Impacto de um programa de exercício físico em pessoas com doença mental grave

Autores

  • Maria Rovira-Font Universitat de Barcelona (UB) (España)
  • Carles Ventura Vall-llovera Grup d’Investigació Social i Educativa en Activitat Física i Esport (GISEAFE) (España)

DOI:

https://doi.org/10.47197/retos.v82.119352

Palavras-chave:

Atividade física, saúde mental, exercício físico, qualidade de vida, sepultura mental trastorno

Resumo

Introdução: níveis insuficientes de atividade física constituem um fator relevante na carga global de morbilidad e afetam de forma significativa a saúde das pessoas com doença mental grave.

Objectivo: o objectivo do estúdio era analisar os efeitos de um programa de exercício físico na melhoria da saúde física e mental das pessoas com doença mental grave atendidas nas áreas dos assistentes.

Metodologia: foi realizado um estúdio multicêntrico com um projeto de um único grupo e com medidas pré e pós-intervenção. A exposição formada por vários participantes foi revelada com um túmulo mental. Foi implementado um programa de exercício físico de 12 semanas com duas sessões semanais. Aplicam-se cinco testes de condição física e três questionários para avaliar as alterações na atividade física, na qualidade de vida e nas alterações emocionais após a intervenção.

Resultados: se observarem melhorias graves na força muscular das extremidades superiores e inferiores, na amplitude de movimento do ombro, no nível de atividade física e na redução dos níveis de ansiedade entre as medidas pré e pós-intervenção.

Discussão: os resultados obtidos são alinhados com as evidências científicas anteriores que indicam que as intervenções baseadas no exercício físico podem gerar melhorias relevantes na saúde física e mental das pessoas com perturbação mental grave.

Conclusões: a realização de um programa de exercício físico constitui uma estratégia viável para melhorar a condição física e contribuir para a redução dos sintomas de ansiedade em pessoas com perturbação mental grave.

Referências

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorder (5th ed.).

Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10(2), 176–181.

Arent, S. M., Walker, A. J., & Arent, M. A. (2020). The effects of exercise on anxiety and depression. En G. Tenenbaum & R. C. Eklund (Eds.), Handbook of sport psychology (4th ed., Vol. 2, pp. 872–890). Wiley.

Arias, D., Saxena, S., & Ephane Verguet, S. (2022). Quantifying the global burden of mental disorders and their economic value. EClinicalMedicine, 54, 101675. https://doi.org/10.1016/j.neubiorev.2024.105641

Bernard, P., Romain, A. J., Vancampfort, D., Baillot, A., Esseul, E., & Ninot, G. (2015). Six minutes walk test for individuals with schizophrenia. Disability and Rehabilitation, 37(11), 921–927. https://doi.org/10.3109/09638288.2014.948136

Brobakken, M. F., Nygård, M., & Wang, E. (2022). Physical Health Impairment and Exercise as Medicine in Severe Mental Disorders: A Narrative Review. Sports Medicine - Open, 8(1), 1–19. https://doi.org/10.1186/s40798-022-00490-3

Bullo, V., Bergamin, M., Gobbo, S., Sieverdes, J. C., Zaccaria, M., Neunhaeuserer, D., & Ermolao, A. (2015). The effects of Pilates exercise training on physical fitness and wellbeing in the elderly: A systematic review for future exercise prescription. Preventive Medicine, 75, 1–11. https://doi.org/10.1016/j.ypmed.2015.03.002

Chan, J. K. N., Correll, C. U., Wong, C. S. M., Chu, R. S. T., Fung, V.S.C., Wong, G. H. S., Lei, J. H. C., & Chang, W. C. (2023). Life expectancy and years of potential life lost in people with mental disorders: a systematic review and meta-analysis. EClinicalMedicine, 65. https://doi.org/10.1016/j.eclinm.2023.102294

Chokphukiao, P., Poncumhak, P., Thaweewannakij, T., Intaruk, R., & Amatachaya, S. (2023). Seated push-up tests: Reliable and valid measures for older individuals when used by primary healthcare providers. Journal of Back and Musculoskeletal Rehabilitation, 36(4), 871–882. https://doi.org/10.3233/BMR-220040

Costa, R., Bastos, T., Probst, M., Seabra, A., Abreu, S., Vilhena, E., Rosenbaum, S., Ward, P. B., & Corredeira, R. (2018). Association of lifestyle-related factors and psychological factors on quality of life in people with schizophrenia. Psychiatry Research, 267(June), 382–393. https://doi.org/10.1016/j.psychres.2018.06.022

Curtis, J., Watkins, A., Rosenbaum, S., Teasdale, S., Kalucy, M., Samaras, K., & Ward, P. B. (2016). Evaluating an individualized lifestyle and life skills intervention to prevent antipsychotic-induced weight gain in first-episode psychosis. Early Intervention in Psychiatry, 10(3), 267–276. https://doi.org/10.1111/eip.12230

Duray, M., & Genç, A. (2017). The relationship between physical fitness and falling risk and fear of falling in community-dwelling elderly people with different physical activity levels. Turkish Journal of Medical Sciences, 47(2), 455–462. https://doi.org/10.3906/sag-1511-101

Edwards, T. B., Bostick, R. D., Greene, C. C., Baratta, R. V., & Drez, D. (2002). Interobserver and intraobserver reliability of the measurement of shoulder internal rotation by vertebral level. Journal of Shoulder and Elbow Surgery, 11(1), 40–42. https://doi.org/10.1067/mse.2002.119853

Fan, Y., Fan, A., Yang, Z., & Fan, D. (2025). Global burden of mental disorders in 204 countries and territories, 1990–2021: results from the global burden of disease study 2021. BMC Psychiatry, 25(1). https://doi.org/10.1186/s12888-025-06932-y

Farholm, A., Sørensen, M., Halvari, H., & Hynnekleiv, T. (2017). Associations between physical activity and motivation, competence, functioning, and apathy in inhabitants with mental illness from a rural municipality: A cross-sectional study. BMC Psychiatry, 17(1), 1–11. https://doi.org/10.1186/s12888-017-1528-3

Fong, S. S. M., Ng, S. S. M., Lee, H. W., Pang, M. Y. C., Luk, W. S., Chung, J. W. Y., Wong, J. Y. H., & Masters, R. S. W. (2015). The effects of a 6-month tai chi qigong training program on temporomandibular, cervical, and shoulder joint mobility and sleep problems in nasopharyngeal cancer survivors. Integrative Cancer Therapies, 14(1), 16–25. https://doi.org/10.1177/1534735414556508

Franco Gallegos, L. I., Aguirre Chávez, J. F., Montes Mata, K. J., & Robles Hernández, G. S. I. (2025). Ejercicio físico y salud mental: una revisión sistemática de sus beneficios en contextos educativos, clínicos y comunitarios. Retos, 71, 220–228. https://doi.org/10.47197/retos.v71.116224

Firth, J., Siddiqi, N., Koyanagi, A., Siskind, D., Rosenbaum, S., Galletly, C., Allan, S., Caneo, C., Carney, R., Carvalho, A. F., Chatterton, M. Lou, Correll, C. U., Curtis, J., Gaughran, F., Heald, A., Hoare, E., Jackson, S. E., Kisely, S., Lovell, K., … Stubbs, B. (2019). The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness. The Lancet Psychiatry, 6(8), 675–712. https://doi.org/10.1016/S2215-0366(19)30132-4

Gagliardi, J., Brettschneider, C., & König, H. H. (2021). Health-related quality of life of refugees: a systematic review of studies using the WHOQOL-Bref instrument in general and clinical refugee populations in the community setting. Conflict and Health, 15(1), 1–14. https://doi.org/10.1186/s13031-021-00378-1

GBD 2019 Mental Disorders Collaborators (2022). Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. (2022). The Lancet Psychiatry, 9(2), 137–150. https://doi.org/10.1016/S2215-0366(21)00395-3

Gianfredi, V., Blandi, L., Cacitti, S., Minelli, M., Signorelli, C., Amerio, A., & Odone, A. (2020). Depression and objectively measured physical activity: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 17(10). https://doi.org/10.3390/ijerph17103738

Graham, A., & Reid, G. (2000). Physical fitness of adults with an intellectual disability: A 13-year follow-up study. Research Quarterly for Exercise and Sport, 71(2), 152–161. https://doi.org/10.1080/02701367.2000.10608893

Gray, M., Glenn, J. M., & Binns, A. (2016). Predicting sarcopenia from functional measures among community-dwelling older adults. BMC Sports Science, Medicine and Rehabilitation, 9(1), 1-6. https://doi.org/10.1007/s11357-016-9887-0

Kandola, A. A., & Osborn, D. P. J. (2022). Physical activity as an intervention in severe mental illness. BJPsych Advances, 28(2), 112–121. https://doi.org/10.1192/bja.2021.33

Khedr, M., El-Gueneidy, M., Shehata, A., & Elkot, M. (2020). Effect of Physical Exercise Program on Psychotic Symptoms and Social Functioning of Patients with Schizophrenia. Alexandria Scientific Nursing Journal, 22(1), 67–80. https://doi.org/10.21608/asalexu.2020.206107

Khedr, M. A., El-Ashry, A. M., El-Sayed, M. M., Elkot, M. A., & Hussein, R. M. (2024). The effect of physical exercises program on social functioning, alexithymia, and sense of coherence among patients with bipolar disorders: A randomized control trial. Archives of Psychiatric Nursing, 49(July 2023), 83–92. https://doi.org/10.1016/j.apnu.2024.02.002

Lopez-moral, A., Munguia-izquierdo, D., & Bueno-antequera, J. (2025). Assessing a clinical vital sign in severe mental illness : validation study of the 5 sit-to-stand test for monitoring muscle strength – The PsychiActive Project. BJPsych Open, 11, e24. https://doi.org/10.1192/bjo.2024.842

Lucas-Carrasco, R. (2012). The WHO quality of life (WHOQOL) questionnaire: Spanish development and validation studies. Quality of Life Research, 21(1), 161–165. https://doi.org/10.1007/s11136-011-9926-3

Mantilla Toloza, S. C., & Gómez-Conesa, A. (2007). El Cuestionario Internacional de Actividad Física. Un instrumento adecuado en el seguimiento de la actividad física poblacional. Revista Iberoamericana de Fisioterapia y Kinesiologia, 10(1), 48–52. https://doi.org/10.1016/S1138-6045(07)73665-1

Marx, W., Manger, S. H., Blencowe, M., Murray, G., Ho, F. Y. Y., Lawn, S., Blumenthal, J. A., Schuch, F., Stubbs, B., Ruusunen, A., Desyibelew, H. D., Dinan, T. G., Jacka, F., Ravindran, A., Berk, M., & O’Neil, A. (2023). Clinical guidelines for the use of lifestyle-based mental health care in major depressive disorder: World Federation of Societies for Biological Psychiatry (WFSBP) and Australasian Society of Lifestyle Medicine (ASLM) taskforce. World Journal of Biological Psychiatry, 24(5), 333–386. https://doi.org/10.1080/15622975.2022.2112074

Maurus, I., Wagner, S., Spaeth, J., Vogel, A., Muenz, S., Seitz, V., von Philipsborn, P., Solmi, M., Firth, J., Stubbs, B., Vancampfort, D., Hallgren, M., Kurimay, T., Gerber, M., Correll, C. U., Gaebel, W., Möller, H.-J., Schmitt, A., Hasan, A., & Falkai, P. (2024). EPA guidance on lifestyle interventions for adults with severe mental illness: A meta-review of the evidence. European Psychiatry, 67(1). https://doi.org/10.1192/j.eurpsy.2024.1766

Midtgaard, J., Schnor, H., Bjerre, E. D., Jespersen, T., Jelsøe, N., Frølund, N., Seier, S., Rønbøg, J. W., Nordsborg, N. B., & Ebdrup, B. H. (2021). Exercise training complementary to specialised early intervention in patients with first-episode psychosis: a feasibility randomised trial. Pilot and Feasibility Studies, 7(1), 1–11. https://doi.org/10.1186/s40814-021-00900-5

Mikkelsen, K., Stojanovska, L., Polenakovic, M., Bosevski, M., & Apostolopoulos, V. (2017). Exercise and mental health. Maturitas, 106(September), 48–56. https://doi.org/10.1016/j.maturitas.2017.09.003

Newcomer, K. L., Krug, H. E., & Mahowald, M. L. (1993). Validity and reliability of the timed-stands test for patients with rheumatoid arthritis and other chronic diseases. The Journal of Rheumatology, 20(1), 21–27.

Noetel, M., Sanders, T., Gallardo-Gómez, D., Taylor, P., del Pozo Cruz, B., van den Hoek, D., Smith, J. J., Mahoney, J., Spathis, J., Moresi, M., Pagano, R., Pagano, L., Vasconcellos, R., Arnott, H., Varley, B., Parker, P., Biddle, S., & Lonsdale, C. (2024). Effect of exercise for depression: Systematic review and network meta-analysis of randomised controlled trials. BMJ, 384, e075847. https://doi.org/10.1136/bmj-2023-075847

Oderda, L. H., Young, J. R., Asche, C. V., & Pepper, G. A. (2012). Fracturas de cadera relacionadas con agentes psicotrópicos: Un metaanálisis de fármacos antidepresores y antipsicóticos de primera generación y de segunda generación. Annals of Pharmacotherapy, 46(7–8), 917–928. https://doi.org/10.1345/aph.1Q589

Oliveira Tavares, V. D., Vancampfort, D., Hallgren, M., Heissel, A., Chaparro, C. G. A. P., Solmi, M., Tempest, G. D., de Oliveira Neto, L., Galvão-Coelho, N. L., Firth, J., & Schuch, F. B. (2021). Reliability and validity of physical fitness tests in people with mental disorders: A systematic review and meta-analysis. Physiotherapy Research International, 26(3), 1–9. https://doi.org/10.1002/pri.1904

Organizacion Mundial de la Salud. (2019). Motion for your mind. World Health Organization, 1–10.

Organizacion Mundial de la Salud. (2020). Directrices de la OMS sobre actividad física y hábitos sedentarios. Journal of Chemical Information and Modeling, 1(9), 1–17.

Organización Mundial de la Salud. (2022a). Informe mundial sobre la salud mental: Transformar la salud mental para todos. In Informe mundial sobre la salud mental: Transformar la salud mental para todos. https://doi.org/10.37774/9789275327715

Organización Mundial de la Salud. (2022b, junio 8). Trastornos mentales: datos y cifras. https://www.who.int/es/news-room/fact-sheets/detail/mental-disorders

Organización Mundial de la Salud. (2024). Physical Activity. https://www.who.int/news-room/fact-sheets/detail/physical-activity

Perez-Cruzado, D., Cuesta-Vargas, A. I., Vera-Garcia, E., & Mayoral-Cleries, F. (2017). Physical fitness and levels of physical activity in people with severe mental illness: A cross-sectional study. BMC Sports Science, Medicine and Rehabilitation, 9(1), 1–6. https://doi.org/10.1186/s13102-017-0082-0

Poncumhak, P., Wiyanad, A., Siriyakul, C., Kosura, N., Amatachaya, P., & Amatachaya, S. (2023). Validity and feasibility of a seated push-up test to indicate skeletal muscle mass in well-functioning older adults. Physiotherapy Theory and Practice, 39(3), 623–630. https://doi.org/10.1080/09593985.2021.2023931

Rebar, A. L., Stanton, R., Geard, D., Short, C., Duncan, M. J., & Vandelanotte, C. (2015). A meta-meta-analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations. Health Psychology Review, 9(3), 366–378. https://doi.org/10.1080/17437199.2015.1022901

Rehm, J., & Shield, K. D. (2019). Global Burden of Disease and the Impact of Mental and Addictive Disorders. In Current Psychiatry Reports (Vol. 21, Number 2). Current Medicine Group LLC 1. https://doi.org/10.1007/s11920-019-0997-0

Rosenbaum, S., Morell, R., Abdel-Baki, A., Ahmadpanah, M., Anilkumar, T. V., Baie, L., Bauman, A., Bender, S., Boyan Han, J., Brand, S., Bratland-Sanda, S., Bueno-Antequera, J., Camaz Deslandes, A., Carneiro, L., Carraro, A., Castañeda, C. P., Castro Monteiro, F., Chapman, J., Chau, J. Y., … Ward, P. B. (2020). Assessing physical activity in people with mental illness: 23-country reliability and validity of the simple physical activity questionnaire (SIMPAQ). BMC Psychiatry, 20(1), 1–12. https://doi.org/10.1186/s12888-020-2473-0

Ruiz, F., Martín, M. B. G., Falcón, J. C. S., & González, P. O. (2017). The Hierarchical Factor Structure of the Spanish Version of Depression Anxiety and Stress Scale -21. Journal Of Energy, 1(3), 427–446.

Sampogna, G., Borgi, M., Collacchi, B., Cirulli, F., Cerino, S., Rullo, S., Di Vincenzo, M., Luciano, M., Di Tommaso, V., Moliterni, S., Bichi, A., Garside, J., Kivistö, S., Iarion, A., & Fiorillo, A. (2022). Using sport-based interventions for people with severe mental disorders: results from the European EASMH study. International Review of Psychiatry, 0(0), 1–11. https://doi.org/10.1080/09540261.2022.2106122

Sampogna, G., Luciano, M., Di Vincenzo, M., Andriola, I., D’ambrosio, E., Amore, M., Serafini, G., Rossi, A., Carmassi, C., Dell’osso, L., Di Lorenzo, G., Siracusano, A., Rossi, R., Fiorillo, A., Giallonardo, V., Del Vecchio, V., Di Cerbo, A., Brandi, C., Marone, L., … Niolu, C. (2022). The Complex Interplay Between Physical Activity and Recovery Styles in Patients With Severe Mental Disorders in a Real-World Multicentric Study. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.945650

Sentissi, O., Zosso, G., Cogordon, A., & Chillà, C. (2023). The effects of a group-based intervention through physical activities and dietary changes in young patients with severe psychiatric disorders: a pilot study. Frontiers in Sport and Active Living, 5, 1–12. https://doi.org/10.3389/fspor.2023.1197925

Shirai, T., Ijiri, T., & Suzuki, T. (2022). Relationship between hand-behind-back motion and internal rotation with the shoulder in extension. Journal of Physical Therapy Science, 34(11), 732–736. https://doi.org/10.1589/jpts.34.732

Singh, B., Olds, T., Curtis, R., Dumuid, D., Virgara, R., Watson, A., Szeto, K., O’Connor, E., Ferguson, T., Eglitis, E., Miatke, A., Simpson, C. E. M., & Maher, C. (2023). Effectiveness of physical activity interventions for improving depression, anxiety and distress: An overview of systematic reviews. British Journal of Sports Medicine, 1203–1209. https://doi.org/10.1136/bjsports-2022-106195

Smith, P. J. & Merwin, R.M (2021). The Role of Exercise in Management of Mental Health Disorders: An Integrative Review. Physiology & Behavior, 176(1), 100–106. https://doi.org/doi:10.1146/annurev-med-060619-022943

Springer, B. A., Marin, R., Cyhan, T., Roberts, H., & Gill, N. W. (2007). Normative values for the unipedal stance test with eyes open and closed. Journal of Geriatric Physical Therapy, 30(1), 8–15. https://doi.org/10.1519/00139143-200704000-00003

Stanton, R. (2018). Integration of the Exercise Professional Within the Mental Health Multidisciplinary Team. En Exercise-Based Interventions for Mental Illness (pp 243-263). Elsevier. https://doi.org/10.1016/B978-0-12-812605-9.00013-7

Stubbs, B., Vancampfort, D., Rosenbaum, S., Firth, J., Cosco, T., Veronese, N., Salum, G. A., & Schuch, F. B. (2017). An examination of the anxiolytic effects of exercise for people with anxiety and stress-related disorders: A meta-analysis. Psychiatry Research, 249(November 2016), 102–108. https://doi.org/10.1016/j.psychres.2016.12.020

The Lancet Psychiatry. (2024). Global burden of disease 2021: Mental health messages. The Lancet Psychiatry, 11(8), 573. https://doi.org/10.1016/S2215-0366(24)00222-0

Vancampfort, D., Correll, C. U., Galling, B., Probst, M., De Hert, M., Ward, P. B., Rosenbaum, S., Gaughran, F., Lally, J., & Stubbs, B. (2016). Diabetes mellitus in people with schizophrenia, bipolar disorder and major depressive disorder: A systematic review and large scale meta-analysis. World Psychiatry, 15(2), 166–174. https://doi.org/10.1002/wps.20309

Vancampfort, D., Rosenbaum, S., Schuch, F., Ward, P. B., Richards, J., Mugisha, J., Probst, M., & Stubbs, B. (2017). Cardiorespiratory Fitness in Severe Mental Illness: A Systematic Review and Meta-analysis. Sports Medicine, 47(2), 343–352. https://doi.org/10.1007/s40279-016-0574-1

Vancampfort, D., Firth, J., Stubbs, B., Schuch, F., Rosenbaum, S., Deenik, J., Ward, P. B., Mugisha, J., Damme, T. Van, & Werneck, A. O. (2025). The efficacy, mechanisms and implementation of physical activity as an adjunctive treatment in mental disorders: a meta-review of outcomes, neurobiology and key determinants. In World Psychiatry, 24.

Vigo, D. V., Stein, D. J., Harris, M. G., Kazdin, A. E., Viana, M. C., Munthali, R., Munro, L., Hwang, I., Kessler, T. L., Manoukian, S. M., Sampson, N. A., & Kessler, R. C. (2025). Effective Treatment for Mental and Substance Use Disorders in 21 Countries. JAMA Psychiatry, 82(4), 347–357. https://doi.org/10.1001/jamapsychiatry.2024.4378

Wheeler, A. J., Roennfeldt, H., Slattery, M., Krinks, R., & Stewart, V. (2018). Codesigned recommendations for increasing engagement in structured physical activity for people with serious mental health problems in Australia. Health and Social Care in the Community, 26(6), 860–870. https://doi.org/10.1111/hsc.12597

Publicado

29-05-2026

Edição

Secção

Artigos de caráter científico: trabalhos de pesquisas básicas e/ou aplicadas.

Como Citar

Rovira-Font, M., & Ventura Vall-llovera, C. (2026). Impacto de um programa de exercício físico em pessoas com doença mental grave. Retos, 82, 822-834. https://doi.org/10.47197/retos.v82.119352