Abstract
Background: Mental disorders are common,
worldwide health problems. Starting July 1st
2015, mental health treatments in Israel have
been incorporated into the "National Health Bill"
)passed by the Knesset in 1994(, bringing to an
end the 21-year-old questionable division of
responsibilities for treatment of body and mind
)HMOs responsible for treatments of the body;
Ministry of Health responsible for treatments
of psychiatric and psychological conditions(.
Therefore ,community caregivers need to take
into account the needs and characteristics related
to the patients ’diagnoses and mental state
when formulating treatment and rehabilitation
programs to address these patients' health issues.
Aim: The aim of this review is to examine the
existing knowledge in the literature regarding the
physical characteristics and level of physical activity
of people with depression, anxiety disorders, and
schizophrenia, and to provide physical therapists
with basic guidelines for managing the diagnosis
and treatment of these patients.
Methods: A total of 106 articles were reviewed
after a systematic and comprehensive search in the
following databases: Google Scholar, PubMed,
ScienceDirect, PsycINFO and Cochran. The first
phase was carried out by searching the keyword
Mental Health that was cross-linked respectively
with the keywords: physical activity, pain, and
body posture. In the second phase, the search was
more specific using the following keywords: body
posture, balance, pain, gait, fine motor, muscle
strength, range of motion. Keywords in each of
the above were cross-linked with the specific
mental illnesses: schizophrenia, depression,
anxiety disorders. The articles reviewed included
interventional clinical trials, crpss-sectional
surveys, cohort studies, literature reviews, and
meta-analyses dealing with populations with
mental illness.
Results: The review we conducted shows that
patients with mental illness manifest unique
physical profiles in accordance with their clinical
diagnosis (schizophrenia, depression, and
anxiety): the physical profile of patients with
schizophrenia is characterized by a slow gait,
decrease in stride length, poor pain perception,
and slowdown in fine motor skills. Patients with
anxiety disorders are characterized by balance
disturbances, while depressed patients are
characterized by a slow gait, slumped posture,
a higher incidence of pain and a decreased pain
threshold and pain tolerance.
Moreover, most of these patients do not engage
in physical activity. There is a consensus that
physical activity contributes to an overall better
mental state and that the optimal physical
intensity to achieve good mental health is
moderate .Physical activity is a key component
in improving self-esteem and an effective tool for
coping with serious mental states.
Discussion: While formulating a diagnosis or
treatment program for patients with mental illness,
one should take into consideration some specific
factors ,such as pain perception ,balance and
gait patterns ,in addition to the general physical
activity program .More research is needed to
improve our understanding of these patients in
order to provide adequate recommendations and
guidelines.
Keywords: physical activity, pain, balance,
posture, motor skills, walking, mental illness