Background: In individuals with severe mental illness (SMI), low muscle strength heightens the risk of mortality and chronic disease development. Routine muscle strength assessments could identify vulnerabilities, thereby reducing the growing burden associated with SMI. However, integration into clinical settings faces obstacles because of limited resources and inadequate healthcare staff training. The 5 sit-to-stand (5-STS) test offers an alternative for measuring muscle strength compared with more complex or demanding tests. Nevertheless, its validity in individuals with SMI remains unexplored. Aims: This study aimed to analyse the criterion validity of the 5-STS test in SMI, considering potential age, gender and body mass index influences. Method: In a cross-sectional study following the ‘STrengthening the Reporting of OBservational studies in Epidemiology’ (STROBE) guidelines, 82 adults with SMI (aged 18–65, 24 women) were assessed. Participants underwent both the 5-STS test and the isometric knee extension strength (KES) test. Results: Analysis revealed a significant moderate correlation coefficient and intraclass correlation coefficient (−0.58 for both) for all participants, indicating that the measures are valid and assess related aspects of the same construct. Strong agreement was observed in women and the older age groups. The 5-STS test demonstrated accuracy, with a standard error of estimate lower than the within-subject variability on the KES test. Bland–Altman plots showed limits of agreement values of −3.39 and 3.52 for the entire sample, and heteroscedasticity analyses indicated consistent differences between the 5-STS and KES tests across all groups analysed, except in the women's group. Conclusions: The 5-STS test seems to be a valid test for assessing muscle strength in individuals with SMI, supporting its usefulness for routine assessment in clinical settings, facilitating detection and intervention in critical situations.

Background: Evidence suggests that aerobic training with blood flow restriction is beneficial for treating fibromyalgia. This study evaluated the feasibility, safety, and effects of an aerobic training program with blood flow restriction for women with fibromyalgia. Methods: Thirty-seven women with fibromyalgia were included, and thirteen with an average age of 59 ± 3, a BMI of 26 ± 3, and who were polymedicated started the intervention period. The intervention group performed aerobic exercise with blood flow restriction using occlusive bands placed in the upper part of the rectus femoris, with a total duration of 14 min of restriction divided into two periods of 7 min with a rest period of 3 min and a total session duration of 17 min. Pressure intensity was measured using the visual pain scale (VAS), scoring 7 out of 10 (n = 7). The non-intervention group performed aerobic exercise without restriction of blood flow for the same periods, rest periods, and total duration of the session (n = 6). The intervention included 2 weekly sessions with 72 h between aerobic walking for 9 weeks. Walking was measured individually using the rating of perceived exertion scale (RPE) with an intensity between 6 and 7 out of 10. Visual and verbal support for the VAS and RPE scale was always provided throughout the sessions supervised by the investigator. Functional capacity was assessed using tests (six-minute walk test, incremental shuttle walk test, knee extension and handgrip test by dynamometer, 30 s chair stand test, and timed up-and-go test). Symptomatology was assessed using questionnaires (Widespread Pain Index, Symptom Severity Score, Fibromyalgia Impact Questionnaire, and Multidimensional Fatigue Inventory), and blood samples were collected. Results: There were no adverse effects, and only one participant in the intervention group withdrew. Between-group and intragroup differences showed that the intervention group obtained improvements in the functional tests; CST p = 0.005; 6MWT p = 0.011; Handgrip p = 0.002; TUGT p = 0.002 with reduced impact of the disease according to the questionnaires; FIQ Stiffness p = 0.027 compared with the nonintervention group. Biochemical results remained within normal ranges in both groups. Conclusions: Blood flow-restricted aerobic training may be feasible, safe, and more effective than unrestricted aerobic training as a physical exercise prescription tool to improve cardiorespiratory fitness, strength, balance, and stiffness in women with fibromyalgia.

Background : One factor that could reduce the burden associated with severe mental disorders is to improve the detection of people at health risk to prioritize the application of therapeutic interventions. Having specific risk values for robust health variables that can be measured through easy-to-use, inexpensive, feasible and reliable tools would make it possible to overcome the usual lack of resources in mental health services. Aims : To provide reference values for levels of physical fitness (a more powerful predictor of disease, disability and mortality than smoking, hypertension, hypercholesterolaemia and diabetes) evaluated through low-resource tools in people with severe mental disorders. Method : In total, 305 people (83 women) with severe mental disorders aged between 20 and 82 years were evaluated on a set of components of physical fitness (aerobic fitness, strength, flexibility, agility and balance) using the Senior Fitness Test battery. Results : Reference values were provided by quartiles according to sex and age (20–39 years, 40–59 years, > 60 years). Women had significant lower performance than men in the aerobic fitness test (p <0.001; Cohen’s standardized effect size [d]: -0.83, 95 % confidence interval [CI]: -0.54, -1.12) and men had significant lower performance in the lower limb flexibility test (p <0.001; d: -0.55, CI: -0.83, -0.26). Performance in all tests was lower as age increased (standardized regression coefficients [β] ranged from -0.10 to -0.40). Conclusions : This study provides the first reference values for physical fitness components specific to adults with severe mental disorders, helping identify individuals at potential health risk and prioritize therapeutic interventions. The main contribution was to provide the first reference values of a set of physical fitness components specific for adults with severe mental disorders.

People with severe mental disorders (SMD) reports low levels of physical activity and high levels of sedentary behaviour in their daily activities. Physical inactivity is the fourth leading cause of global mortality, and it is an independent risk factor for several somatic diseases. Therefore, reducing the growing burden of SMDs is a global health priority. Most mental health services do not consider physical exercise as a key factor in the prevention and treatment of this growing problem. Solving this gap could contribute significantly to reducing patient mortality and comorbidity. For this reason, we need to improve our knowledge of how these interventions can be designed and implemented in the “real world” conditions to improve the uptake and adherence of patients. This chapter explores the implementation gap in mental health services and exposes the barriers, facilitators, and experiences that patients, staff, and trainers reported during the implementation of a physical exercise program. Request access from your librarian to read this chapter's full text.

People with severe mental disorders (SMD) coexist with other diseases derived from a lack of physical activity and sedentary lifestyles. Although physical exercise programs can be interesting when it comes to solving this problem, adherence to them is low and the dropout rate is notable, so that these people do not manage to benefit from the positive effects of physical activity. In this sense, encouraging autonomous motivation seems to be the key to achieving greater attendance at training sessions and achieving a stage of change of action or maintenance. To this end, directing attention toward the support and satisfaction of three basic psychological needs (autonomy, competence, and relationships) seems essential. In this endeavor, different behavior change techniques (BCTs) have been successfully used to promote more self-determined motivations and increase physical activity.

To address this need, PowerONyou was started in 2013 at the University Pablo de Olavide, as a research project by the CTS-948 group, ‘Physical Activity, Health and Sports’. Over time, it has evolved into a community intervention programme, implemented in mental health centres and sociohealth environments in collaboration with healthcare professionals. The programme aims to enhance the health, quality of life and social integration of individuals with SMD through exercise as a therapeutic strategy. A distinctive feature of PowerONyou is its comprehensive approach. The programme not only designs exercise protocols to meet the specific needs of each individual but also provides training for healthcare professionals, caregivers and patients to integrate physical activity into treatment plans and daily routines, thereby ensuring that the benefits extend beyond direct intervention. Moreover, the programme emphasises the refinement of diagnostic and health assessment methods and the development of low-cost, practical solutions to identify vulnerabilities and prioritise interventions.