Improving Muscular Fitness May Benefit People With Bipolar Disorder

Physical activity can increase the risk for hypoglycemia in hospital patients with diabetes.
Physical activity can increase the risk for hypoglycemia in hospital patients with diabetes.
Physical rehabilitation has the potential to improve the performance of daily activities in individuals with bipolar disorder.

Muscular rehabilitation interventions may help people with bipolar disorder improve their ability to perform daily life activities, suggests new research published in the Nordic Journal of Psychiatry. Researchers found that depressive symptoms and muscular fitness independently play a role in daily life functioning in a small group of patients with bipolar disorder.

Davy Vancampfort, PhD, of the University of Leuven in Belgium, and colleagues assessed depressive symptoms, muscular fitness, and walking capacity in 42 patients with bipolar disorder. The patients participated in a standing broad jump test to determine their muscular fitness, as well as a 6 minute walk test. They also underwent full-fasting metabolic screenings, completed physical activity questionnaires, and self-reported their depression symptoms. Among the participants, 38% had metabolic syndrome and 56% smoked.

Dr Vancampfort’s team found that the distance participants walked in 6 minutes strongly correlated with how high they jumped during the broad jump. “Better performance on both physical fitness tests was significantly associated with higher physical activity levels expressed as the sum of weekly minutes per week and the sum of weekly [metabolic equivalent] MET-minutes per week,” the authors wrote. “Older age, a longer illness duration, a higher number of cigarettes smoked, and higher levels of depressive symptoms were significantly associated with a lower performance on both physical fitness tests,” although higher body mass index was only associated with a shorter 6-minute walk distance.

Participants’ age and scores on the Depressive Symptomatology Self Report and physical activity questionnaire explained 83% of the variance in participants’ standing broad jump scores. Meanwhile, 82.3% of the variance in 6-minute walk test performance was explained by depressive symptoms score, having metabolic syndrome, and broad jump scores.

Although individuals with bipolar disorder are advised to get 150 minutes of at least moderate-intensity physical activity every week, only a small proportion actually do for a variety of sociodemographic, medical, and illness-related factors, the authors wrote.

“The present findings indicate that clinicians should consider muscular fitness when considering the daily life functioning of people with bipolar disorder,” wrote Dr Vancampfort and fellow researchers. “Multidisciplinary treatment of people with bipolar [disorder] should target muscular fitness improvements in order to maintain the walking capability,” and the standing broad jump test may be worth adding to routine screening of people with this psychiatric condition, they suggested.

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Vancampfort D, Stubbs B, Sienaert P, et al. Depressive symptoms and muscular fitness contribute independently to the ability to perform daily life activities in people with bipolar disorder. Nord  J Psychiatry. 2016; Apr 6. [Epub ahead of print]