Physical activity with people with severe mental health disorders
The World Health Organization (WHO) estimates that 25% of the general population will have a severe mental disorder (SMD) during their lifetime. Having such a disorder can lead to the adoption of unhealthy lifestyles that, in turn, generate various comorbidities such as obesity, diabetes or hypertension. People with SMD live between ten and twenty years less than the general population. It is through physical activity that the risks derived from these comorbidities can be reduced and the quality of life and general well-being of people can be improved.
The use of physical activity as an adjunct treatment to pharmacological treatment and as a fundamental strategy for health promotion in hospital centres is an innovative and feasible bet. That is why a project was initiated, promoted by the Research Group on Sports and Physical Activity (GREAF) of the University of Vic, in collaboration with the University Hospital of Vic ( Consorci Hospitalari de Vic ) and the Hospital Sant Joan de Déu de Manresa (Fundació Althaia ), and funded by the Official College of Professionals in Physical Activity and Sports of Catalonia (COPLEF) . It was promoted with the aim of evaluating the impact of a physical activity programme on physical activity (PA) levels, mood and perception of general health in hospitalised people.
The commitment to recovery and social inclusion through sport
In this project, an experimental study was carried out with assignment to an intervention group (n=33, Hospital Universitari de Vic) who carried out a physical activity program, and a control group (n=14, Hospital Sant Joan de Déu) who carried out the usual daily physical activity of each person treated without following a specific program. The intervention took place from October 2021 to March 2022. The variables studied were physical activity (International Activity Questionnaire; IPAQ-short version), mood (Analog Mood Scale) and perception of general health (Analog General Health Perception Scale). All variables were measured before and after the implementation of the program in both groups, and mood and perception of general health were also measured before and after each physical activity session with the intervention group.
Regarding the intervention, the program consisted of carrying out physical activity sessions with the people treated in the experimental group, volunteers and fit according to the inclusion criteria, and the medical prescription of the psychiatric team that take into account the decompensation on a psychiatric and psychological scale, and the physical pathologies that present contraindications for the practice of physical activity. Mainly, moderate aerobic intensity sessions were carried out, in addition to working on the conditional capacities of strength, endurance, flexibility, range of motion and balance. The sessions were carried out on the terrace of the mental health unit, three days a week, 60 minutes/session, and in groups of up to twelve people. In all of them, music was played and the content was adapted to each individual need, as far as possible. In the control group, volunteers and fit, according to the criteria and medical prescription, also participated, and they were asked to perform their daily and usual physical activity.
Regarding the results , first, we analyzed the values that were measured before and after the intervention (PA, mood, perception of general health). Regarding PA, the intervention group practiced 73.75 more minutes per week of vigorous physical activity and 36.25 more minutes per week of gentle physical activity, compared to the control group. The intervention group also increased energy expenditure to 2,672 MET's per week, compared to the control group. At the end of the project, the level of physical activity of 16 people had increased. Regarding mood, this was also increased during the admission of the experimental group compared to the control group by 2/10 points. The value of the perception of general health also presented an increase of 18/100 points in the experimental group compared to the control group.
Secondly, the variables were measured before and after the physical activity sessions (mood and perception of general health). Compared to the value before the sessions with the experimental group, the mood increased by 1.1/10 points and the perception of health by 8.11/100 points. During this time interval there were no changes in the medication or the dose, that is, the change between the values is due to the practice of physical activity within the session. This difference in the values before and after the session decreased as the weeks of admission passed in the mood (from 1.8 points; first week to 0.4 points; sixth week) and in the perception of health (from 9.25 points; first week to 4.45 points; sixth week). In other words, people who were admitted longer did not improve the levels in the variables as much as in the first weeks. The reason for this could not be concluded.
The results of the present study have been compared with similar interventions, obtaining results in the same direction. The increase in the level of physical activity was similar to the results of Deenik et al. (2019) although they proposed a different methodology during the sessions. Also, Dimeo et al. (2001), although the typology of activities proposed were different, achieved similar results in the level of mood before and after the intervention. In the perception of health, Skrinar et al. (2002) demonstrated how the practice of physical activity generated an increase in general health, with a different health questionnaire, but always showing improvements in the same line. Finally, Brand et al. (2018) had already emphasized the impact that single sessions of physical activity generate on the psychological dimension, we have analyzed two variables that are in this dimension.
The implementation of this intervention has demonstrated that it is feasible to implement a physical activity program in the acute hospital phase, providing improvements in the well-being of people during admission. Therefore, it would be advisable to use physical activity as an adjuvant treatment to pharmacological treatment. It would be necessary to review the program before transferring it and carrying it out in the future in the different mental health units of Catalonia, as a fundamental strategy in the practice of promoting physical activity and improving the quality of life of the mental health population in the acute hospital or subacute hospital phase.
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