Publication Name	World Journal of Psychiatry
Manuscript ID	120307
Country	China

Category	Psychology, Educational
Manuscript Type	Opinion Review
Article Title	Moving beyond efficacy: Why, how, and for whom exercise works in schizophrenia
Manuscript Source	Invited Manuscript
All Author List	Xin-Chu Zhou and Jia-Chen Qu
Funding Agency and Grant Number	Funding Agency Grant Number 2025 Provincial Teaching Reform Research Project of Undergraduate Universities in Hubei Province 2025513
Corresponding Author	Jia-Chen Qu, PhD, Post Doctoral Researcher, Postdoc, Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, No. 169 East Lake Road, Wuchang District, Wuhan 430071, Hubei Province, China. qujc_doc@163.com
Key Words	Schizophrenia; Exercise intervention; Mechanism of action; Dose-response; Precision medicine; Brain-derived neurotrophic factor
Core Tip	Exercise interventions have demonstrated efficacy in alleviating symptoms of schizophrenia, but their mechanisms remain fragmented and clinical application inconsistent. This opinion review challenges the traditional brain-derived neurotrophic factor-centered model, proposing a multi-system, multi-modal perspective involving neuroplasticity, neurotransmitter homeostasis, systemic inflammation attenuation, and psychosocial behavioral activation. By addressing optimal dosage, exercise type-symptom matching, and individual response variability, we propose a precision exercise prescription framework that incorporates personalized strategies. Future researches are supposed to focus on the integration of multi-modal biomarkers and artificial intelligence to shift exercise from “universal validation” to clinical “precision application”, thereby maximizing individualized long-term rehabilitation outcomes in schizophrenia.
Citation	Zhou XC, Qu JC. Moving beyond efficacy: Why, how, and for whom exercise works in schizophrenia. World J Psychiatry 2026

Received	2026-02-24 01:02
Peer-Review Started	2026-02-24 01:04
First Decision by Editorial Office Director	2026-03-17 06:54
Return for Revision	2026-03-17 06:54
Revised	2026-03-31 05:17
Publication Fee Transferred
Second Decision by Editor	2026-04-21 02:48
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-04-21 04:02
Articles in Press	2026-04-21 04:02
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2220-3206 (online)
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