schizophrenia patients and fifty-five healthy controls participated in this r and omised controlled trial .  Global brain volumes , hippocampal volume , and cortical thickness were estimated from 3-Tesla MRI scans . Cardiorespiratory fitness was assessed with a cardiopulmonary ergometer test . Subjects were assigned exercise therapy or occupational therapy ( patients ) and exercise therapy or life-as-usual ( healthy controls ) for six months 2h weekly . Exercise therapy effects were analysed for subjects who were compliant at least 50 % of sessions offered . Significantly smaller baseline cerebral ( grey ) matter , and larger third ventricle volumes , and thinner cortex in most areas of the brain were found in patients versus controls . Exercise therapy did not affect global brain and hippocampal volume or cortical thickness in patients and controls . Cardiorespiratory fitness improvement was related to increased cerebral matter volume and lateral and third ventricle volume decrease in patients and to thickening in the left hemisphere in large areas of the frontal , temporal and cingulate cortex irrespective of diagnosis . One to 2h of exercise therapy did not elicit significant brain volume changes in patients or controls . However , cardiorespiratory fitness improvement attenuated brain volume changes in schizophrenia  patients and increased thickness in large areas of the left cortex in both schizophrenia patients and healthy controls Background Patients with schizophrenia frequently have disabling gait deficits . The net mechanical efficiency of walking ( ϵnet ) is an accurate measure often used to evaluate walking performance . Patients with gait deficits have a reduced ϵnet with excessive energy expenditure during sub-maximal walking . Maximal strength training ( MST ) improves ϵnet in healthy individuals and is associated with reduced risk of mortality . The aim of this study was to investigate whether MST improves ϵnet in patients with schizophrenia . Methods Patients ( ICD-10 schizophrenia , schizotypal or delusional disorders ( F20-F29 ) ) were included in a non-r and omized trial . Patients were assigned to one of two groups : 1 ) MST consisting of 4x4 repetitions at 85 - 90 % one repetition maximum ( 1RM ) performed in a leg press apparatus or 2 ) playing computer games ( CG ) . Both groups carried out their activity three days per week for eight weeks . 1RM , ϵnet at 60 watt walking , peak oxygen uptake ( VO2peak ) , the Positive and Negative Syndrome Scale ( PANSS ) and the 36-items short form ( SF-36 ) were measured pre and post intervention . Results The baseline ϵnet was 17.3 ± 1.2 % and 19.4 ± 3.0 % in the MST ( n = 6 ) and CG groups ( n = 7 ) , respectively , which is categorized as mechanical inefficiency . The MST group improved 1RM by 79 kg ( p = 0.006 ) and ϵnet by 3.4 % ( p = 0.046 ) more than the CG group . The MST group improved 1RM and ϵnet , by a mean of 83 kg ( p = 0.028 ) and 3.4 % ( p = 0.028 ) , respectively . VO2peak at baseline was 34.2 ± 10.2 and 38.3 ± 9.8 ml·kg-1·min-1 in the MST and CG groups , respectively , and did not change ( p > 0.05 ) . No change was observed in PANSS or SF-36 ( p > 0.05 ) . Conclusions MST improves 1RM and ϵnet in patients with schizophrenia  . MST could be used as a therapeutic intervention for patients with schizophrenia to normalize their reduced ϵnet 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 Increased mortality in schizophrenia is caused largely by coronary heart disease ( CHD ) . Low cardiorespiratory fitness ( CRF ) is a key factor for CHD mortality . We compared CRF in patients with schizophrenia to CRF of matched healthy controls and reference values . Also , we examined the effects of exercise therapy on CRF in patients with schizophrenia and in controls . METHODS Sixty-three patients with schizophrenia and 55 controls , matched for gender , age , and socioeconomic status , were r and omized  to exercise ( n = 31 ) or occupational therapy ( n = 32 ) and controls to exercise ( n = 27 ) or life as usual ( n = 28 ) . CRF was assessed with an incremental cardiopulmonary exercise test and defined as the highest relative oxygen uptake ( VO(2peak ) ) and peak work rate ( W(peak ) ) . Minimal compliance was 50 % of sessions ( n = 52 ) . RESULTS Male and female patients with schizophrenia had a relative VO(2peak ) of 34.3 ± 9.9 and 24.0 ± 4.5 mL.kg(-1).min(-1 ) , respectively . Patients had higher resting HR ( 
    Output:
    
Overall , the results demonstrate that aerobic exercise  significantly reduces psychiatric symptoms , potentially improves mental and physical quality of life and reduces metabolic risk and weight .
Specifically , yoga reduces psychiatric symptoms , whilst Tai-chi and progressive muscle relaxation may also have benefits to patients .
No adverse event was observed supporting the notion that physical therapy is safe in people with schizophrenia .
In general , the quality of physical therapy RCTS is improving and current research demonstrates that physical therapy approaches are valuable interventions and can help improve the psychiatric , physical and quality of life of people with schizophrenia