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FYSIOTERAPEUTEN 7/16
Mental disorders impose an enormous
disease burden on societies throughout the
world. More than 450 million people across
the globe suffer from mental illness (1). In a
survey done in Australia by National Survey
of Mental Health and Wellbeing of Adults
in 2007, 1 in 5 adults were reported to have
had mental disorders within 12 months of
the survey being undertaken (2).
Mental disorders comprise a broad range
of problems. They are generally characteri-
zed by a combination of abnormal thoughts,
emotions, behavior and relationships with
others. Some examples: schizophrenia, de-
pression, intellectual disabilities and dis-
orders due to drug abuse (1). People with
mental illness, like depression, schizophre-
nia and bipolar disorder, often have poor
physical health and experience significant
psychiatric, social and cognitive disability.
Good mental health is fundamental to the
well-being of individuals, families and com-
munities (2). Poor mental health is identi-
fied as one of the biggest causes of disability,
poor quality of life and reduced productivi-
ty. There is also a strong association between
mental health conditions and people repor-
ting multiple pain sites (2).
It has also been documented that phy-
sical activity can improve quality of life for
people with serious mental illness. Impro-
ved physical health can alleviate psychiatric
and social disability (3). A notable number
of longitudinal and cross-sectional studies
have proven the usefulness of physical ac-
tivity as a preventative strategy and as ad-
junct treatment for mental illness. Several
physiotherapy interventions are potentially
effective in improving physical and mental
health and health related quality of life. The
most commonly used forms of exercise are
aerobic- and strength exercises (4). Aerobic
exercises, such as walking, jogging, cycling,
swimming, have been proven to reduce anx-
iety and depression (5).
Health factors affected by exercise
Mood: Exercises improve mood by increas-
ing blood circulation to the brain. It can also
influence the hypothalamic pituitary adre-
nal axis, and thus influence the physiological
reaction to stress. In addition to this, exerci-
ses can counteract negative mood by impro-
ving self-esteem and cognitive function (5).
Sleep pattern: Moderate exercise may pre-
sent a non-pharmacological treatment alter-
native for sleep and metabolic disorders (6).
Cognitive function: One of the possible
mechanisms by which physical activity im-
proves cognition in older people at increased
risk of dementia is an alteration in cerebral
vascular functioning and brain perfusion
(7). Cassilhas et al. observed that resistance
training for elderly people resulted in im-
provement of cognitive function and mood.
This was due to improved blood flow facilita-
ting transportation of nutrients and oxygen
to critical CNS structures related to learning,
thus improving cognitive function (8).
Self esteem: Exercise alleviate symptoms
such as low self esteem and social withdra-
wal (9). A 20 week exercise program was
found to improve self-esteem at all levels of
global esteem, physical self-worth and per-
ception of physical condition (10). People
engaged in physical exercise are likely to
have fewer stress symptoms and more psy-
chological wellbeing than those who do not
(11).
Quality of life (QOL): Physical exercise
performed by patients with schizophrenia:
10 weeks, 40 min per day, had a positive ef-
fect on the QOL of these patients (12).
Improved coping to stress: Coping re-
fers to a behavioral or cognitive response or
strategy to prevent or alleviate stress. Phy-
sical exercise contribute to effective coping
by enhancing the improved problem focus
derived from positive emotion (11).
Exercise improves cardio vascular fitness
(3).
Exercise also reduce tiredness that can
increase mental alertness (3).
Exercise improve endurance, energy and
stamina (3).
Physical exercise and specific
conditions
Effects of exercise in substance abuse
disorders
Alcohol misuse results in psychological
and cognitive changes with impaired brain
function, leading to impairment of memory,
judgment, abstract thinking, disturbances of
balance and coordination. It also results in
skeletal myopathy, reduced muscle strength,
mass and function (13-15). Exercise help
drug dependent patients to experience po-
sitive mood states without the use of drugs.
This is due to an increase in the concentra-
tion of dopamine and dopamine receptor
binding (16,17). Various forms of exercises
also reduce the risk of relapse, as they alle-
Jaswinder Kaur
and
Deepti Garnawat
,
Department of Physiotherapy, Dr. Ram
Manohar Lohia Hospital, New Delhi, India.
Contact : Jaswinder Kaur: email:
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The mental health benefits
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