Schizophrenia (SZ) is a chronic, severe psychiatric disorder that affects approximately 1% of the population (Barnett 2018). The psychiatric symptoms and high rate of relapse of SZ can significantly impair cognitive and social functioning, including problem-solving skills, interpersonal relationships, and work performance (Brekke et al., 2005). Moreover, individuals with SZ usually have higher disability and premature mortality rates compared to the general population (McCutcheon et al., 2020). Falls are a common concern in hospital settings, with studies reporting a fall rate between three and five falls per 1000 bed days (Healey et al., 2008; Oliver et al., 2010; Pham et al., 2022).Osteoporosis and its precursors, e.g. osteopenia and low bone mineral density (BMD), have been reported in chronic patients with SZ (Kishimoto et al., 2012; Stubbs et al., 2014; Gomez et al., 2016; Cui et al., 2018) and were strong predictors for subsequent falls and fractures in psychiatric hospitals (Stubbs et al. 2015; Stubbs et al., 2018).~Dance/movement therapy (DMT), as one of the creative arts therapies (Millard et al., 2021), is an emerging therapy for the rehabilitation of patients with SZ in recent years (Xia and Grant 2009; Ren and Xia 2013; Millman et al., 2021; Wu et al., 2022). DMT therapy uses dance activities and body movements to enhance well-being, mood, and quality of life. DMT therapy uses movement, dance, and interpersonal communication to explore a person's emotional, cognitive, social, and physical integration, enabling patients to enhance self-expression, accept and reconnect with their bodies, and strengthen their fitness (de Witte et al., 2021). The patients share their emotions, concerns, and coping strategies with others through dance/movement (Biondo et al., 2021; Bryl et al., 2022). It can be applied to individuals of all ages, races, and genders and can be efficacious in individuals who experience losses in social, physical, and psychological functions. DMT has also been used to improve the cognition and social function of patients with mental diseases in psychiatric hospitals (Millman et al. 2021). In particular, a few studies have reported a critical role of DMT intervention in negative symptoms in chronic patients with SZ (Röhricht and Priebe 2006; Priebe et al., 2016). However, there is still a lack of evidence that whether DMT is an effective therapy to increase the mean bone mineral density and reduce the risk of fractures due to falls in long-term hospitalized patients with SZ.~In the present study, we hypothesized that DMT intervention was effective to increase BMD and balance ability and decrease the metabolic parameters in long-term hospitalized male veterans with SZ as compared to the control group. We also examined whether DMT intervention can significantly change BMI, the levels of lipid profile, and serum calcium in patients.
Fractures are common accidents for long-term hospitalized patients with schizophrenia (SZ) in psychiatric hospitals, and once they occur, patients usually endure the pain of fractures for a long time. Accumulating evidence has supported implementing dance/movement therapy (DMT) as a promising intervention for patients with SZ. However, no study has been conducted to investigate its role in balance ability and metabolic parameters in SZ. This study was designed to investigate the treatment outcome of a 12-week DMT intervention on bone mineral density, balance ability, and metabolic profile in patients with SZ using a randomized, controlled trial design.