Psychology

The importance of exercise in enhancing health cannot be overemphasized. Physical inactivity has been implicated in many diseases and health related conditions including diabetics, hypertension, arteriosclerosis, coronary heart disease and obesity among many others. For example, physical activity has been found to roughly double the risk of coronary artery heart disease and is a major risk factor for stroke (Boon, Colledge  Walker, 2006). Exercise is not only helpful in preventing many of these diseases but is also an important tool used in patients recovering from Non-Mental health related problems. Results suggest that regular physical exercise might help to maintain sound motor functions and decrease insulin resistance and a risk for arteriosclerosis in middle-age and elderly women (Kamijo  Murakami, 2009).

Non- Mental Health Related Problems
A lot of health problems fall into this category and they can be defined on the basis of the absence of an involvement of mental impairment in the pathology of the health condition. Non-mental health related problems can be grouped according to the system involved

1. The Genitourinary System.
Health problems that can occur here include urethral strictures, benign prostrate hyperplasia, carcinoma of the bladder, hydrocoele, testicular torsion, urolithiasis, infertility, acute and chronic renal failure, glomerulonephritis and a host of others.

2. The Respiratory System.
Conditions that can affect this system include asthma, pneumonia, chronic obstructive pulmonary disease, tuberculosis, pulmonary embolism, lung tumors, thoracic outlet syndrome among others.

3. The Endocrine System.
Conditions here include obesity, hypoparathyroidism, hyperparathyroidism, Cushings syndrome, diabetes mellitus, hypothyroidism, hyperthyroidism etc.

4. Orthopaedics.
This includes all diseases and conditions affecting the bones and this are osteomyelitis, back pain, degenerative bone diseases, rheumatic disorders, musculoskeletal abnormalities, pathologic fractures etc.

5. The Reproductive System.
This involves problems such as obstetric hemorrhage, ovarian tumors, complications in pregnancy, tumors of the uterus, sexually transmitted diseases such as HIV, Hepatitis, gonorrhea, syphillis, infertility etc.

6. Gastrointestinal System.
Conditions here include peptic ulcer diseases, jaundice, malabsorption syndromes, tuberculosis, hemorrhoids, rectal prolapse, small bowel tumors, carcinoid syndrome, colorectal tumors, upper and lower gastrointestinal bleeding, appendicitis, intestinal obstruction and inflammatory bowel diseases.

7. Cardiovascular System.
Health problems that can affect the cardiovascular system include hypertension, congenital heart diseases, congestive cardiac failure (CCF), cardiomyopathies, rheumatic heart diseases, cor pulmonale, infective and non infective endocarditis, ischemic heart diseases, arteriosclerosis etc.

8. Metabolic Diseases.
These are diseases that are as a result of defects in metabolism. They are majorly inherited diseases. They include phenylketonuria, alcaptonuria, albinism, galactosaemia, lactose intolerance, Lesch-Nyhan syndrome, Niemann-Pick disease etc.

9. Oncology.
This includes all malignant tumors and can affect virtually all systems in the body. Some of these are breast cancers, lung cancers, prostate cancers, skin cancers, colorectal cancers, osteosarcomas, lymphomas, leukemia etc.

10. Infectious Diseases.
Infectious diseases are also capable of affecting any of the systems and they include tuberculosis, pneumonia, gastroenteritis, candidiasis, cholera, typhoid, viral hemorrhagic fevers, myasis etc.

Factors that affect the Quality of Life
The quality of life of an individual can be affected by a variety of factors that may act by reducing or improving the individuals quality of life (QOL). In general, some variables used to determine the QOL of individuals include self confidence, self esteem, security, peace of mind, sense of achievement, sense of accomplishment, opportunity, freedom, sense of love, sense of reception of affection, comfort, congenial surrounding, good health, leisure, humor, relaxation, respect, social acceptance, understanding, helping and accepting others, personal prestige among many others. Information concerning these variables is usually collected from an individual and is used to estimate hisher quality of life. The quality of life can therefore be affected by factors that impinge negatively on any of these parameters.

Social rejection, loneliness, failure, insecurity, loss of opportunities, bad health, stress, hatred, diminishing self esteem are therefore factors that can easily get in the way of an individuals quality of life.

Quality of Life Issues Faced by Patients with Health Problems
As stated above, the state of an individuals health is pivotal in influencing the quality of life of such person. There will clearly be a reduction in the quality of life of people having diseases or illnesses but some health related factors further influence the net quality of life. In this case, the quality of life can be termed Health-Related Quality of Life (HRQOL). Health-related QOL is often defined and measured as physical functioning, a narrower view than general QOL (Kring  Crane, 2009).

Factors that affect Health-related Quality of Life in Patients with Health Problems
A number of factors influence the QOL of patients with health problems and this goes a long way in determining the outcome of treatment. Some of the major factors that influence QOL in patients with health problems include

1. Marital Status.
It has been found that most married individual have a better quality of life compared to unmarried individuals. This can be explained based on the emotional and moral support that people with health problems get from their partners. Divorcees have also been found to have a lower quality of life compared to people living with their partners.

2. Financial StatusIncome.
This is also important in determining the quality of life of people with health problems. The more financially buoyant an individual with a health condition, the more will be his quality of life. Poor people therefore generally have a relatively lower quality of life compared to high income earners

3. Severity of Symptoms.
The extent of the symptoms faced by patients with health problems also affects their quality of life. According to a study carried out to describe pain severity and pain interference and to explore the impact of pain severity on postoperative health-related quality of life of older people during their first year after discharge for hip surgery in Taiwan, it was found that pain experienced during the first month after discharge significantly impacted quality of life throughout the year following discharge, even after controlling for covariates (Shyu, Chen, Chen, Wu  Su, 2008).

4. Level of Education.
According to a study, patients that graduated from high school or the university had greater social and economic, health and functional and global quality of life scores than those that had graduated from primary or secondary school (Durmaz, Ozdemir, Ozdemir, Keles, Bayram, Bozkurt, 2009). A high level of education therefore favors a better quality of life.

5. Residence.
It has been found that patients that live in urban areas have a better quality of life compared to those living in rural areas. Patients living in cities have greater health and functional, psychosocialspiritual, and global quality of life scores than those living in rural areas (Durmaz et al).

6. Necessity of Hospital Admission.
The need to be admitted in a hospital is also a player in determining the quality of life. Patients who have health problems but do not need hospital admission have been found to have a better quality of life compared to patients that have to be admitted in the hospital and this worsens as the patient stays longer in the hospital.

Methods used to treat Patients with Health Problems
With advancement in medial research, different methods have been used to treat patients with diverse diseases. The major methods utilized in treatment include

1. Surgery.
Surgical procedures are medical procedures which involve an incision with instruments that are done to repair damage or to limit a particular disease. The rate of surgical procedures has greatly and widely increased as surgical treatments for various diseases are being advanced and performed. Examples of surgical procedures include laparotomy, thyroidectomy, appendectomy, incision and drainage, herniotomy etc.

2. Pharmacotherapy.
This is the method that relies on the use of drugs for the treatment of diseases. This is an essential part of treatment as most diseases require its use. Many drugs are used for variety of illness. Modern medicine relies heavily on drugs as the main tool of therapeutics (Rang, Dale, Ritter  Moore, 2003). Other therapeutic procedures such as surgery, diet, exercise, etc. are important, but none is so widely applied as drug-based therapeutics (Rang et al, 2003). Drugs are also important in chemotherapy and have been widely used in managing patients with cancer.

3. Exercise.
As stated earlier, exercise is also a potent therapeutic procedure used by health professionals in the treatment of various health problems e.g. obesity. It is also used to improve the quality of life in patients with health problems.

4. Diet.
Diet has been implicated in most diseases. Diet is an important part of treatment. Patients with particular conditions are always placed on specific diets in order to improve on the symptoms of the condition. For example, diabetics are usually placed on diets that are low in carbohydrate due to their inability to adequately metabolize glucose.

Importance of Exercise
The high incidence of some life threatening diseases can be traced to physical inactivity. Diseases and conditions such as diabetes mellitus, obesity, hypertension, hormonal imbalance, congestive cardiac failure all have physical inactivity as a high risk factor.

The benefits of regular exercise to the body include
1. Fitness.
Exercise is important in keeping fit. Regular aerobic physical activity is helpful in increasing the level of fitness.

2. Body Metabolism.
Involvement in regular exercise is helpful in preventing blood lipid and glucose abnormalities. In patients who have sedentary lifestyles, here is accumulation of cholesterol and low-density lipoproteins which are harmful to the body. Constant exercise is important in burning these excess body fats and reduces the susceptibility of this group of people to other debilitating health conditions.
 
3. Muscular Strength and Endurance.
Exercise has been found to increase endurance and strength. Evidence supporting the health benefits of activities that increase muscular strength and endurance in non-elderly populations has accumulated rapidly in recent years (Haskell, Lee, Pate, Powell, Blair, Franklin, Macera, Heath, Thompson, Bauman, 2010). For example, mechanical loading on skeletal tissue by resistance exercise can effectively stimulate an increase in bone formation in young adults and slow bone loss in middle age (Haskell et al, 2010)

4. Energy.
Physical activity is very essential in the burning of calories. The calories burnt helps to meet the energy requirements of the body.

5. Stress and Psychological Influence.
Exercise is also of great value in reducing stress. It is also a potent tool in reducing depression and anxiety and enhances the consciousness or feeling of well being.
All these benefits of exercise will help improve the quality of life and since exercise is essential in preventing a host of health problems, the absence of these health problems is equivalent to a better quality of life.

Importance of Exercise in People with Health Problems
Exercise serves as an important tool in restoring patients with health problems to an optimal healthy status thereby alleviating their quality of life. Exercise improves mood and QOL by increasing overall health through socialization, goal setting, participation, decreased body weight, or decreased fatigue (Bicego, Brown, Ruddick, Storey, Wong  Harris, 2005).

Therapeutic Importance of Exercise
Exercise is used as a therapeutic tool in various situations. Though it does not substitute other interventions in the management of health problems, its function is important in ensuring total recovery. For example, aggressive postoperative physical therapy is effective in shortening hospital stay in postoperative hip and knee arthroplasty patients, and contributes significantly to the degree of postoperative knee flexion regained (Beaupre, Lier, Davies  Johnston, 2004).   Some studies that have been carried out have established the importance of exercise in patients with health problems.

Some of these studies are
1. Low Back Pain.
Exercise is not only used in patients with low back pain but is also important in preventing the pain. A recent systematic review concluded that exercise therapy relieves pain and increases function in patients suffering from non-specific low back pain, a finding supported by other published treatment guidelines (Waller, Lambeck  Daly, 2008). A better prognosis in the presence of exercise will therefore have an influence on improving the quality of life of people with health problems.

2. Post Polio Syndrome.
This study was to investigate and compare the impact of hospital and home exercise and programs on aerobic capacity, fatigue, and quality of life in patients with post-polio syndrome (Oncu, Durmaz  Karapolat, 2008).Patients with post polio syndrome usually have a reoccurrence of the classical symptoms of polio including pain and fatigue. Exercise has been found to ensure the avoidance of dependence in such patients. The study showed that there were improvements in the parameters of fatigue and quality of life in both home and hospital based exercise groups (Oncu et al, 2008).

3. Breast Cancer.    
Studies have shown that women with breast cancer who were less active reported higher fatigue (Berger  Higginbotham, 2000). An improved quality of life in patients with breast cancer has therefore been found to be partly dependent on the level of exercise that patients engage in. According to a study designed to examine daily fatigue patterns during the third cycle of chemotherapy in women with breast cancer, it was found that the patterns of change in fatigue were similar between exercisers and non-exercisers, but non-exercisers consistently reported higher fatigue levels during the third cycle of chemotherapy (Wu, Dodd  Cho, 2008).

4. Haemodialysis.
A study was also carried out to assess the effects of intradialytic exercise training on health-related quality of life indices in haemodialysis and it was found that multiple regression analysis indicated that the improvement in quality of life depended on the participation in exercise programs, the effects of training and the reduction in the level of depression (Ouzouni, Kouidi, Sioulis, Grekas  Deligiannis, 2008). This further proves the essentiality of exercise in improving the quality of life in patients with health-related problems

5. Knee Arthroplasty for Osteoarthritis.
Primary Total Knee Arthroplasty is often used in patients suffering from idiopathic knee osteoarthritis. It is used as a final stage treatment for the condition. The objective of this study was aimed at investigating the effects of a preoperative or postoperative rehabilitation program on health related quality of life, for patients affected by final-stage idiopathic knee osteoarthritis, before and after primary total knee arthroplasty (Evgeniadis, Beneka, Malliou, Mavromoustakos  Godolias, 2008). The study showed that a preoperative general strengthening exercise program is feasible, seems to be beneficial to patients mental health affected by final stage idiopathic osteoarthritis and assists in the early return of basic functional abilities during the in-patient rehabilitation period (Evgeniadis et al, 2008).

6. Heart Failure.
This particular study was to determine whether subjects with chronic heart failure, who completed a 12 week rehabilitation program, would have significantly greater quality of life, better aerobic fitness, less difficulty with symptoms of heart failure, greater self efficacy for exercise, and higher daily activity levels when compared with subjects in a control group (Collins, Langbein, Koetje, Bammert, Hanson, Reda  Edwards, 2004). It was established that exercise training in adults with heart failure increases exercise tolerance and perceived physical function (Collins et al, 2004). This will translate into a better quality of life in patients with heart failure further stressing the importance of exercise in patients with health problems.

7. Colorectal Cancer.
The objective of this study was to examine the relationship between physical activity and QOL. It was concluded from the study that changes in mild exercise from prediagnosis to post-surgery are positively associated with QOL in colorectal cancer patients but that experimental research is needed before any definitive conclusions can be drawn (Courneya, Friedenreich, Arthur  Bobick, 1999).

8. Lumbar Spine Decompression Surgery.
This study was aimed at determining the effectiveness of exercise following lumbar decompression surgery and it was found that there is strong evidence to support the long-term effectiveness of structured intensive exercise programs, initiated 4-6 weeks post-operatively (McFeely  Gracey, 2006).

The use of Exercise so far in improving the Quality of Life of People with Health Problems
There is extensive evidence that physical activity during adulthood is related to adult health status (Twisk, 2001).Therefore, there seems to be a general acceptance of the role of exercise in improving the quality of life of the general population and also of people with health problems. Exercise is widely used in hospitals as a therapeutic tool in patients with health problems and the importance has been widely appreciated though there is significant non-compliance accounting for the increase in conditions and diseases related to physical inactivity. Physiotherapists are often available in hospitals to help patients that are recuperating restore their physical fitness.

There have been several recommendations for the use of physical activity in improving the quality of life in people with health problems. A prototype is the system organized around patients with arthritis in which the major goal is to preserve and increase the range of motion of affected joints through recreational activities, increase muscle strength, power and endurance and to increase the aerobic fitness and conditioning to prevent other associated health risks.

Conclusion
The importance of exercise in improving the quality of life in patients with health problems can no longer be gainsaid. Different studies have proved the efficacy of physical activity in patients suffering from health problems and have been found to significantly improve the quality of life in such patients. There should be the encouragement of the use of exercise in facilitating the rapid healing of severe health problems. This is an important role for physicians and all other forms of health care providers. Exercise is therefore an inevitable tool in increasing and improving the quality of life in general and most importantly in people living with health problems.

Future Research
Different researches are going on into how to improve the level of exercise in the general population. There is an ongoing research into the use of mental imaging in contributing to exercise performance and behavior (Kossert  Chandler, 2007). This research though far from finish is aimed at ensuring that humans reap maximal benefit from engaging in exercise. It was concluded that exercise imaging might indeed prove to be an effective tool in enhancing performance and adherence in physical activity programs (Kossert et al, 2007). With the assumed success of future researches into this, it is believed that the quality of life of patients with non-mental health-related problems will improve.