**2. Benefits**

One of the characteristics of the population with some type of SMD is the reduction in the level of quality of life. This has been defined by the World Health Organization [11] as a personal perception, based on the objectives, standards, concerns, and expectations of each individual, of the position they occupy in life according to the cultural environment and the value system established at the time of measurement. In order to quantify this broad concept, six main factors must be addressed: physical health, psychological state, level of dependence, social relations, personal beliefs, and the relationship with the environment.

Of all these factors, three stand out for having been directly analyzed in the available studies on the implementation of physical activity programs for people with SMD. These factors are physical health, mental health, and social relationships, and the benefits obtained in these studies promote the recommendation of physical activity for people with SMD in all clinical intervention guidelines. However, it should be noted that the WHO currently recommends at least 150 minutes of aerobic physical activity per week at a moderate or vigorous intensity in order to obtain significant results, guidelines followed by the studies analyzed for the benefits described in the following section.

#### **2.1 Physical health**

The contributions of the programs examined in the area of physical health, understood as the link between well-being and proper bodily functioning, have been various.

Applying WHO recommendations, the regular practice of physical activity has been directly and significantly related to improvements in anthropometric measurements, functional fitness, and motor skills of participants. This is due not only to the individual effect on each of these variables but also to the interrelationship between them. Anthropometric measurements include body weight and body circumference

#### *Benefits and Barriers of Physical Activity in Social Inclusion and Quality of Life in People… DOI: http://dx.doi.org/10.5772/intechopen.106767*

and are related to the nutritional and health status of the participants. Their in-depth analysis not only allows predictions to be made about users' performance but also about their health and even survival. At the same time, changes in anthropometric measurements lead to changes in body composition which, together with muscular strength, cardiorespiratory endurance, flexibility, and balance are the main components of functional fitness, as well as motor qualities for which benefits have been proven in different studies [12, 13].

However, physical health is not only related to physical fitness but also to the development of healthy eating and consumption habits. These habits are particularly relevant among people with SMD as, due to medication and the symptoms of the disorder itself, they tend to have a greater appetite and have diets that are low in fruit and vegetables but high in fat and sugar. Physical activity programs have reported improvements in this area by combining physical exercise with educational workshops on healthy behaviors, improving participants' diets and promoting the abandonment of substance, alcohol, and tobacco use, which reduces the possibility of developing diseases related to unhealthy habits [14].

All these improvements, both in terms of physical fitness and eating habits, promote the improvement of the autonomy of this sector of the population. Although this is also influenced by the social aspect, the physical sphere plays a very important role [15]. Improved anthropometric measurements, functional fitness, and motor skills allow for better performance of daily activities, without the need for assistance and/or support. In addition, the inclusion of healthy eating habits and the reduction or cessation of substance, alcohol, and tobacco use also contribute positively, as they do not require supervision in this regard and prevent the occurrence of related health problems.

#### **2.2 Mental health**

Physical activity programs for people with SMD have also reported various benefits in terms of mental health, understood as a state of being aware of one's individual capacities and being able to face everyday difficulties, work productively, and contribute to the community of which one is a part.

Several authors have focused their studies in this area, determining the improvement of factors such as self-esteem, stress, and anxiety [16, 17]. Similarly, in other work where the effect of a regular football league on mental health was evaluated, they also found improvements in self-stigma [18]. Even in studies where mental health status has been measured in a general way, mental health status has improved equally [19]. Physical activity allows participants to create new goals that they are capable of achieving, giving them the confidence that they can achieve what they set out to do and feel that they contribute to the community in some way. In this way, the perception of self-worth is positively modified while increasing self-esteem and self-image, thus promoting improved mental health.

Likewise, several authors have found significant improvements in symptomatology, both positive and negative, in SMD [20–22] that is addressed through the practice of physical activity thanks to the contributions of this type of activity. On the one hand, the hormonal release that is produced intervenes in the reduction of symptoms related to certain disorders, such as depression or anxiety. On the other hand, the possibility it offers in terms of disconnection also plays a positive role. Users have the opportunity to disconnect the mind by focusing on the task at hand, reducing the attention on negative symptoms that are occurring.

Therefore, physical activity programs develop positive expectations toward symptom improvement so that adherence to such programs is increased [23]. However, the need to control the energy used in physical activity is demonstrated, given that excess energy can also lead to problems in adaptation and behavioral problems [24].

Likewise, in other study proposed, it can be observed how the practice of regular physical activity from an early age acts as a protective factor in various psychological problems, such as depression by acting on all the factors studied earlier [25].

#### **2.3 Social relationships**

Although there are few practical studies that have directly measured how physical activity affects interactions between two or more people involving a set of implicit norms, they have demonstrated benefits for participants.

In terms of the benefits of physical activity on a social level, some studies highlight improvements in personal and social functioning [12], allowing for the emergence of positive social relationships, reducing self-stigma, all thanks to the contact established during the activity sessions, both between people with SMD and those who do not have SMD [16]. Therefore, the socialization of this group is promoted [15], in which fun acts as a common thread, leading to a reduction in stereotypes and symptomatology and the creation of bonds between those involved [26]. In this way, the practice of physical activity may be a suitable way to improve social support for people with SMD [17].

These improvements appear indirectly, i.e. it does not seem to be necessary for physical activity programs to devote part of the session to this task. In fact, these are benefits detected through studies whose objectives were physical and mental health variables, in which no improvements were obtained, but which were nevertheless positively valued by the participants in view of the social possibilities presented [27].

The internal characteristics of team activities, especially when they are carried out in groups, and the wide range of possibilities they offer, allow participants to value them positively by fostering positive experiences through the exchange of sessions with like-minded people. Team activities offer a wide range of social opportunities by allowing interaction between participants, both during the activity itself, which requires cooperation, and after the activity has ended, and by encouraging the emergence of positive stimulus from other users who are in the same situation.
