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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


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


Exercise also reduce tiredness that can

increase mental alertness (3).

Exercise improve endurance, energy and

stamina (3).

Physical exercise and specific


Effects of exercise in substance abuse


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


Deepti Garnawat


Department of Physiotherapy, Dr. Ram

Manohar Lohia Hospital, New Delhi, India.

Contact : Jaswinder Kaur: email:




ble akseptert

29.4.2016. Fagkronikker vurderes av

fagredaktør. Ingen interessekonflikter


The mental health benefits

of physiotherapy