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This systematic review and network meta-analysis examined the relative effectiveness of different exercise therapies for people living with schizophrenia. Researchers searched eight major English and Chinese academic databases, identifying thirty randomised controlled trials involving 2,628 patients and comparing nine different exercise-based treatments.
The analysis found that aerobic exercise, yoga, and tai chi all demonstrated the ability to alleviate schizophrenia symptoms when compared to control therapies. Using a statistical ranking method called surface under the cumulative ranking curve, the researchers found that combining aerobic exercise with tai chi had the highest likelihood of reducing overall positive and negative symptoms as measured by the Positive and Negative Syndrome Scale. Yoga ranked highest for reducing negative symptoms and positive symptoms separately, whilst tai chi alone showed the greatest probability of improving psychiatric rehabilitation outcomes as measured by the Inpatient Psychiatric Rehabilitation Outcome Scale.
The authors acknowledge that these findings carry important caveats. The certainty of the evidence is limited by relatively small sample sizes across the included studies, considerable variation in exercise protocols, and a moderate risk of bias in some of the included trials. The researchers conclude that further large-scale, multicentre, rigorously designed trials using standardised exercise protocols are needed to confirm these findings.
Conclusion: Tai chi, alongside yoga and aerobic exercise, appears to offer meaningful benefits for managing schizophrenia symptoms, though stronger evidence from well-designed trials is still required.
Source: Liu Q, Li Z, Zhang H and colleagues. Medicine (2026). View on PubMed (PMID 42675692) · doi:10.1097/MD.0000000000050203