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The rising prevalence of physical comorbidities among patients with mental illness has increased the relevance of physical rehabilitation within psychiatric care. However, specific physical rehabilitation practices in specialized psychiatric hospitals in Japan remain insufficiently documented. This exploratory and descriptive study aimed to characterize the rehabilitation content provided and to categorize patient characteristics and comorbidities in a single specialized psychiatric hospital using an expert-led consensus approach. Clinical data from 150 patients (median age 71.0 years) who received physical rehabilitation were retrospectively analyzed. Patient categorization was conducted through a multidisciplinary consensus-building process involving an expert panel of physical therapists, occupational therapists, psychiatrists, and nurses, each with over 10 years of clinical experience. Using a hierarchical rule set based on International Classification of Diseases, 10th Revision (ICD-10) codes and clinical referral data, five distinct categories were identified: Disuse Syndrome (41%), Neurologic Disorders (20%), Lower Limb Lesions (18%), Parkinson’s Syndrome (15%), and Upper Limb Lesions (6%). Across all categories, rehabilitation interventions focused on foundational motor therapies, such as range of motion (27%) and strength training (23%). Mobility-oriented interventions were selectively provided to patients with high bedridden status based on clinical potential. Overall, practices in this setting primarily targeted disuse syndrome and maintenance of basic motor function and were delivered with input from multiple professional disciplines; such practices may inform future research on structured multidisciplinary rehabilitative approaches, especially for aging psychiatric populations.

Even today, patients with schizophrenia often have an unfavorable outcome. Negative symptoms and cognitive deficits are common features in many patients and prevent recovery. In recent years, aerobic endurance training has emerged as a therapeutic approach with positive effects on several domains of patients’ health. However, appropriately sized, multicenter randomized controlled trials that would allow better generalization of results are lacking. The exercise study presented here is a multicenter, rater-blind, two-armed, parallel-group randomized clinical trial in patients with clinically stable schizophrenia being conducted at five German tertiary hospitals. The intervention group performs aerobic endurance training on bicycle ergometers three times per week for 40–50 min/session (depending on the intervention week) for a total of 26 weeks, and the control group performs balance and tone training for the same amount of time. Participants are subsequently followed up for 26 weeks. The primary endpoint is all-cause discontinuation; secondary endpoints include psychopathology, cognition, daily functioning, cardiovascular risk factors, and explorative biological measures regarding the underlying mechanisms of exercise. A total of 180 patients will be randomized. With currently 162 randomized participants, our study is the largest trial to date to investigate endurance training in patients with schizophrenia. We hypothesize that aerobic endurance training has beneficial effects on patients’ mental and physical health, leading to lower treatment discontinuation rates and improving disease outcomes. The study results will provide a basis for recommending exercise interventions as an add-on therapy in patients with schizophrenia.The study is registered in the International Clinical Trials Database (ClinicalTrials.gov identifier [NCT number]: NCT03466112) and in the German Clinical Trials Register (DRKS-ID: DRKS00009804).

Abstract Background and Hypothesis People with psychotic disorders have limited strategies to manage acute psychological distress and emotions. Exercise has physical and mental health benefits but immediate psychological effects in this population remain underexplored. This study compared immediate psychological responses to resistance training (RT) and aerobic exercise among individuals with psychotic disorders in psychiatric rehabilitation and examined whether clinical characteristics were associated with these responses. Study Design Fifty-three participants were randomized to RT or aerobic exercise. Immediate psychological responses—psychological distress, positive wellbeing, and fatigue—were assessed using the Subjective Exercise Experiences Scale at 2 timepoints within an 8-week trial (week 3: n = 52; week 8: n = 48), pre- and 10 min post-exercise. Baseline assessments included clinical and motivational variables. Primary analyses used linear mixed models for repeated measures. Study Results Both exercise types led to large increases in positive wellbeing (RT: Hedges’ g = 1.24; aerobic: g = 1.31) and reductions in psychological distress (RT: g = –0.91; aerobic: g = –1.05). A significant group-by-time interaction was observed for fatigue, which increased in RT (g = 0.43) and decreased in aerobic (g = –0.58). Higher fatigue was associated with greater controlled motivation (β = 1.72) and depressed mood (β = 0.80) at baseline. Conclusions RT and aerobic exercise improved positive wellbeing and reduced psychological distress whereas fatigue differed by exercise type. Findings suggest exercise may be a promising intervention for modulating immediate psychological responses in people with psychotic disorders in psychiatric rehabilitation.

The integration of artificial intelligence (AI) technologies into physical and mental rehabilitation has the potential to significantly transform these fields. AI innovations, including machine learning algorithms, natural language processing, and computer vision, offer occupational therapists advanced tools to improve care quality. These technologies facilitate more precise assessments, the development of tailored intervention plans, more efficient treatment delivery, and enhanced outcome evaluation. This review explores the integration of AI across various aspects of rehabilitation, providing a thorough examination of recent advancements and current applications. It highlights how AI applications, such as natural language processing, computer vision, virtual reality, machine learning, and robotics, are shaping the future of physical and mental recovery in occupational therapy.

AbstractObjectiveTo evaluate whether a structured online supervised group physical and mental health rehabilitation programme can improve health related quality of life compared with usual care in adults with post-covid-19 condition (long covid).DesignPragmatic, multicentre, parallel group, superiority randomised controlled trial.SettingEngland and Wales, with home based interventions delivered remotely online from a single trial hub.Participants585 adults (26-86 years) discharged from NHS hospitals at least three months previously after covid-19 and with ongoing physical and/or mental health sequelae (post-covid-19 condition), randomised (1:1.03) to receive the Rehabilitation Exercise and psycholoGical support After covid-19 InfectioN (REGAIN) intervention (n=298) or usual care (n=287).InterventionsBest practice usual care was a single online session of advice and support with a trained practitioner. The REGAIN intervention was delivered online over eight weeks and consisted of weekly home based, live, supervised, group exercise and psychological support sessions.Main outcome measuresThe primary outcome was health related quality of life using the patient reported outcomes measurement information system (PROMIS) preference (PROPr) score at three months. Secondary outcomes, measured at three, six, and 12 months, included PROMIS subscores (depression, fatigue, sleep disturbance, pain interference, physical function, social roles/activities, and cognitive function), severity of post-traumatic stress disorder, general health, and adverse events.ResultsBetween January 2021 and July 2022, 39 697 people were invited to take part in the study and 725 were contacted and eligible. 585 participants were randomised. Mean age was 56 (standard deviation (SD) 12) years, 52% were female participants, mean health related quality of life PROMIS-PROPr score was 0.20 (SD 0.17), and mean time from hospital discharge was 323 (SD 144) days. Compared with usual care, the REGAIN intervention led to improvements in health related quality of life (adjusted mean difference in PROPr score 0.03 (95% confidence interval 0.01 to 0.05), P=0.02) at three months, driven predominantly by greater improvements in the PROMIS subscores for depression (1.39 (0.06 to 2.71), P=0.04), fatigue (2.50 (1.19 to 3.81), P<0.001), and pain interference (1.80 (0.50 to 3.11), P=0.01). Effects were sustained at 12 months (0.03 (0.01 to 0.06), P=0.02). Of 21 serious adverse events, only one was possibly related to the REGAIN intervention. In the intervention group, 141 (47%) participants fully adhered to the programme, 117 (39%) partially adhered, and 40 (13%) did not receive the intervention.ConclusionsIn adults with post-covid-19 condition, at least three months after hospital discharge for covid-19, an online, home based, supervised, group physical and mental health rehabilitation programme was clinically effective at improving health related quality of life at three and 12 months compared with usual care.Trial registrationISRCTN registry ISRCTN11466448.

Objective Drug-dependent individuals often face severe physical and mental health impairments, necessitating safe and adaptable rehabilitation strategies. This study aims to investigate the effects of Pilates exercise on the physical and mental health of drug-dependent individuals. Specifically, the study seeks to evaluate changes in body composition, physical fitness, blood biochemistry, and psychological outcomes following a structured Pilates intervention. Methods This study was conducted as a double-blind, parallel-group, randomized controlled trial. A total of 43 substance-dependent individuals were recruited from the Judong Drug Rehabilitation Center and randomly assigned to either the Pilates intervention group ( n  = 22) or the control group ( n  = 21). The experimental group underwent Pilates program of two weekly sessions for 24 weeks, while the control group received conventional rehabilitation. We assessed physical and mental health indicators at baseline, 12, and 24 weeks. Repeated measures analysis of variance was employed to discern inter-group differences, and Spearman correlation analysis was applied to assess the relationship between fluctuations in scores on anxiety and depression scales and those of associated physiological metrics. Results After 24 weeks of Pilates intervention, the intervention group showed significant improvements ( p  < 0.05) in body fat percentage, skeletal muscle mass, sit-and-reach distance, push-up performance, one-leg standing with eyes closed, vital capacity, white blood cell count, and neutrophil count. Psychological assessments revealed significant differences in scores on the Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) between the experimental and control groups ( p  < 0.01), with more pronounced effects in the experimental group. Additionally, changes in SDS scores were correlated with changes in sit-and-reach distance ( r  = -0.657, p  < 0.001), one-leg standing with eyes closed ( r  = -0.734, p  < 0.001), and vital capacity ( r  = -0.490, p  = 0.001). Changes in SAS scores were correlated with changes in the neutrophil-to-lymphocyte ratio ( r  = -0.304, p  = 0.048), platelet-to-lymphocyte ratio ( r  = -0.320, p  = 0.037), sit-and-reach distance ( r  = -0.595, p  < 0.001), one-leg standing with eyes closed ( r  = -0.704, p  < 0.001), and vital capacity ( r  = -0.472, p  = 0.001). Conclusion The Pilates intervention significantly enhanced participants’ physical attributes—body composition, strength, endurance, flexibility, balance, lung function, and immune response—while alleviating anxiety and depression. Correlations were identified between mental health improvements and physical gains, indicating that tailored exercise, informed by ongoing health monitoring, could optimize drug rehabilitation outcomes. Clinical trial registration ChiCTR-IPR-2400087067, Registered on: 18/7/2024.

Background Following the COVID-19 pandemic, millions of people continue to experience ongoing physical and mental health sequelae after recovery from acute infection. There is currently no specific treatment for the diverse symptoms associated with post-COVID-19 condition. Physical and mental health rehabilitation may help improve quality of life in such patients. This study reports the cost-effectiveness of a programme of physical and mental health rehabilitation compared to best practice usual care in people with post-COVID-19 condition who were previously hospitalised. Methods We conducted an economic evaluation within a randomised controlled trial from the perspective of the UK national health service (NHS) and personnel social services perspective (PSS). Resource used and health-related quality of life were collected using bespoke questionnaire and the EQ-5D-5 L questionnaire at three, six, and 12 months. Incremental costs and quality adjusted life years accrued over the follow-up period were estimated and reported as the incremental cost-effectiveness ratio. Estimate uncertainty was managed by multiple imputation and bootstrapping cost-effectiveness estimates; and displayed graphically on the cost-effectiveness plane. Results Over a 12-month time horizon, incremental costs and QALYs were £305 (95% CI: -123 to 732) and 0.026 (95% CI: -0.005 to 0.052) respectively. The ICER was £11,941 per QALY indicating cost-effective care. Sensitivity analyses supported the base case findings. The probability of the intervention being cost-effective at a £30,000 per QALY willingness-to-pay threshold was 84%. Conclusion The within-trial economic evaluation suggested that people with post-COVID-19 condition after hospitalisation should be offered a programme of physical and mental health rehabilitation as it likely reflects a cost-effective use of NHS resources. Hospitalisation for COVID-19 has become less commonplace: further evaluation in non-hospitalised patients may be worthwhile. Trial registration ISRCTN registry ISRCTN11466448 23rd November 2020.

Objectives: To study the effects of physical stimulation based on walking exercises, equilibrium and endurance on cognitive function and walking efficiency in patients with dementia. Methods: Randomized controlled trial including 31 subjects suffering from dementia (age: 81.8 ± 5.3 years). The intervention group (n = 16) benefited from a 15-week physical activity programme involving three 1-hour sessions per week. The control group (n = 15) did not practice any physical activities. Before and after rehabilitation, all subjects were evaluated with the Rapid Evaluation of Cognitive Functions test (ERFC French version) and walking analysis. Results: After the 15 weeks of rehabilitation, the subjects from the intervention group improved their overall ERFC score (p < 0.01), while those in the control group decreased their overall ERFC score. Interactions were also observed between walking parameters and groups (p < 0.01); the intervention group improved walking capacities through heightened walking speed, stride length and a reduction in double limb support time. Lastly, the subjects from the control group presented a reduction in both walking speed and stride length. Conclusion: This study shows that a physical activity programme can slow cognitive decline and improve quality of walking in elderly persons suffering from dementia.

Background Chronic low back pain (LBP) is a leading cause of disability worldwide. Biopsychosocial rehabilitation programs have been advocated for its management, especially since the widespread acceptance of the biopsychosocial model of chronic pain. Despite extensive evidence of its short-term benefits, few studies have reported on its long-term effect and more specifically on indirect outcomes such as return to work and quality of life (QoL). The present study evaluated the long-term effect of a multidisciplinary biopsychosocial rehabilitation (MBR) program for patients with chronic LBP, for which short- and intermediate-term efficacy had been established, with an emphasis on recovering work capability. Methods This prospective cohort study enrolled 201 patients on a four-week MBR program incorporating physical and occupational therapies and psychological counselling. Assessments occurred at program admission and discharge and at 6 and 18 months. Work capability, Oswestry Disability Index, Tampa Scale for Kinesiophobia, Core Outcome Measures Index (COMI), and Hospital Anxiety and Depression Scale were assessed. Multiple mixed models were used to detect changes in each outcome. Logistic regressions were calculated to identify predictors of recovery of work capability. Results Of the 201 patients who fulfilled the eligibility criteria, 160 (79.8%) attended the discharge assessment, 127 (63.2%) attended the 6-month follow-up, and 107 (53.3%) continued to the 18-month follow-up. Initially, 128 patients (71.5%) had been on sick leave. At 6 and 18 months, 72 (56.7%) and 84 (78.5%) participants had recovered their work capability, respectively. There were significant improvements in pain, disability, kinesiophobia, and anxiety and depression scores over time. Patients who recovered work capability showed significantly greater improvements in their total COMI score, general QoL, and disability, which were the best three predictors of recovering work capability. Conclusions This study extends previous results confirming the program’s contribution to recovering work capability among chronic LBP patients.

Individuals with schizophrenia display substantial deficits in social functioning (SF), characterized by chronic, lifelong presentations. Yet, at present there are few effective interventions to enhance SF in this population. Emerging evidence from studies of clinical populations that display similar SF deficits suggests that aerobic exercise (AE) may improve social skills. However, this putative impact has not been investigated in schizophrenia. Employing a single-blind, randomized clinical trial design, 33 individuals with schizophrenia were randomized to receive 12 weeks of Treatment-As-Usual (TAU; n = 17) or TAU + AE (n = 16) utilizing active-play video games (Xbox 360 Kinect) and traditional AE equipment. Participants completed an evaluation of aerobic fitness (VO2max) as well as self-, informant-, and clinician-reported SF measures at baseline and after 12 weeks. Twenty-six participants completed the study (79%; TAU = 13; AE = 13). At follow-up, the AE participants improved their VO2max by 18.0% versus − 0.5% in the controls (group x time interaction, F1,24 = 12.88; p = .002). Hierarchical stepwise regression analyses indicated 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 (controlling for baseline demographics, medications, mood symptoms, and social networks). Compared to the TAU group, AE participants reported significant improvement in SF (23.0% vs. − 4.2%; group × time interaction, F1,24 = 7.48, p = .012). The results indicate that VO2max enhancement leads to improvements in SF in people with schizophrenia. Furthermore, low VO2max represents a modifiable risk factor of SF in people with schizophrenia, for which AE training offers a safe, non-stigmatizing, and nearly side-effect-free intervention.