Exercises to Improve Gait and Postural Control in Adults with Schizophrenia: A Scoping Review

Background. Adults with schizophrenia may experience gait and postural control problems, which increase fall risk, limit community participation, and contribute to cardiometabolic comorbidity. Exercise-based interventions are increasingly used in multidisciplinary care; however, the extent and characteristics of programs targeting postural control and gait outcomes in this population are unclear. 

Objective. This scoping review aimed to map the available evidence on interventions addressing gait and postural control problems in adults with schizophrenia.

Methods. A scoping review was conducted using the Arksey and O’Malley framework and reported in accordance with PRISMA-ScR guidance. PubMed, PEDro, and CINAHL were searched for studies published from 2012 to 2023 that examined exercise or physical activity interventions in adults with schizophrenia or related psychotic disorders and reported outcomes related to gait and/or postural control. Data were charted on study characteristics, intervention dose (frequency, intensity, type, time), setting and personnel, outcome measures, limitations, and recommendations.

Results. Eighteen (18) studies (n = 591 participants) met the inclusion criteria. Interventions were categorized as technology-based programs (e.g., exergaming/virtual reality), mind–body and dance-based approaches (e.g., yoga, Baduanjin, dance movement therapy, Greek traditional dance), structured aerobic and strength training, and multimodal programs. Postural control was most commonly assessed using center-of-pressure metrics, the One-Leg Balance Test, and the Timed Up and Go (TUG) test; gait outcomes frequently included the TUG, walking-capacity measures such as the Six-Minute Walk Test, and walkingefficiency outcomes. Most interventions were reported as feasible and generally safe; however, substantial heterogeneity in protocols and outcomes, as well as variable attrition, limited cross-study comparability.

Conclusion. Evidence on exercise interventions to improve gait and postural control in adults with schizophrenia remains limited but is growing. However, heterogeneity in study designs, outcome measures, and intervention protocols limits cross-study comparisons. Future research should prioritize rigorous, adequately powered randomized controlled trials and the validation of schizophrenia-appropriate outcome measures to support evidence-based intervention development and improve mobility and quality of life.