Therapeutic impact of exercise on psychiatric diseases - Guidelines for exercise testing and prescription

Aerobic exercise seems to be effective in improving general mood and sympto ms of depression and anxiety in healthy individuals and psychiatric patient s. This effect is not limited to aerobic forms of exercise. There are almos t no contraindications for psychiatric patients to participate in exercise programmes, provided they are free from cardiovascular and acute infectious diseases. However, very little is known about the effects of exercise in p sychiatric disease other than those in depression and anxiety disorders. A few reports indicate the need for controlled investigations in psychotic an d personality disorders. Unfortunately, no general concept for a therapeutic application of physical activity has been developed so far. Reliance on submaximal measures is hig hly recommended for fitness assessment. Monitoring of exercise intensity du ring training sessions is most easily clone by measuring the heart rate usi ng portable devices (whereas controlling the exact workload may be preferab le for scientific purposes). Appropriate pre- and, post-training testing is emphasised to enable adequate determinations of fitness gains and to event ually allow positive feedback to be given to patients in clinical settings.