A quasi-experimental matched- control design was used to examine the effects of aerobic dance intervention on the cognitive functions of people with schizophrenia. All participants were volunteers, and after a detailed explanation of the study procedures, written consent forms were obtained from them. The participants had to be between the ages of 20- 60 years old, their diagnosis of schizophrenia had to be made by a psychiatrist, been diagnosed for at least 2 years, stable psychiatric condition, score higher than a 24 on a mini- mental state examination, speak in mandarin or Taiwanese, and be willing to participate in an exercise program. The intervention was led by two senior occupational therapists and was held 3 times a week for 3 months. Each session was a total of 50-60 minutes (5 minute warm up, 40 minutes of aerobic dance, 5 minute break, and a 10 minute cool down). They monitored the participant’s heart rates using a radial pulse measurement before and after the program. The program was choreographed with simple and easy to teach movements that used both upper and lower body. The movements were designed to be similar to movements that the participants would be familiar with such as wiping windows, washing clothes, and swimming. They recorded the attendance and they used an incentive such as a water bottle or towel to give to each participant who did not miss any sessions for that month. A informational meeting was held every month to continue to promote the benefits of regular exercise and motivate the participants to finish the program. The control group took part in coloring and handwriting activities while the intervention group was in their aerobic class. The control group had the same schedule as the intervention group, but the control group did not have monthly meetings.
There were 4 different tests that were conducted to test for improvements the Symbol Digit Modallist test, the Rey Auditory Verbal Learning Test, The Trail making test, and the semantic association of verbal fluency. The symbol digit modalities test asked participants to pair abstract symbols with specific numbers as fast as possible in 90 seconds. The score shows the number of correctly matched symbols in a range from 0 to 110. The higher score indicates a faster processing speed. The rey auditory verbal learning test is a validated instrument that measures memory. In this test the participants were required memorize 15 words and after a 30 minute delay they were asked to recall the words. Then the recognition part of the test consisted of 30 words, 15 of the previous words intermixed with 15 words that are unrelated. The participants were asked if they recognized any of the words they were shown. From this they come up with 4 different scores the immediate recall score, learning effect score, a delayed recall score, and recognition score.The trail making test had 2 parts part a and b. Part a was a sheet of paper with 25 circles numbered 1-25 on it. The participants were asked to draw lines to connect the circles in ascending order. Part B consisted of 13 numbers and 12 Chinese characters placed randomly on a sheet of paper. The participants were then asked to connect the numbers alternating with numbers in ascending order. Part A tested selective attention and part B examined divided attention and the cognitive flexibility of executive function. The score was based of the time it took for the participants to finish the task. The semantic Association of Verbal Fluency test had 3 categories fruit, fish, and vegetables. The participants were asked to write down as many items that they could think of in each category in 1 minute. The results show that the intervention group improved significantly on the Symbol Digit Modalities Test (SDMT), the Rey Auditory Verbal Learning test (RAVLT) immediate recall, learning score, delayed recall and the semantic association of verbal fluency test. Where as the control group had no significant differences for any of the cognitive measurements.
The results showed the positive effects that aerobic dance group exercise has on the cognitive function of people with schizophrenia. The intervention group experienced significant changes in their processing speed, memory and executive functions, compared to the control group who had no significant changes. Due to cognitive impairment being a factor in schizophrenia clients, aerobic dancing could be an effective activity-based treatment that would help improve their cognitive functions.
One of the limitations of this study is the sample size. At the end of the study there was only 17 participants in the intervention group. If there was a larger sample size the results could have been more varied. Another limitation of the study was the informational monthly meeting was only held for the intervention group.
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