Electronic Supplementary Material Table S1.Cardiorespiratory fitnessdata in people with severe mental illness (23 studies containing 30 study estimates)

Study / Design / Participants / Baseline cardiorespiratory fitness (VO2) / Intervention characteristics / Exercise outcomes
Knubben et al. [28] / RCT / 38 (17♂) inpatients with MDDand bipolar disorder (DSM-IV); 49±13years / VO2max= 27.9±10.3 mlO2/kg/min / Individualized daily walking on a treadmill for 10 days, 3*5min corresponding to a lactateconcentration of 3±0.5 mmol/l in capillary blood 80% HRmax, in between 3 min at half of the speed by instructed study personnel / VO2 max remained unchanged, 28.1±10.1 mlO2/kg/min post-intervention (p=0.99)
Krogh et al. [29] / RCT / 165 (43♂) outpatients with MDD(DSM-IV); 38.9±9.5years; BMI=26.5±5.4 / VO2max= 27.9±7.1 mlO2/kg/min for the entire group / Either strength or aerobic training, 2/week, 16 weeks versus relaxation training, supervised by a physiotherapist / In strength and aerobic training reduction in VO2max from 27.1±6.6 mlO2/kg/min to 29.2±7.4 mlO2/kg/minand from 26.0±6.3 mlO2/kg/min to 28.9±6.6 mlO2/kg/min, respectively versus from 28.8±7.7 mlO2/kg/min to 30.5±6.8after relaxation
Pajonk et al. [30]a / RCT / 8♂ outpatients with schizophrenia(DSM-IV); 32.9±10.6 years / VO2max= 28.0±7.0 mlO2/kg/min / 12 weeks, 3/week,
30 min individualized cycling a heart rate (±10beats/min) corresponding to a
blood lactate concentration of 1.5
to 2 mmol/L versus 12 weeks,
3/week, 30 min table top football
supervised by a research assistant. / In the exercise group VO2max to 26.7±10.8 mlO2/kg/min and BMI from 28.0± 5.9 to 27.6± 6.5versus from 23.9±3.7mlO2/kg/min to 23.9±3.7 mlO2/kg/min 23.3±2.9 after table top football
Heggelundet al. [31] / NRCCT / 17 (13♂) inpatients with schizophrenia, 1 delusional disorder, 1schizo-affective disorder (ICD-10); 33.6±10.3years / VO2peak=36.0±7.4 and 38.3±9.8mlO2/kg/min in the experimental (n=12) and control group (n=7) respectively / 8-week HIT 3/week: 4*4-min walking or running with min 5% inclination on a treadmill at 85-95% HR peak at a work load corresponding to 70% HR peak between each interval versus computer game (Tetris) by an exercise physiologist / 12% increase in VO2 peak in HIT-group (to 40.2 ±6.6 mlO2/min/kg, P<0.001) and BMI from 28.8±4.7 to 28.5±4.5 versus no change in control group
Strassniget al. [32] / Cross-sectional / 117 (71♂) obese community patients with schizophrenia (DSM-IV); 45.1±11.1years; BMI=37.2±7.3 / VO2max= 26.5±5.4 mlO2/kg/min; which is 42±11% of the on age- and gender norms predicted V02max / / / /

Electronic Supplementary Material Table S1.Continued

Study / Design / Participants / Baseline cardiorespiratory fitness (VO2) / Intervention characteristics / Exercise outcomes
Krogh et al. [33] / RCT / 117 (40♂) outpatients with MDD(DSM-IV) / VO2max in exercisers= 25.9±6.9 mlO2/kg/min versus 26.0±11.7 mlO2/kg/min in the stretching group / Either strength or aerobic training, 3/week 12 weeks, supervised by a physiotherapist / Only improvements after aerobic exercise: to 29.3±7.7 mlO2/kg/min versus 24.9±7.6 mlO2/kg/min in the stretching group; BMI from 26.2±6.2 to 26.1±4.9 in the exercise group
Nilsson et al. [34] / Cross-sectional / 10♂ in- and outpatients with schizophrenia (DSM-IV) (34.7±7.9years; BMI=28.5±6.3) versus 10 matched healthy controls / VO2max predicted= 26.4±7.7mlO2/min/kg versus 45.8±16.0mlO2/min/kg in the healthy controls (P=0.0029) / / / /
Scheeweet al. [35] / RCT / 63 (46♂) outpatients with schizophrenia spectrum (DSM-IV) (29.6±7.4years; BMI=26.3±6.0) and 55 matched sedentary controls / VO2peak= 32.6±8.9mlO2/min/kg / 6 months, 2/week, 1h cardiorespiratory (week 1-3: 45%, week 4-12:65%, week 13-26:75% HRR) and muscle exercises (6 exercises weekly; 3*10-15 repetitions maximum for biceps, triceps, abdominal, quadriceps, pectoral, deltoid muscles) by a psychomotor therapist versus occupation therapy (creative and recreational activities) / Deterioration in VO2 peak only in controls (from 33.3 ±12.3 to 31.1 ±9.3 mlO2/min/kg) and not in exercisers (to 32.9 ±9.7 mlO2/min/kg); BMI from 27.2±7.5 to 26.7±6.2 in the exercise group
Strassnig et al. [36] / PE / 6(4♂) outpatients with schizophrenia spectrum (DSM-IV) (36.8±10.4years; BMI=35.1±3.8) / VO2max predicted= 26.5±5.4 mlO2/min/kg / 6 weeks, 3/week, 30min at a treadmill; target training heart rate was set at 65% of maximum (220-age) / 16% increase in VO2 max predicted (to 31.0±4.4 mlO2/kg/min; Z=−2.1, p=0.028); BMI from 35.1±3.8 to 33.2±3.2 in the exercise group
Ostermannet al .[37] / Cross-sectional / 23 (17♂) inpatients with schizophrenia (DSM-IV) (28.2±4.1years; BMI=23.6±2.7) and 23 matched controls / VO2peak= 27.1±6.2mlO2/min/kg versus 36.1±8.1mlO2/min/kg in healthy controls (P<0.001) / / / /

Electronic Supplementary Material Table S1.Continued

Study / Design / Participants / Baseline cardiorespiratory fitness (VO2) / Intervention characteristics / Exercise outcomes
Abdel-Baki
et al. [38] / PE / 7 inpatients with schizophrenia, 9 schizoaffective
disorder, 7 bipolar disorder and 2 psychotic disorder specified (all ♂ ) (DSM-IV) / VO2max= 37.3±12.6 mlO2/kg/minin completers and VO2max= 35.9±12.9 mlO2/kg/min) in non-completers / 14 weeks, 2/week, 30-min individualized session on a treadmill:5-min low intensity, 10*30-sec at 80 to 95% HR max with 90-sec at 50 to 65% of HR max between intervalsand 5-min cool-down period supervised by a kinesiologist / VO2max increased by 38% (t =−5.68, degrees of freedom=12, p <0.001)
Bredinet al. [39] / PE (pilot data of RCT) / 13(7♂) patients with schizophrenia or schizoaffective disorder (DSM-IV); 30.9±7.2years; BMI=29.0±6.0 / VO2peak= 20.5±11.1mlO2/min/kg which is 57±25% of the on age- and gender norms predicted V02 peak / 12 weeks, 3/week, 30min moderate to vigorous aerobic exercise (progression based on HR changes +5%/week) OR 12 weeks, 3/week, 30min resistance training (50%–70% 1RM) 2 sets of 10–15 repetitions using 8–10 exercises supervised by qualified exercise professionals / 12% increase in VO2 peak or 2.8±3.4mlO2/min/kg (both, cardiorespiratory and resistance group included).
Ozbulutet al. [40] / Cross-sectional / 30 (17♂) outpatients with schizophrenia (DSM-IV) (33.9±13.4years; BMI=27.7±2.7) and 30 matched controls / VO2max= 25.8±7.1mlO2/min/kg versus 33.1±6.8mlO2/min/kg in healthy controls (P=0.009) / / / /
Kimhyet al. [41] / Cross-sectional / 32 (20♂) outpatients with schizophrenia or schizoaffective disorder (DSM-IV);37.3±9.4years; BMI=32.1±6.1 and 64 matched controls / VO2max=21.5±6.5mlO2/min/kgversus 28.9±7.0mlO2/min/kg in healthy controls (P=0.009) / / / /

Electronic Supplementary Material Table S1. Continued

Study / Design / Participants / Baseline cardiorespiratory fitness (VO2) / Intervention characteristics / Exercise outcomes
Kerling
et al. [50] / RCT / 42(26♂) inpatients with MDD (DSM-IV) / VO2peak=26.5±6.4mlO2/min/kgin exercisers versus 31.0±10.0mlO2/min/kg in controls (P=0.09) / Individualized 3/week 45min at moderate intensity on bicycle ergometer, during hospitalization supervised by a physician versus treatment as usual / Only improvements after aerobic exercise: to 29.3±6.7 mlO2/kg/min (SE 22)versus 30.6±10.1 mlO2/kg/min (SE 23)in the treatment as usual group
Kimhy
et al. [42] / RCT / 33(21♂) outpatients with schizophrenia
(DSM-IV); 18-55years / VO2peak=21.51±6.49mlO2/min/kg / 12 weeks, 3/week, 60min cardiorespiratory (week 1: 60%, week 2: 65%, week 3: 70%, week 4-12:75% HR max using active-play video games (e.g., Xbox Kinect) and traditional exercise equipment versus care as usual supervised by a Bachelor
of Science in Therapeutic Recreation. / 18.0% increase in VO2 peak versus −0.5% in controls (p=0.002)
Leone
2015 [43] / PE / 8 outpatients with schizophrenia (DSM-IV); 33.8±6.7 years / VO2max=26.2±4.7mlO2/min/kg / 8 weeks, 2/week, 75min strength training and 200 m2 circuit including various obstacles (cones, hurdles and stairs) as quickly as possible walking or running / VO2max increased to 30.4±6.0mlO2/min/kg; BMI from 28.5±4.2 to 29.2±3.2 and waist from 101.9±11.1 to 99.4±8.6cm
Nyboe
et al. [44]a / Longitudinal / 99 first episode outpatients (ICD-10); 24.9±7.1
years versus 50 matched controls / VO2max= 36.99±11.14mlO2/min/kg versus 53.26±13.16mlO2/min/kg in healthy controls / / / /
Rosenbaum et al. [45] / PE / 19 (10♂) inpatients with first-episode psychosis (DSM-IV);19.9±2.4 years / VO2max predicted= 32.8±7.1 ml/kg/minwith 61% <20th percentile
compared to normative data / 12weeks, 2/week, 45min ergometer cycling at HR (±10 beats) corresponding to 65% of VO2 peak, supervised by an exercise physiologist / 20.1% increase in VO2 peak (31.8±9.5 to 38.2±12.6ml/kg/min (p=0.002); BMI from 27.05±4.6 to 27.2±4.4 in the exercise group

Electronic Supplementary Material Table S1.Continued

Study / Design / Participants / Baseline cardiorespiratory fitness (VO2) / Intervention characteristics / Exercise outcomes
Schuch
et al. [46] / PE / 14 (4♂) outpatients with bipolar disorder (DSM-IV); 35.9±8.6years; BMI=28.3±4.4 versus 16 matched controls / VO2max=23.8±4.1mlO2/min/kg versus 28.7±5.5mlO2/min/kg in healthy controls (P=0.01) / / / /
Schuch
et al. [47] / RCT / 50 (4♂) inpatients with MDD (DSM-IV) / VO2max= 29.1±5.0mlO2/min/kg in the exercise group)versus 26.4±5.2mlO2/min/kg in control group / a weekly individualized exercise dose of 16.5 kcal/kg of weight/week of aerobic exercise; 3/week during hospitalization, supervised by aexercise physiologist / No post-exercise data on VO2
Vancampfort et al. [48] / Cross-sectional / 47(34♂) inpatients with schizophrenia (DSM-IV); 34.2±11.1years; BMI=25.8±4.3 / VO2max predicted= 34.6±8.7mlO2/min/kg / / / /
Vancampfort
et al. [49] / Cross-sectional / 12 (4♂) outpatients with bipolar disorder (DSM-IV); 49.4±5.1years / VO2max= 25.7±7.2mlO2/min/kg versus 28.1±5.4mlO2/min/kg in healthy controls / / / /

aData obtained from the authors. NRCCT=non-randomized clinical controlled trial, RCT= randomized controlled trial, PE=pre-experimental, VO2=oxygen uptake,

BMI=body mass index, HR=heart rate, MDD=major depressive disorder.