We still tend to treat exercise as general lifestyle advice,
said Carl Zhou. Psychiatric researchers argue that doctors should prescribe physical activity with the exact, structured care given to pharmaceutical treatments.
Publishing in Genomic Press, a team from the University of Ottawa and the University of Toronto outlines how targeted exercise can use the muscle-brain axis to support mental health, cognition, and physical well-being. Carl Zhou and Nicholas Fabiano from the University of Ottawa alongside Stanley Wong from the University of Toronto suggest that exercise should be prescribed with specific clinical precision.
How Muscles Signal the Brain
Carl Zhou laid out the clinical standard: The evidence we reviewed supports something more deliberate: a prescription that names the type of activity, the frequency, the intensity, the duration, the safety considerations, and a plan for follow-up, just as we would for a medication.
Drawing on randomized trials, meta-analyses, and cohort studies, the paper details how physical activity releases signalling proteins called myokines during skeletal muscle contraction. These act like hormones to influence brains through metabolic, inflammatory, neuroendocrine, and neurotrophic pathways, affecting both cognition and psychological state. Mood receives the bulk of the benefits from physical activity.
In a randomized trial involving older adults, aerobic exercise increased anterior hippocampal volume and improved memory.
Doses for Severe Conditions
While the World Health Organization recommends getting 150–300 minutes of moderate activity per week, dose-response analyses show that 75 minutes per week is enough to boost psychological wellbeing.
The starting point does not have to be impressive. It has to be possible,
explained Nicholas Fabiano.
Small, repeated successes build self-efficacy and habit.
Pharmaceutical treatments for schizophrenia carry severe side-effects, yet meta-analyses show that aerobic exercise can improve cognition, working memory, and attention.
Stanley Wong noted, In schizophrenia, exercise can work on psychiatric symptoms, cognition, and physical health at the same time, in a population with substantial unmet needs in all three.
Clinicians Prescribe Safe Activities to Improve Patient Health
Creating effective exercise prescriptions requires clinicians to prescribe safe, individualized activities and address barriers to participation. Research indicates that exercise improves mood, cognition, cardiometabolic health, sleep, functioning, and quality of life. Further adequately powered research is required, particularly to establish the cognitive benefits of exercise in people with schizophrenia. Exercise infrastructure, transportation, and community-based programs help patients succeed.
Instead of sending you to the pharmacy for a mood elevator, your psychiatrist might just assign you to a local kickball league,
the authors suggest.