Developing a broad range of physiotherapy approaches designed for the treatment and rehabilitation of mental health patients

Abstract

The treatment of psychiatric disorders has often played second fiddle to diseases of the body, with mental problems suffering stigma issues and often being under funded. However, Yamamoto says: ‘This is an area that needs research focus because the problem is getting worse, rather than better. For instance, in Japan, psychiatric illness is the single biggest reason why people may miss work.’ Long-term studies by the Japanese government reveal that patients hospitalised because of a mental disorder are rarely discharged within three months and it is not uncommon for people to remain in hospital for well over a year. Therefore, while there is an urgent need to find ways for patients to receive appropriate and holistic healthcare enabling them to live independently, Yamamoto says: ‘Medication is still regarded as the first choice of treatment for mental disorders in Japan, despite the evidence that lifestyle interventions and corrective physiotherapy are important for early and lasting rehabilitation of patients.’ BBAT focuses on small, soft movements that are associated with daily living. Directing patients to concentrate on the movements and their generation is an integral part of the therapy. BBAT proponents claim that as patients become better attuned to their bodies and their movements, and rebuild a sense of ownership and agency, their movements become more rhythmic and coherent, their confidence increases, and energy levels and concentration are all improved. Yamamoto has tested this hypothesis through clinical trials. In one instance, 18 schizophrenia patients were administered BBAT for 40 minutes twice a week, for eight weeks. Before and after measurements were taken which recorded posture, ability to copy body poses, the difference between real and imagined locomotion and simple mental rotation exercises in which the patient had to identify whether a picture was pointing right or left. Their condition was also recorded using the positive and negative syndrome scale, which is a commonly accepted method for assessing the severity of schizophrenia symptoms. Yamamoto says: ‘Following treatment, patients showed big improvements in posture, sense of agency, locomotion and in the mental rotation tasks. We were greatly encouraged by these results, although we realise further work is necessary.’