World Physical Therapy Day: The benefits of physiotherapy for mind, body, and soul

World Physical Therapy Day, celebrated annually on September 8, is dedicated to raising awareness about the vital role of physical therapy in promoting health, wellness, and quality of life. "Physiotherapy is a secret key to unlocking the path of better health," poses Dhanalakshmi V, chief physiotherapist, Manipal Hospital (old airport road), Bangalore.

Often associated with rehabilitation after injuries or surgeries, physiotherapy goes far beyond its traditional scope."Physiotherapy has emerged as a powerful tool in improving both physical and mental health, offering a holistic approach that recognises the intricate connection between bodily function and cognitive well-being. This comprehensive approach extends far beyond traditional muscular and skeletal rehabilitation, providing a range of benefits that encompass mental health, cognitive function, and overall quality of life," shares Shivangi Borkar, head of the department of physiotherapy, P. D. Hinduja Hospital and MRC. Ahead of World Physical Therapy Day, the medical experts will delve into the often-overlooked benefits of physiotherapy, extending beyond pain relief, and explore how physiotherapy can positively impact mental health, sleep patterns, and cognitive abilities.

How can physiotherapy improve overall quality of life and well-being?

Dhanalakshmi V: One of the major advantages of physiotherapy is its significant impact on physical health. Physical activity has been shown to improve mood, reduce symptoms of anxiety and depression, enhance mental function, and build confidence as well as self-esteem.

Physiotherapy extends its scope to all age groups. Hydrotherapy in young kids helps improve strength and reduce hyperactivity. It also increases attention span in learning. Women's wellness programs such as lamaze, post-delivery exercises, and pelvic floor rehab are known to have various health benefits. Over the years, geriatric (old age) support programs including fall prevention, and balance and coordination exercises are also gaining significant attention in the community for their significant benefits.

Can physiotherapy be beneficial for individuals who do not have any specific health conditions?

Dhanalakshmi V: We empower patients to learn, recognise, and develop the power to manage themselves through preventive strategies. Preventive physiotherapy involves taking proactive measures to protect your physical health and prevent potential physical issues that may arise in the future. This approach includes early assessments, personalised exercise programs, and education on maintaining proper movement patterns.

Rather than waiting for injuries or discomfort, preventive physio focuses on strengthening your body, improving flexibility, and endurance, and reducing the risk of developing lifestyle conditions like hypertension, diabetes, high cholesterol, obesity, and heart-diseases.

By establishing a regular routine of physical activity, these individuals can improve their overall health and well-being and physiotherapy contributes to every aspect of improving quality of life.

How can physiotherapy help improve sleep quality and address sleep disorders?

Dhanalakshmi V: Quality sleep plays a very important role in the optimal functioning of most, if not all, body systems. It is critical for tissue healing, pain modulation, cardiovascular health, and immune and mental function. Without adequate sleep, people can experience increased pain perception, depression, increased anxiety, attention deficits, and reduced quality of life.

Most of the sleep disorders including Obstructive Sleep Apnea and Upper Airway Resistance Syndrome are associated with breathing disturbances and physiotherapy has a major role in providing appropriate breathing exercises and respiratory muscle training. This training aims to strengthen the pharyngeal, intercostal, and diaphragmatic muscles, which can reduce the collapsibility of the upper airway during sleep. Also, participating in low levels of aerobic exercise and progressive muscle relaxation techniques in those people enhances the quality of sleep. Further gentle stretching and myofascial release techniques for neck muscles, orofacial muscles, and temporomandibular (TM) joints can be useful in patients with Sleep Bruxism.

Are there specific exercises or techniques that can be incorporated into a physiotherapy regimen to enhance sleep?

Dhanalakshmi V: Physical therapists can educate patients about appropriate positioning for sleep called ‘Sleep Ergonomics' considering the patient's diagnoses as well as addressing impaired bed mobility if needed.

Pain is often considered to be one of the major contributing factors to poor sleep quality. Therefore, education for individuals about sleep positions for pain-free or pain-reduced sleep may help limit sleep disruption. For example, a person with lower back pain may benefit from learning to sleep on their side (sleep side-lying position) with a pillow between their knees or on their back (supine position) with pillows under their knees. This may help reduce the increased curvature of the back. A consultation with a physiotherapist can help you identify the underlying cause behind your lack of sleep and suggest a way to improve your sleep quality.

How does physiotherapy contribute to improving mental health, and what specific conditions can it benefit?

Borkar: Exercise, a cornerstone of physiotherapy practice, plays a crucial role in enhancing overall well-being, particularly for patients dealing with various neurological and psychological conditions. It's well-established that regular physical activity can improve mental health by boosting serotonin levels, making it an effective intervention for those with depression. The prescribed exercise routines in physiotherapy not only stimulate the release of endorphins, often referred to as 'feel-good' hormones, but also contribute to a sense of accomplishment and self-efficacy, further bolstering mental resilience.

Chronic pain, a common issue addressed in physiotherapy, often has profound effects on mental health. By effectively managing and reducing chronic pain, physiotherapists indirectly contribute to improved mental well-being. The relationship between persistent pain and mental health disorders like depression and anxiety is well-documented, and alleviating physical discomfort can lead to substantial improvements in psychological state.

Can physiotherapy help improve brain function and prevent cognitive decline?

Borkar: The impact of physiotherapy extends into the realm of cognitive function and memory. Physical activity, as prescribed by physiotherapists, has been shown to have profound effects on brain health. Regular exercise increases blood flow to the brain, ensuring a steady supply of oxygen and nutrients crucial for optimal cognitive function. This enhanced circulation supports the growth of new neural connections, a process known as neuroplasticity, which is essential for learning, memory formation, and overall brain health.

In the context of preventing cognitive decline, physiotherapy offers promising interventions. Studies have shown that regular exercise can increase the size of the hippocampus, a brain region crucial for memory formation. This structural change correlates with improved memory function and potentially reduces the risk of age-related cognitive decline.

Physiotherapy techniques that focus on improving balance and coordination have been found to enhance the brain's processing speed and reaction time. These improvements extend to cognitive abilities as well. Dual-task training, where individuals perform physical tasks while simultaneously engaging in cognitive challenges, has shown particular promise in improving cognitive-motor performance and potentially slowing cognitive decline.

Can physiotherapy help delay the onset of dementia?

Borkar: While exercise may not prevent dementia, it can certainly delay its onset by enhancing cognitive functions. Various game-based exercises are especially effective in this regard, as they help improve attention, memory, and problem-solving skills. For example, physiotherapists might give a patient three words or objects to remember - such as "parrot," "dish," and "water." After engaging them in another activity, they can ask them to recall these words, which helps improve their memory.

Cognitive exercises incorporated into physiotherapy sessions include building block towers to enhance attention span, copying geometric shapes to sharpen visual-motor skills, and solving puzzles or performing simple arithmetic to boost brain activity. These exercises not only target specific cognitive abilities but also provide engaging and varied therapy sessions, increasing patient motivation and compliance.

Are there any specific exercises or techniques that can target cognitive abilities, such as memory, attention, and problem-solving?

Borkar: By incorporating a mix of physical exercises and cognitive activities, physiotherapists can significantly enhance a patient's mental function, confidence, and overall well-being. This integrated approach recognises that physical health and mental well-being are deeply interconnected, and addressing both simultaneously can lead to more comprehensive and lasting improvements.

Specific exercises and techniques used in physiotherapy can target various cognitive abilities. Aerobic exercises, such as brisk walking, swimming, or cycling, have been consistently linked to improvements in memory and executive function. Coordination exercises, which require precise movements and hand-eye coordination, can enhance problem-solving skills and spatial awareness. Rhythmic exercises, including dancing or tai chi, have shown benefits in improving cognitive flexibility and processing speed.

Resistance training, often incorporated into physiotherapy programs, has been associated with improved executive function and memory. The cognitive demands of planning and executing specific movements, combined with physical exertion, create a beneficial environment for brain health.

Some physiotherapists also incorporate mindfulness techniques into their practice, which can enhance attention, focus, and overall cognitive awareness.

Also Read: Physical inactivity on the rise: Experts share ways to incorporate exercise amid sedentary lifestyle and hectic schedules

How can digital neuro-rehabilitation services enhance the benefits of physiotherapy?

Borkar: Digital neuro-rehabilitation services are increasingly offering these types of interventions, especially for patients recovering from stroke, Parkinson's disease, and other brain injuries, providing them with valuable tools for recovery and mental fortitude. These digital platforms allow for more accessible and continuous care, enabling patients to engage in therapeutic exercises even outside of traditional clinical settings. The integration of cognitive exercises with physical therapy, along with the advent of digital rehabilitation services, represents an exciting frontier in healthcare, promising more effective and personalised treatments for a wide range of conditions affecting both body and mind.

What is the importance of a personalised physiotherapy program?

Borkar: From alleviating symptoms of mental health disorders to enhancing memory and potentially delaying the onset of dementia, the benefits of physiotherapy extend far beyond physical rehabilitation. However, it's important to note that while these exercises and techniques show great promise, the most effective approach often involves a personalised program. A qualified physiotherapist can develop a tailored plan that takes into account an individual's specific needs, health status, and goals. This personalised approach ensures that the interventions are not only effective but also safe and sustainable for each individual.

As research in this field continues to evolve, the role of physiotherapy in promoting comprehensive health and well-being is likely to expand further, offering new hope and strategies for maintaining both physical and mental health throughout life.