Abstract
Background: Schizophrenia is a complex psychiatric disorder that requires both pharmacological and behavioral treatment and is often accompanied by multimorbidity. Physical activity supports overall health and plays an important role in preventing and managing both somatic and mental disorders. This study aimed to evaluate the impact of an Adapted Physical Activity program using Nordic Walking (AAF-NW) on the quality of life of patients with schizophrenia, depending on the number of steps taken during an eight-week intervention, and to assess its influence on body composition and posture. Methods: A prospective, single-center pilot study was conducted using a pre-post experimental design and direct participatory observation. Eighteen patients from a psychiatric hospital (16 men, 2 women; mean age 43.9 years) completed the intervention. Quality of life (WHOQOL-BREF), musculoskeletal pain (Nordic Musculoskeletal Questionnaire), and subjective exercise intensity (Borg scale, 6-20) were assessed. Measurements were taken before and after the program. All continuous variables (step counts, anthropometric measures, and WHOQOL scores) were tested for normality using the Shapiro-Wilk test and visual inspection of histograms and Q-Q plots. Depending on distribution, parametric or non-parametric tests were applied, with results quantified using appropriate test statistics, effect sizes, and p-values to ensure methodological rigor and transparency. Results: No systematic increase in the number of steps was observed during the training period. A non-significant improvement in quality of life was noted, along with significant reductions in body weight and waist circumference. Conclusions: Regular, structured AAF-NW group activities may potentially support the rehabilitation and treatment process in psychiatric hospitals when implemented on a continuous basis. Although improvements were observed, the findings are exploratory and should be interpreted with caution. Further studies on larger, more homogeneous samples are needed to confirm these preliminary results.