Effect of physical therapy on the sense of perceived fatigue in persons with residual type schizophrenia: report of two cases.

Some schizophrenics experience difficulty in explaining precisely their physical condition because of their blunted senses of fatigue and malaise. In this case presentation, using Borg's scale, we examined the effect of a physical therapy program on the sense of perceived fatigue in two male outpatient cases with residual schizophrenia over 6 years. Case 1 showed that the HR and the RPE linearly increased as the exercise strength increased after year 2. On the other hand, case 2's changes in RPE were not parallel to linear increases in HR, and consistently expressed a certain range of exercise as "light" and ended with "very, very hard" which continued over 6 years. These results suggested that the long period of continuing repetitive physical therapy in case 1 caused habituation to the exercise and he became aware of physical responses, and these resulted in an improvement of RPE. We suggest that awareness of the degree of a patient's ability of expression through the observation of changes in RPE could provide a useful clue for advancing various therapeutic programs for patients with residual schizophrenia.