Outcome assessments used in studies examining the effect of prescribed exercise interventions for people living with severe mental illness, a scoping review

Abstract

Background: Exercise interventions are increasingly incorporated in the management of severe mental illness; however, best practice screening and outcome monitoring for this unique population are yet to be established. This review aims to explore assessment measures reported in publications of exercise interventions in severe mental illness. Methods: A scoping review was implemented with a structured search of Embase, PubMed, Medline, PsychINFO, Scopus, and SportDiscus using terms related to severe mental illness, exercise, and health. Studies were included if they incorporated an exercise intervention for people with severe mental illness and measured physical and/or mental health outcomes. Studies were analysed for population, assessment measures, and methodological quality. Results: 1832 studies were identified and following screening and full text review 38 studies involving 2854 participants were included for analysis, primarily psychotic (n = 13), depressive disorder (n = 9) and mixed severe mental illness populations (n = 13). The most frequently reported health domains and assessment measures used included body composition (weight and body mass index), symptom severity, cardiorespiratory fitness (volume of oxygen consumption), cardiometabolic health (blood pressure and metabolic blood sampling), and quality of life. Methodological quality varied with 13 determined as good, 12 fair, and 13 poor. Conclusion: The review identified domains and assessment tools frequently reported in the exercise and severe mental illness literature. However, given the heterogeneity and scarcity of the research, along with lack of reporting of sufficient detail, best-practice clinical recommendations are still limited. There remains a need to establish best practice assessment and monitoring procedures within exercise interventions in severe mental illness