The Effectiveness of Exercise Therapy Treatment with Mental Illness Evidence Based Practice Articles Presentation

3 evidence based articles Rao, A., Chou A., Bursley, B., Smulofsky, J., Jezequel, J. (2014). Systematic review of the effects of exercise on activities of daily living in people with Alzheimer’s disease. American Journal of Occupational Therapy, 68(1), pp. 50-56. Knapen, J., Vancampfort, D. (2013). Evidence for exercise therapy in the treatment of depression and anxiety . International Journal of Psychosocial Rehabilitation, 17(2), pp. 75-87. Alexandratos, A., Barnett, F., Thomas, Y. (2012). The impact of exercise on the mental health and quality of life of people with severe mental illness: A critical review. British Journal of Occupational Therapy, 75(2), pp. 48

Article types/inclusion data Meta-analyses of existing research dealing with both physical and mental benefits of exercise with mental illness. Utilized both Quantitative and Qualitative studies. Inclusion data: Randomized controlled trials, single blinded studies, 10 year time period, English only articles (1),published by peer review journal, intervention included exercise and mental health outcomes. Studies focused on: Schizophrenia, Alzheimer’s disease, anxiety, depression, bipolar depression, schizoaffective disorder, and dementia.

Types of exercise utilized:Duration/ intervals Walking- slow to moderate walking, 10-30 min/30-60 min/60 min + Weight training- Low to moderate training, 20-60 min intervals. Swimming- Not specified Balance training-Not specified Resistance training- Low to moderate, with 20-30 min. intervals. Yoga, relaxation/breathing techniques- Not specified Stretching/flexibility training Aerobics/water aerobics Client centered activites Clients exercised 3-6 X weekly, with studies ranging from 6 weeks to 12 months.

General outcomes/benefits Decrease in symptoms of serious mental illness such as hallucinations. This may be attributed to functional distraction/new neural pathways. Reduction of primary symptoms in depression, anxiety, and schizophrenia. Maintenance of ability in dementia/Alzheimer’s. Multiple modality exercise programs seemed to provide the most benefit ie; walking/weight training or yoga/aerobics. Best results were obtained with medium interval sessions (30-60 min), with lower results in both shorter and longer sessions. Additional benefits: improved self-esteem, discovery of purpose, socialization in groups, stress management/coping skills increased, increased general health, increase in self-control, improved cognition(visual/audible), and improved energy.

Exercise Video: depression Link to video: Exercise Video

Potential issues Lack of double blind studies, cross-contamination of subjects, high drop-out rates, and gender/age bias. Small numbers of subjects in most studies. Quantitative and Qualitative studies are mixed. Recipients of mental health care are not, in general, highly motivated to perform physical exercise, making motivation difficult in these studies. Because of this, more athletic participants were included. Most, if not all studies, had physical outcomes as primary issues of these studies. There is little research to support physical exercise benefits strictly for mental health. More studies need to be performed in this area. Lack of control groups in most studies. Less affected individuals were included primarily. Future studies need to have more subjects, better control groups, and need to include more severe cases of mental illness. Safety can be a concern with these types of studies, especially when working with demantia/Alzheimer’s clients.

Conclusions: Physical exercise seems to improve primary and secondary conditions of mental illness. Duration, intervals, and types of exercise seem to have direct correlations with outcomes. Mechanisms of action are unknown, although there are current studies looking at EEG data to investigate biological implications of exercise. Exercise cannot hurt, if done under supervision with safety precautions and following a structured format. Secondary improvements to self-esteem, purpose, motivation, and socialization. Physical exercise, even in functional contexts, can and should be utilized with our clients in occupational therapy. I need to start working out more, in order to be ready for these types of interventions.