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dothelial function by increasing production

of nitric oxide and thus improve vascular

shear stress (22).

Effect of exercises on mental health in

neurological conditions

Alzheimer’s disease is the most common

cause of dementia. Physical therapy for

Alzheimer’s disease can provide interven-

tions for secondary problems such as loss

of strength, range of movement, ADL’s,

posture, balance and co-ordination (23).

Exercises have proven to improve cognition,

ADL and quality of life in patients with early

onset of dementia (24).

Schizophrenia is one of the most debili-

tating psychiatric disorders (4). Schizophre-

nic people may have poorer quality of life

than other people in the community. Acil A

A et al. examined the effects of a 10 weeks

physical exercise program on mental states

and QOL of individuals with schizophrenia.

They found that mild to moderate aerobic

exercise is an effective program for decreas-

ing psychiatric symptoms and for increasing

QOL in patients with schizophrenia (12).

Parkinson’s disease: Exercise might pre-

vent the disease, as well as an adjunctive tre-

atment. Exercise can also improve physical

functioning, strength, balance, gait speed

and health related quality of life in people

with Parkinson’s disease (3). Reuter et al.

observed that 20-week of intensive sports

activity resulted in improvement of mood,

motor disability and subjective well-being

in early to medium stage Parkinson’s disease

patients (25).

Physiotherapy intervention

Physical activity plays an important role in

recovery of mental health. Physiotherapists

are effective members of multidisciplinary

teams of doctors, nurses, dietitians, thera-

pists and social workers. Physiotherapy ma-

nagement can compliment medication and

psychotherapy within the multidisciplinary

team. The role and tasks of physiotherapists

in these teams will vary, from management

of pain, increasing joint mobility, relaxation

exercises, improvement of strength, endu-

rance and balance, gait training and to de-

vice exercise programs tailored to patient


Interventions include:

Relaxation and deep breathing exercises


Various stretching exercises, calisthenics,

walking, running, aerobic exercises and

swimming can be performed either indo-

ors or outdoors, for patients with substance

abuse disorder (13), gynecological disorders

and other conditions.

Range of motion, strength and enduran-

ce exercises.

Coordination exercises: Important for

impaired level of coordination in substan-

ce abuse and for patients with Alzheimer’s


Postural management: Regular chan-

ges in body positions are essential for pre-

vention of poor posture, muscle tightness,

spasms and decreased joint movement (23).

Balance, equilibrium and gait training:

balance and gait training is important in

Alzheimer’s- and Parkinson’s disease. Trans-

fers, reaching and grasping, posture balance

and gait training are core areas of physiothe-

rapy in Parkinson’s disease.

Ergonomic advice: Includes adaptations

at home and equipment to make patient in-

dependent (23).


The burden of depression, anxiety and other

mental disorders call for concerted, inter-

sectoral response. Not only to raise public

awareness, but also to provide treatment

and prevention strategies that can reduce

this large and growing health problem, in-

cluding the economic losses attributable to

them (1). The correlations between poor

mental health and an increased prevalence

of musculoskeletal conditions, multiple are-

as of pain, chronic and preventable diseases,

emphasizes the need for an effective and ho-

listic multidisciplinary approach to the ma-

nagement of these conditions (2).



WHO report on mental illness 2014 .


Mental Health and Physiotherapy ,


Physiotherapy association - position and statement,

1-4, 2011.

3. Kaur J, Mason M, Bhatia M, Role of Physiotherapy in

mental health disorders, Delhi Psychiatry Journal, Vol.

16, No.2, October 2013, 404-408.

4. Vancampfort Davy, Probat Michel, Skjaerven Liv,

Helvik ,

Physical Therapy, Systematic Review of the benefits of Physical Therapy with in a multidisciplinary care approach for people with schizophrenia

, Jan 2012,

Vol.92, No.1, 11-21.

5. Sharma A, Madan V,

Exercise for mental health ,

Letter to editor, Prim Care Companion J Clin Psychia-


6. Fábio S Lira, Gustavo D Pimentel, Ronaldo VT Santos,

Exercise training improves sleep pattern and metabolic profile in elderly people in a time-dependent manner ,

Lipids in Health and Disease2011,110-113.

7. Nicola T. Lautenschlager, Kay L. Cox, ; Leon Flicker,

Jonathan K. Foster, DPhil; Frank M. van Bockxmeer,

Ef- fect of Physical Activity on Cognitive Function in Older Adults at Risk for Alzheimer Disease - A randomized Trial ,

JAMA. 2008;300(9):1027-1037.

8. Cassilhas R.C, Viana V.A.R, GrassmannV ,

The impact of resistance exercises on the cognitive function of the eldely ,

Medicine and Science in Sports and Exercise,

2007, 1401-1407.

9. Sachdev M, Kaur J, Mason M, Enhanching mental

wellbeing and health of post menopausal women, Delhi

Psychiatry, Journal, Vol.17, No.1, April 2014, 125-129.

10. McAuley E, Mihalko SL, Bane SM,

Exercise and self esteem in middle aged adults – Multidimensional Relationships and physical fitness and self efficacy influences ,

Journal of Behavioral Medicine, Feb 1997,

Vol.20, Issue 1, 67-83.

11. Kim JH, Mckenzie LA,

The impact of physical exercise on stress coping and well being in university students in the context of leisure ,

Health 2014, 2570-


12. Acil AA, Dogan S, Dogan O.

, The effects of physical exercises to mental state and quality of life in patients with schizophreni a

, Journal of Psychiatric and Mental

Health Nursing, December 2008, Volume 15, Issue 10,


13. Kaur J, Garnawat D, Bhatia M, Rehabilitation for

Substance abuse disorders, October 2013, Vol.16,

No.2, 400-403.

14. Herbsleb M, Schulz S, Ostwrmanna S et al,

The Relation of Autonomic function to physical Fitness in patients suffering from alcohol dependency ,


Alcohol Dependence, 2013, 132, 505-512.



16. Brown RA, Abrantis AM, Read JM et al,

A pilot study of aerobic exercise as an adjunctive treatment for Drug Dependence ,

Mental Health Physical Activity


17. Brown RA, Abrantis AM, Read JM et al,

Aerobic exercises for Alcohol recovery: Rationale, Program description and preliminary findings


2009;33(2), 220-249.

18. Segar ML, Catch VL, Roth Rs, Gracia WS,

The effect of aerobic exercise on self-esteem and depressive and anxiety symptoms among breast cancer survivors


Oncology Nursing Forum 1998 ;25(1) 107-113.

19. Bartholomew John B , Morrison, D, Joseph T Cicco-


Effects of Acute Exercise on Mood and Well-Being in Patients with Major Depressive Disorder ,

Medicine &

Science In Sports & Exercise, 2032-2037, 2005.

20. Kaur J, Garnawat D, Shweta S, Bhatia M, Body

Awareness Therapy: An Approach to Treat Various

Disorders, Delhi Psychiatry Journal, October 2015,

Vol.18, No.2, .

21. Sachdeva M, Kaur J, Garnawat D, Psycho-physiothe-

rapeutic treatment of Polycystic Ovary Syndrome, Delhi

Psychiatry Journal, April 2015, Vol. 18, No.1, 151-154.

22. Randeva HS, Lewandowski ,Drzewoski J,

Exercises decreases Plasma total Homocysteine in overweight young women with Polycystic Ovary Syndrome

, J

ClinEndocrinolMretab 2002; 87(10): 4496-4501.

23. Kaur J, Garnawat D, Bhatia M, Rehabilitation in

Alzheimer’s Disease, Delhi Psychiatry Journal, April

2013, Vol.16, No.1, 166-170.

24. Hooghemstra AM, Eggermont LHP, Scheltns P, Van

der Flier WM,

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BMC Neurol, 2012, 12, 75.


Reuter I   Engelhardt M




Baas H, Therapeutic value of exercise training in Parkinson’s disease


Medicine and Science in Sports and Exercise