Table 2.

Aerobic exercise studies in schizophrenia, including methodology, cardiorespiratory fitness measurements, and clinical outcome

Year	Publication	Study design and diagnosis	Sample size, n		Intervention	Control	Measurement of CRF and PA	Intervention duration /follow-up	Outcome
			IG	CG
2021	Kimhy et al. 2021 [105]	Single-blind RCT SZ	16	17	Aerobic exercise program with 2 active-play video games (Xbox 360 Kinect) and traditional aerobic exercise equipment (treadmill, bike) Sessions: 3x/week, 1 h Moderate intensity: activities that expend 3.0–5.9 times the energy expended at rest; 60% of HRmax in week 1, 65% in week 2, 70% in week 3, and 75% in weeks 4–12 Supervision by a BSc in Science of Therapeutic Recreation	UC	CRF: VO2peak, cycle ergometer	12 weeks	↑ In VO2max by 18.0% vs. 0.5% Improvements in VO2max significantly predicted enhancement in SF as indexed by self-, informant-, and clinician-reported measures, predicting 47%, 33%, and 25% of the variance, respectively Significant improvement in SF (23.0% vs. − 4.2%)
2020	Andersen et al. 2020 [99]	RCT SZ	21	26	HIIT Walking/running on a treadmill, Sessions: 2x/week, 45 min Intensity: 4 × 4 min 85–95% of HRmax, active breaks consisting of 3 min of ~ 70% of HRmax Supervision by mental health care providers with or without PA competence (half of the participants, respectively)	PC gaming skills (Nintendo Wii sports console), supervised	CRF: VO2max (treadmill, maximum exercise session, mod. Balke protocol) PA: Actigraph GT3X + accelerometer	12 weeks	No significant within-group differences in CRF ↑ Workload in 61% of HIIT ↑ In VO2max when adding PA competence of the mental health care providers No significant effect on PA level or body composition
2020	Dubreucq et al. 2020 [113]	Quasi experimental trial SZ	57	30	Exercise-enriched integrated social cognitive remediation intervention Sessions: 1x/week, 2 h Intensity: not defined Supervised by two facilitators	Active CG practicing Touch Rugby 12 × 2-h sessions Supervised by specialized sport scientists		12 weeks 6 months’ follow-up	Moderate to large improvements in social function, symptom severity, verbal abstraction, aggression bias, and self-stigma that were specific to the IG and were not observed in participants playing only Touch Rugby. Effects were persistent over time and even larger between post-treatment and follow-up
2020	Korman et al. 2020 [102]	Single arm, prospective feasibility study SMI; 92% SZ	42	No CG	Mixed aerobic and resistance training: circuit training, combined with a dietary intervention (six individual and group sessions) Sessions: 3x/week, 1 h Intensity: Moderate from week 3. (RPE at 2–3 for the first 2 weeks, then increased to a minimum RPE of 4/10 by week 3 and further increased as per individual participant's capacity) Supervised by exercise physiology students	No CG	Functional exercise capacity: 6 MWT PA: questionnaire SIMPAQ Motivation towards exercise: BREQ	10 weeks	Significant improvements in functional exercise capacity, volume of exercise, general psychiatric symptoms, and negative psychotic symptoms No change in anthropometric and metabolic blood markers
2020	Massa et al. 2020 [101]	RCT Outpatient SZ	21	17	Aerobic exercise on a stationary bicycle, groups of about 5 participants Sessions: 3x/week, initially 20 min to 45 min (increasing 5 min each week) Intensity began at low levels (50% of maximal HRR) to 80% of HRmax (increased by 5% every week) Supervised by at least one qualified instructor	Stretching and balance training for same amount of time, groups of about 5 participants	400 m walk test → Estimate VO2max	12 weeks 8 weeks’ follow-up	Subjects in both groups were slower at the 400 m walk in week 12 compared with baseline, but the IG had significantly less slowing than the CG Between week 12 and week 20, the aerobic exercise group had a significantly greater change score on the Composite and Visual Learning Domain of the MATRICS Consensus Cognitive Battery
2019	Brobakken et al. 2019 [100]	RCT Feasibility study SZ	25	23	Aerobic interval training in groups, walking/running on a treadmill Sessions: 2x/week, 35 min Intensity: 4 × 4 min 85–95% of HRpeak, active pauses consisting of 3 min of ~ 70% of HRpeak Supervised by experienced healthcare professionals	Two aerobic interval training sessions and encouragement to exercise on their own	CRF: VO2peak	12 weeks	↑VO2peak by 10%, no change in the CG No intergroup difference in weight, body mass index (BMI), waist circumference, blood pressure, lipids, or glucose at posttest ↑Weight and BMI in the CG, no change in the IG
2019	Hallgren et al. 2019 [60]	Single-arm feasibility study First-episode psychosis; majority SZ	91	No CG	Circuit training: high-volume resistance exercises, aerobic training, and stretching Sessions: at least 3x/week, 1 h Supervised by exercise science graduates and exercise physiologist	No CG		12 weeks	Significant post-intervention improvements for processing speed, visual learning, and visual attention; all with moderate effect sizes
2019	Larsen et al. 2019 [114]	RCT, Feasibility study First-episode psychosis, SZ, Schizotypal and delusional disorder, and other non-organic psychotic disorders	13	12	Cross-fit-oriented training Session: 3x/week, 1 h Moderate to high intensity Supervised by two instructors (undergraduate students)	Waiting list CG		8 weeks	Three main themes and ten subthemes emerged during the analysis: (1) motivation and expectations for enrollment (subthemes: routines and structure, social obligation, goal setting and self-worth); (2) new demands and opportunities (subthemes: practicalities of the training, an understanding exercise setting, and alone and together); and (3) looking ahead—reflections on impact (subthemes: restored sleep and circadian rhythm, energy and sense of achievement, changed everyday life, and hope of finding a new path)
2019	Shimada et al. 2019 [62]	Pilot RCT SZ	(A) 16	15	(A) Aerobic exercise: individual and group programs Sessions: 2x/week, 1 h Intensity: individually calibrated at 60–80% of aerobic capacity. Patients were required to participate in a minimum of 75% of each session Supervised by occupational therapists	UC	n.a	12 weeks	IG and CG patients showed significant improvements in cognition, intrinsic motivation, psychiatric symptoms, and interpersonal relations
2017	Bhatia et al. 2017 [115]	Single-blind RCT SZ	A) 104 (B) 90	92	(A) Yoga training (postures and breathing) (B) Physical exercise training: brisk walks, jogging, and directed aerobic exercises Sessions: 5x/week, 1 h Supervised by qualified instructors	UC	n.a	21 days 6 months’ follow-up (provided with a yoga training booklet, compliance charts)	Speed index of attention domain in group (A) showed greater improvement than group (B) at 6 month follow-up In group (B), accuracy index of attention domain showed greater improvement than UC alone at 6-month follow-up For several other cognitive domains, significant improvements were observed with (A) or (B) compared with UC alone
2017	Cheng et al. 2017 [107]	RCT SZ	26	28	Aerobic dance program Sessions: 2x/week, 60 min Intensity: 60–79% of predicted HRmax Supervised by professional instructor	UC	Muscular endurance (1-min flexed leg sit-up), flexibility (sit-and-reach test), cardiorespiratory endurance (3-min step test; HR)	8 weeks 4 weeks’ follow-up	Significant between-group differences at posttest and in the follow-up for all of the health-related fitness outcomes with the exception of muscular endurance
2017	Curcic et al. 2017 [63]	RCT SZ	40	40	Individual training: Walking/running 2–4 km outside Sessions: 4x/week, 45 min Intensity: 65–75% HRmax Supervised by a fitness trainer	UC	CRF: VO2max	12 weeks	After 12 weeks, patients in IG showed a significant increase of VO2max and significantly higher level of VO2max compared to the CG Significant differences on PANSS general psychopathology subscale and on PANSS total score. The pharmacotherapy and exercise had influence on PANSS general psychopathology and PANSS total score
2016	Duncan et al. 2016 [116]	Randomized cross-over study SZ	28		Bout of exercise: walking on the treadmill Intensity: moderate (64–76% of the calculated HRmax) 1 × 10 min	Passive sitting for 14 min	Mean HR, percent maximum HR, Borg RPE	10-min post-tests after 14 and 24 min	Significant differences between pleasure at baseline, both immediately after task and 10 min after task. No other main effects or interactions
2016	Ho et al. 2016 [68]	RCT Chronic SZ	(A) 51 (B) 51	49	(A) Tai Chi: 22 simple movements (B) Moderate aerobic exercise routine to achieve 50–60% of maximal oxygen consumption Both groups: 1x/week, 60 min AND 2x/week, 45 min Supervised by mental health professionals	Wait list control UC; they were offered the Tai chi or exercise class on a voluntary basis after the 3-month post-intervention follow-up assessment	Heart rate	12 weeks 3 months’ follow-up	Compared with CG, the Tai-chi group showed significant decreases in motor deficits and increases in backward digit span and mean cortisol, while the exercise group displayed significant decreases in motor deficits, negative and depression symptoms and increases in forward digit span, daily living function, and mean cortisol No significantly different therapeutic effects of the two interventions, except for fewer symptom manifestations in the exercise group
2016	Kang et al. 2016 [67]	RCT Chronic SZ	118	126	Community-based integrated intervention = Tai Chi Intervention AND Social Skills Training Sessions 2x/month, 120 min: 45 min social skill training, 45 min Tai Chi, 30 min break Supervised by three full-time psychiatrists and one assistant Both groups received medication maintenance treatment to prevent relapse	Medical treatment alone		12 months	Compared with the medical treatment alone group, the community-based integrated intervention group had lower scores on PANSS and negative symptoms, a lower risk for aggressive behavior, and a greater improvement in adherence to medication after 1 year of intervention
2016	Keller-Varady et al. 2016 [29]	Controlled interventional study SZ	(A) 22 (B) 21	22 healthy controls	(A) Endurance group: dynamic aerobic endurance training on bicycle ergometers Sessions: 3x/week, 30 min Intensity: set according to the individual results of a baseline assessment of endurance capacity, equivalent to blood lactate concentrations of 2 mmol/l Supervised by sport scientist (B) Table soccer group: table soccer Sessions: 3x/week, 30 min Supervision: n.a All participants continued with their usual medication	Healthy control in endurance group	Endurance capacity by ergometer stress test Standardized questionnaire, specially developed for measuring PA	12 weeks 3 and 6 months’ follow-up	Improvements of endurance capacity in (A), but not in (B) Patients and healthy controls showed comparable adaptations to endurance training, as assessed by physical working capacity and maximal achieved power Differences in changes of performance at a lactate concentration of 3 mmol/l
2016	Malchow et al. 2016 [88]	RCT SZ	2021 healthy controls	19	Endurance training on bicycle ergometers Sessions: 3x/week, 30 min Intensity: individually defined intensity, gradually increased according to blood lactate concentrations of approximately 2 mmol/l, HR, Borg Scale Supervised by sports scientists From week 6, the computer-assisted training program COGPACK was added as an intervention in each group to train cognitive performance	Table soccer in groups (2–4 players)	Endurance capacity (PWC130) by maximal exercise stress test PA was monitored throughout the study, not defined	6 weeks 3 months	No significant increases in the volumes of the hippocampus or hippocampal substructures in SZ patients or healthy controls Increased volume of the left superior, middle, and inferior anterior temporal gyri compared with baseline in SZ patients after the endurance training, whereas patients playing table soccer showed increased volumes in the motor and anterior cingulate cortices. After the additional training-free period, the differences were no longer present Improvements of endurance capacity in exercising patients and healthy controls No change in psychopathological symptoms
2016	Su et al. 2016 [61]	3-month follow-up study, single blind, randomized SZ	30	27	Aerobic exercise: individually tailored for each participant because exercise prescriptions were based on each individual's age-adjusted HRmax Sessions: at least 3x/week, 40 min One-on-one supervision throughout the sessions	Stretching and toning control group, individually conducted, own pace Same social interactions as those in aerobic exercise group	Estimated VO2max	12 weeks 3 months’ follow-up	No significant difference between the two groups in any cognitive outcome measured at follow-up; improvement over time was noted in certain cognitive domains in the IG No significant between-group differences in aerobic fitness at posttest and follow-up Fitness level was not related to changes in cognitive performance
2016	Yoon et al. 2016 [108]	Single-arm pilot study SZor schizoaffective disorder	24	No CG	Exercise intervention: group-based outdoor cycling 1x/week, at least 40 min Individual performance (average speed, distance, and duration) and heart rate, were monitored by individual supervising staff during every session.) Supervised by two professional cyclists and other staff: medical doctors, nurses, and social workers	No CG	Cardiorespiratory function test (step test): 3-min YMCA step test	3 months 6 months’ follow-up	Significant increase in participant’s self-esteem, positive relationship, global function, and quality of life CRF significantly improved after 3 months At the 9-month follow-up, 6 months after program completion, only in interpersonal relationship change the improved effects were maintained
2015	Kaltsatou et al. 2015 [69]	RCT, outpatient SZ	16	15	Greek traditional dancing program Sessions: 3x/week, 60 min Intensity: 60–70% of individual HRmax (220-age) Supervised by a PA instructor	Sedentary CG, Patients were asked to refrain from any other form of organized PA during study period	6 MWT Sit-to-stand test, 10 times Lower limb strength testing Hand-grip strength	8 months	↑ Walking distance in the 6 MWT, sit-to-stand test, Berg Balance Scale score, lower limbs maximal isometric force, Positive and Negative Syndrome Scale total score, Global Assessment of Functioning scale total score, and Quality of Life total score
2015	Kimhy et al. 2015 [117]	Single-blind RCT, inpatient SZ	16	17	Aerobic exercise program utilizing 2 active-play video games (Xbox 360 Kinect) and traditional aerobic exercise equipment (treadmill, bike) Sessions: 3x/week, 1 h Intensity: moderate intensity, minimal aerobic exercise intensity was set to 60% of HRmax in week 1, 65% in week 2, 70% in week 3, and 75% in weeks 4–12 Supervised by a BSc in Science of Therapeutic Recreation	UC	CRF: VO2peak	12 weeks	↑ VO2peak by 18.0% in the IG vs a − 0.5% decline in the CG Improvement of neurocognition by 15.1% vs − 2.0% CRF and increases in BDNF predicted 25.4% and 14.6% of the neurocognitive improvement variance, respectively
2015	Loh et al. 2015 [118]	RCT, inpatient SZ	52	52	Structured, organized walking intervention, 3x/week, supervised 3x/week, the first month: 20-min walking exercise, second month: 30-min walking exercise, third month: 40-min walking HR was monitored before and after the exercise to prevent overexertion Supervised by ward staff nurses and assistant medical officers	Treatment as usual	IPAQ-M	12 weeks 3 months’ follow-up	At 3-month follow-up, significant within-group differences in QOL (SF-36), psychiatric symptoms (PANSS), and personal and social performance (PSP) Increase in the median SF-36 scores, with increases shown in physical functioning, physical role limitations, social functioning Reduction of median PANSS in positive and negative symptom, and general psychopathology scales Increase in the median PSP score Between-group differences at post-intervention (favoring intervention) were significant for PANSS positive and SF-36
2015	Malchow et al. 2015 [58]	RCT SZ	2223 healthy controls	21	Endurance training on bicycle ergometers Sessions: 3x/week, 30 min Intensity: individually defined intensity, gradually increased according to blood lactate concentrations of approximately 2 mmol/l, HR, Borg Scale Supervised by sports scientists From week 6, the computer-assisted training program COGPACK was added as an intervention in each group to train cognitive performance	Table soccer in groups (2–4 players)	Endurance capacity (PWC130) by a maximal exercise test on a bicycle ergometer	6 weeks 3 months 6 months’ follow-up	After 3 months, improvement in GAF and SAS-II social/leisure activities and household functioning adaptation in the endurance training augmented with cognitive remediation, but not in the table soccer augmented with cognitive remediation group Significant improvements in the severity of negative symptoms and performance in the VLMT and WCST in the endurance training augmented with cognitive remediation group from week 6 to the end of the 3-month training period
2015	Masa-Font et al. 2015 [111]	RCT Severe mental illness; 67% SZ	169	163	Educational program AND PA program based on different stages → 24 sessions 2x/week over 3 months: The first 8 sessions (40 min) consisted of making first contact with PA. The other 16 sessions (60 min) aimed to increase the number of daily steps taken to reach 10,000 steps per day on routes adapted to the physical condition of the participants AND Dietary intervention → 16 sessions 2x/week, 20 min to provide basic knowledge on healthy dietary habits Supervised by professionals	No intervention, usual program of regular check-ups with their reference psychiatrist All the participants in both the IG and CG kept up their usual visits with their reference mental health professional and continued the usual treatment for their disease	PA: IPAQ, METs expended per week	3 months 12 months’ follow-up	↑ Average weekly walking METs in the IG BMI decreased significantly more in the CG No significant differences in the waist circumference
2015	Silva et al. 2015 [70]	RCT “blind” SZ	(A) 12 (B) 9	13	(A) Resistance: progressive resistance training Intensity: from 40% 1RM in week 1 up to 85% 1RM in week 20 (B) Concurrent exercise: endurance training and strength resistance training Intensity: from 40% VO2max in week 1 up to 75% VO2max in week 20 Sessions: 2x/week, 60 min Supervised by professional physical educators	Control: equipment load was kept at a minimum, treadmill speed remained at 4 km/h	CRF: VO2max	20 weeks	A significant time-by-group interaction was found for (A) and (B) on the Positive and Negative Syndrome Scale total score for disease symptoms, positive symptoms, and on the arm extension one-repetition maximum test Improvements in (A) on negative symptoms, on the role-physical domain of the Short Form-36 Health Survey, and on the chest press 1RM test
2015	Svatkova et al. 2015 [90]	RCT SZ	(A) 16 (B) 17	(A) 24 (B) 24 healthy controls	(A) Aerobic and anerobic exercise. Aerobic exercise: bicycle ergometer, rowing machine, cross trainer, treadmill and muscle strength exercises (6 exercises per week, 3 times). Anaerobic exercise: working with weights 2x/week, 1 h: 40 min aerobic training, 20 min anaerobic training Intensity: n.a Supervision: n.a (B) No exercise = life-as-usual	(A) exercise (B) no exercise = life- as-usual Healthy controls	CRF: VO2peak Structured questionnaire to assess the level of daily life physical activities at baseline Brain scans	6 months	Irrespective of diagnosis, regular physical exercise of an overlearned skill, such as bicycling, significantly increases the integrity, especially of motor functioning-related white matter fiber tracts, whereas life-as-usual leads to a decrease in fiber integrity Significant differences in the exercise and non-exercise group from the first to the second measurement in Wpeak and VO2peak
2014	Oertel-Knöchel et al. 2014 [37]	MDD (n = 22) and SZ (n = 29)	(A) 16 (B) 17	18	(A) Cognitive training combined with aerobic physical exercise: boxing, circuit training Intensity: 60–70% of individual HRmax (calculated from HRmax from ECG) Supervised by a trained physical exercise instructor (B) CT combined with relaxation training (no yoga or PMR, just breathing, “enjoy exercises”) CT and relaxation conducted by instructors Both sessions: 3x/week, 75 min (30 min CT and 45 min training)	Waiting list CG		4 weeks	Increase in cognitive performance in the domains visual learning, working memory and speed of processing; decrease in state anxiety; and increase in subjective quality of life in the total group of patients The effects in SZ patients compared with MDD patients were stronger for cognitive performance, whereas there were stronger effects in MDD patients compared with SZ patients in individual psychopathology values. MDD Reductions in depressive symptoms and state anxiety values in patients Reduction of negative symptoms severity in SZ patients
2014	Vancampfort et al. 2014 [119]	Pilot Study cross-sectional SZ	88		No intervention		Spirometry: 2 spirometry attempts while seated, conducted by trained technicians CRF: 6-min walk test PA: IPAQ	Screening: 6 months	Patients with MetS had a reduced predicted forced expiratory volume for 1 s and predicted forced vital capacity Significantly more patients with MetS were diagnosed with restrictive lung dysfunction SZ patients with restrictive lung dysfunction had a significantly larger waist circumference, were less physically active and walked less on the 6 MWT than patients without
2013	Scheewe et al. 2013 [64]	RCT SZ	31	32	Exercise therapy:  Muscle strength exercises (six exercises/week, 3 × 10 to 15 RM for biceps, triceps, abdominal, quadriceps, pectoral, and deltoid muscles). 2x/week, 1 h Intensity: increased stepwise: week 1–3, 45%; week 4–12, 65%; week 13–26, 75% of HR reserve based on baseline CPET data Supervised by a psychomotor therapist	Occupational therapy creative and recreational activities	CRF: VO2peak and Wpeak	6 months	↑ Wpeak in IG compared with CG Exercise therapy reduced symptoms of SZ, depression, need of care, and increased VO2peak in the IG compared with CG No effect for MetS factors
2013	Scheewe et al. 2013 [85]	RCT SZ	(A) 18 (B) 14	(A) 25 (B) 27	(A) Exercise therapy intervention: upright and recumbent bicycle ergometer, rowing machine, cross trainer, and treadmill AND muscle strength exercises (for biceps, triceps, abdominal, quadriceps, pectoral, deltoid muscles) 1 h of exercise consisting of both cardiovascular exercises (40 min) and muscle strength exercises (20 min) twice weekly Supervised by a psychomotor therapist specialized in psychiatry (B) Occupational therapy by an occupational therapist 1 h/twice weekly: Occupational therapy comprised creative and recreational activities, no physical activity	(A) Exercise therapy (B) Life as usual More details n.a	CRF: VO2peak	6 months	Significantly smaller baseline cerebral (gray) matter, and larger third ventricle volumes, and thinner cortex in most areas of the brain in patients versus controls No changes in global brain and hippocampal volume or cortical thickness CRF 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 1–2 h of exercise therapy did not elicit significant brain volume changes in patients or controls CRF improvement attenuated brain volume changes
2012	Scheewe et al. 2012 [106]	RCT SZ	(A) Exercise therapy 31// Healthy controls 27 (B) Occupational therapy 32	28	Exercise therapy:  (A) Muscle strength exercises (six exercises weekly; three times 10–15 RM for biceps, triceps, abdominal, quadriceps, pectoral, and deltoid muscles) Sessions: 2x/week, 1 h  Intensity was increased stepwise (week 1–3, 45%; week 4–12, 65%; week 13–26, 75% of HRR based on baseline CPET data  Supervised by a psychomotor therapist (B) Patients not randomized to exercise therapy were offered occupational therapy 2x/week, 1 h: creative and recreational activities	Life as usual, not allowed to incorporate moderate physical activity more than 1 h weekly	CRF: VO2peak and Wpeak	6 months	Patients had higher resting HR and lower peak HR, peak systolic blood pressure, relative VO2peak, Wpeak, RER, minute ventilation and HR recovery than controls In patients, exercise therapy increased relative VO2peak compared with decreased relative VO2peak after occupational therapy In controls, relative VO2peak increased after exercise therapy and to a lesser extent after life-as-usual Exercise therapy increased Wpeak in patients and controls compared with decreased Wpeak in nonexercising patients and controls
2012	Takahashi et al. 2012 [87]	?? SZ	13	10	Program including exercise, nutrition education and medication counseling Exercise module: aerobic exercise (walking and jogging), muscle-stretching exercise and sports exercise (basketball). The exercise module was 30–60 min long, and was delivered twice a day (a total of 60–120 min per day) from Monday to Saturday For each participant, the exercise intensity level was set at 11–13 (fairly light to somewhat hard) on the Borg scale Supervised by a group of professionals from diverse disciplines (physical therapists, psychiatric nurses, psychiatrists, nutritionists, and pharmacists) All patients received antipsychotics, and their medications remained unchanged during this study	Attended the day-hospital unit but not the program		3 months	Body mass index 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 [23] 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
2011	Heggelund et al. 2011 [104]	RCT SZ	12	7	HIIT Sessions: 3 days/week, 36 min: 4 × 4 min Intensity: 4 min 85–95%, 3 min 70% HRpeak Supervised by an exercise physiologist	Played PC (Tetris) games; 3 days/week, 36 min Supervised by the same exercise physiologist	CRF: VO2peak	8 weeks	The HIIT group improved VO2peak by 12% compared with the CG group Net mechanical efficiency of walking improved 12% in the HIIT group compared with the CG group No significant changes in PANSS, CDSS or SF-36 in either group
2011	Methapatara and Srisurapanont 2011 [120]	RCT SZ	32	32	Pedometer walking AND motivational interviewing program → 5 × 1-h sessions:  First session: individual motivational interviewing with a focus on obesity/overweight and motivation for adequate daily walking  Second session: group education on nutrition, exercise, warming up, cooling down, and implementation of pedometer  Third session: specific, measurable, acceptable, realistic, and timed criteria were used to set an individual goal, the first goal of daily walking was set at a minimum of 3000 steps per day  Forth session: group practicing of pedometer walking under supervision  Fifth session: therapist gave feedback on the patients’ practice, informed about self-regulation principles to cope with lapses and relapse	Control patients received the usual care only and no pedometer		12 weeks	Bodyweight of intervention group decreased more than that of the control group at week 4, 8, and 12 BMI at week 12 was significantly different between groups The decreases of waist circumference were significantly more in the intervention group for all three time-points of assessment
2011	Vancampfort et al. 2011 [65]	Pilot study SZ	(A) 40 (B) 40	40	(A) One single 30-min yoga session, trained by a physiotherapist (B) One single 20-min aerobic exercise session, performed on an electronically braked ergometer; consisted of cycling for 20 min at self-selected intensity with heart rate feedback. A physiotherapist was present during exercise	No exercise, participants sat quietly in a room for 20 min and were allowed to read. A physiotherapist was also present	n.a	One single event	After single sessions of yoga and aerobic exercise, individuals with SZ or schizoaffective disorder showed significantly decreased state anxiety, decreased psychological stress, and increased subjective wellbeing compared to a no-exercise control condition. The magnitude of the changes did not differ significantly between yoga and aerobic exercise
2010	Pajonk et al. 2010 [57]	RCT, day-hospital/outpatient SZ	88 healthy control	8	Aerobic exercise training (cycling) Sessions: 3x/week, 30 min Intensity: heart rate (± 10 beats/min) corresponding to a blood lactate concentration of about 1.5–2 mmol/l (14–18 mg/dl) derived from the results of the pretest Supervised by one of the investigators	Played table football The comparison group of patients played tabletop football for 30 min, 3 times per week, in a setting with comparable levels of stimulation to those provided for aerobic exercise. Tabletop football enhances coordination and concentration but does not improve aerobic fitness	CRF: VO2max	3 months	After exercise training, relative hippocampal volume increased significantly in patients (12%) and healthy individuals (16%), with no change in the non-exercise group of patients Changes in hippocampal volume in the exercise group were correlated with improvements in aerobic fitness measured by change in maximum oxygen consumption In the SZ exercise group, change in hippocampal volume was associated with a 35% increase in the N-acetylaspartate to creatine ratio in the hippocampus Improvement in test scores for short-term memory in the combined exercise and non-exercise SZ group was correlated with change in hippocampal volume

BDNF brain-derived neurotrophic factor, BMI body mass index, BREQ Behavioral Regulation In Exercise Questionnaire, CDSS Calgary Depression Scale for Schizophrenia, CG control group, CPET cardiopulmonary exercise testing, CRF cardiorespiratory fitness, CT cognitive training, EBA extrastriate body area, GAF Global Assessment of Functioning, HIIT high-intensity interval training, HR heart rate, HR_max heart rate maximum, HR_peak peak hear rate, HRR Heart rate reserve, IG Intervention group, IPAQ International Physical Activity Questionnaire, IPAQ-M International Physical Activity Questionnaire, Malay version, MATRICS Measurement and Treatment Research to Improve Cognition in Schizophrenia, MDD Major depressive disorder, MET metabolic equivalent, MetS Metabolic Syndrom, MWT Minute walk test, n.a. not applicable, PA Physical activity, PANSS Positive and Negative Syndrome Scale, PMR progressive muscle relaxation, PSP personal and social performance, PWC130 Physical Working Capacity 130, QoL Quality of Life, RCT Randomized controlled trial, RER respiratory exchange ratio, RM Repetition maximum, RPE Rating of perceived exertion, SAS II Social Adjustment Scale-II, SF-36 Short-Form-36, SIMPAQ Simple Physical Activity Questionnaire, SZ schizophrenia, UC usual care, VLMT verbal learning memory test, VLMT verbal learning memory test, VO2_max maximal oxygen uptake, VO2_peak Peak oxygen uptake, WCST Wisconsin Card Sorting Test, W_peak Watt peak, WSCT Wisconsin Card Sorting Test, YT Yoga Training