“In order for man to succeed in life,
God provided him with two means, education and physical activity.
Not separately, one for the soul and the other for the body, but for the two together.
With these means, man can attain perfection.”

― 
Plato

There is a common belief that physical activity has a positive effect on mood and the nervous system. A large number of studies describe the relationship between overall health, mood, and physical activity.

However, only a few studies have examined the relationship between physical activity and mental disorders. The decrease of depression and other mental disorders in those who do exercises raises the question of whether exercise can be used to prevent such disorders.

According to research by the Centers for disease control, physical activity has a number of health benefits. Its absence can have negative consequences for health and well-being, increasing the risk of developing coronary heart disease, diabetes, certain cancers, obesity, hypertension, and many death factors.

In addition, physical exercise is an integral part of many diseases’ treatment and rehabilitation. Improved physical well-being can also lead to improved psychological well-being, and it is generally recognized that physical activity can positively affect mood and anxiety.

 

Assessment tools and research methods

Standardized tools have been developed for evaluating physical activity regardless of location (sports playgrounds, home, transport, work, etc.). One of these tools is the international physical activity questionnaire (IPAQ), which allows you to calculate the last week’s metabolic equivalents and then to form an appropriate set of exercises.

In the European Union, physical activity (in everyday life) measured using IPAQ has been associated with an assessment of one’s overall and mental health. A total of 16,230 respondents aged 15 and over were studied; in some of the 15 countries, evidence was found for the relationship between the amount of physical activity and its impact on mental health.

 

Mental health and physical activity

In most studies, fitness was not directly evaluated. In 1992 it was found that people in good physical shape who do not exercise have a lower level of mental health than others. These indicators are typical for both teenagers and elders.

Recommendations for physical activity have been changing recently: Previously it was recommended to perform 3-5 physical exercises a week, now experts advise to stick to moderate-intensity activity for at least 30 minutes a day daily in addition to classic physical exercises, to do fast walking and gardening.

 

Depression and exercise

Early research on exercise as a treatment for depression and anxiety disorders was positive, but suffered from a number of shortcomings and may have dampened enthusiasm for introducing such exercises into everyday care and treatment. But in the last decade, controlled clinical trials have been conducted to find the exercise useful to treat depression and reduce depressive symptoms in patients with severe depression.

Exercise has been shown to reduce depression rates twice of the standard deviation, and an even greater effect has been reported in clinical studies (ex. psychoactive drugs-addicted persons, heart attack survivors, or those who are on hemodialysis).

Moreover, it was found that exercise was just as effective as cognitive therapy which has increased the probability of success by up to 67-74%. It was confirmed that 16 weeks of group training in elderly patients with severe depression were as effective as treatment with antidepressants in combination with sertraline. Most notably, the relapse rate was significantly lower in the exercise group (8%) compared to sertraline (38%) or the combined group (31%). Experts report that the effectiveness of exercise in adults with severe depression is usually comparable to antidepressants, and might be better than placebo if combined.

There was no difference between aerobic (jogging or brisk walking) and non-aerobic (strength training, coordination, and flexibility training) exercising activity that reduces depressive symptoms. Depression scores decreasing was recorded when performing stretching and relaxation exercises.

Despite the patient’s characteristics (age, gender, depression severity level) were not significant, physical exercise has shown a positive effect, compared to the standard treatment of depression (pharmacotherapy, psychotherapy).

 

Sports as a mental disorder prevention

Further randomized interventional studies are needed to conclude that sports activity is a promising therapy that prevents the occurrence of mental disorders.

This preventive effect may be particularly important for individuals with a high genetic risk of developing mental disorders, as well as for individuals with disorders triggered by physical illnesses and traumatic events.

An important component of research is the physical activity readiness questionnaire (PAR-Q), which is used in preparatory screening for moderate-intensity exercise programs.

The training program is assigned after testing the selected exercises. For long-term programs, exercise adjustments are made as to the patient’s physical fitness changes. Provided tests after the program execution are the main feedback instrument.

 

Training regulations

  1. You should conduct 3-4 training sessions a week lasting at least 20-30 minutes for 8-14 weeks.
  2. It is recommended to do records in a daily activity diary.
  3. Moderate-intensity activities, such as walking, are more effective than intensive exercise programs.
  4. An individually developed training program that is focused on specific groups or adapted to a specific person is more effective than common exercise.
  5. Recommendations for exercises and motivational messages in printed or online forms are more effective than verbal explaining.

 

IMPORTANT!

 

Patients with anxiety disorders should be informed that in rare cases, physical activity can trigger panic attacks.

When choosing the intensity of physical activity, it is necessary to consider the state of the patient’s cardiovascular system.

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