**3. Barriers**

However, despite all these benefits, the practice of physical activity continues to be a pending subject in this population, possibly due to different barriers, that is to say, elements that hinder participation and continuation in programs of this type. These barriers can be classified into three main groups: personal, social, and/or related to the activity program itself.

#### **3.1 Personal barriers**

Regarding this type of factors, a study points to the importance of lack of motivation and fatigue [28], to which other researchers add poor physical self-awareness that leads to shortcomings at the motivational level as it predetermines poor performance and performance in physical activity [29]. To these variables, some authors add their

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

own emotional influences [30], closely related to low mood and the presence of high levels of stress [31]. Another research also includes low self-efficacy and stigma [32]. Although it has previously been concluded that these variables are reduced or even eliminated, their existence hinders adherence to physical activity programs and thus the possibility of eliminating them and accessing the benefits they bring.

Along the same lines, it is established as a barrier the personal experience with the disorder, taking into account the symptoms of the disorder and the side effects of medication [33]. To this, together with negative expectations and an incorrect body perception, we must add the achievement of immediate negative results and the misconceptions evoked toward the sport practice itself (type of activity, intensity, etc.) [23].

However, these are barriers that can be overcome by providing the right support to the participants, both during, before, and after the tasks. In this way, the creation of false expectations would be avoided and the demotivation inherent in their nonachievement would be easier to counteract. Such support should come from the relationships established between the providers of the intervention, as well as from the rest of those involved in the program. This would require coordination between all those involved, although this is a barrier that is still present today [34].

#### **3.2 Social barriers**

The existence of certain social conditioning factors also plays an important role, such as a clear lack of support, both at family and social level and from the health system itself [33]. Thus, according to other studies, the lack of medical staff involved during the development of physical activity is considered a barrier to its practice, since it is interpreted as a lack of support from the environment and increases demotivation [21, 29]. This is a sector of the population that requires more support from their environment to adhere to this type of activities, facing the personal barriers they face.

It is highlighted the shortcomings at the organizational level. On the one hand, they highlight the lack of staff during the development of the physical activity, resulting in difficulties at the level of supervision and, therefore, of individual adaptation of the activity itself, as well as in the absence of guidance and support. On the other hand, they highlight the usual lack of financial resources, not only at an organizational level for these programs, but also at a personal level. These are people with greater economic difficulties that affect the possibilities of accessing sports facilities and acquiring adequate material [35].

#### **3.3 Program barriers**

With regard to the constraints related to the physical activity program itself, environmental restrictions, lack of staff and support in supervising the implementation of the activities, and the presence of rigid structures that limit spontaneous exercise, that is to say, preestablished exercise site conditions that allow for few changes, are identified [24]. The existence of such structures and the lack of support result in a lack of adaptation of the activities to be performed, which is considered another barrier to be taken into account [21].

At the same time, the lack of appropriate equipment is also seen as a barrier. Currently, the logistical factors of these interventions are characterized by being mostly deficient and not adapted to the needs of the participants or needing to be provided by the participants themselves, a sector of the population with economic deficiencies. This not only leads to lower participation but also contributes to feelings of insecurity during the activities [36].

On the other hand, there is a notable lack of physical activity programs that include and consider the participation of people with severe mental disorder (SMD) [26]. There is insufficient support from previous physical activity programs that could serve as a reference and motivation for both the organizers and the participants themselves. Thus, participation is diminished, as well as the creation of interventions that consider the inclusion of this population.

### **4. Conclusions**

The review of the literature carried out throughout this work has allowed us to develop the main objective established, which was to identify the benefits reported by the practice of physical activity for people with SMD and the barriers that act as a hindrance to its implementation.

The results obtained reveal that the practice of physical activity in people suffering from some type of SMD has many benefits. It allows for an improvement in physical fitness, whether in terms of anthropometric measurements or physical condition, and facilitates the acquisition of healthy habits, thereby reducing the likelihood of developing diseases related to unhealthy habits, such as smoking or a sedentary lifestyle [37]. This is of great relevance as it aims to reduce certain health risk factors identified by the World Health Organization as the main causes of death from cardiovascular problems, placing it at around 61% of total deaths [38].

In terms of mental health, this also benefits as the practice of physical activity intervenes on psychological problems such as self-esteem, stress, or anxiety. The development of these factors is of great importance as it contributes positively to the improvement of autonomy [39]. This improvement also contributes to the reduction of the symptoms of the disorder, as stated by Stubbs. This reduction in symptomatology could lead to a reduction in the consumption of drugs, together with the benefits of sport on certain health problems derived from the side effects of the medication prescribed for the disorder in question [40].

Other reported benefits are related to social factors. The studies analyzed have found that the practice of physical activity promotes socialization and the development of social relationships, which acts against the usual isolation in this population [41].

Nevertheless, it should be noted that, despite the potential negative impact and recommendations due to the benefits found, people with SMD often do not engage in any type of physical activity [42]. Low adherence is prevalent and needs to be corrected to achieve significant results as regular practice is important [43]. This lack of adherence is due, in part, to the presence of various barriers that need to be addressed. According to those found throughout the literature review, these include personal, social, and program-specific factors.

Regarding the former, the main stumbling block to consider is demotivation toward this practice. This may be related to various factors, such as a low self-concept, fatigue, erroneous beliefs about individual abilities and skills, and even negative emotional influence caused by stress or low mood. These problems are derived from the physical inactivity itself or appear as a consequence of the disorder or as side effects of the pharmacological treatment administered [39, 44, 45].

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

There are also barriers around the physical activity program itself. These lie in logistical factors such as lack of equipment, lack of support from physical activity specialists, and nonstandardized locations, i.e. limitations intrinsic to the facilities in which the activity takes place. These barriers contribute to demotivation due to the difficulties of access that they entail [32].

In terms of social factors, two main ones stand out. On the one hand, the lack of support from the environment and, on the other hand, the problems derived from the healthcare system. In this regard, the lack of training and awareness in this regard both on the part of the immediate environment and healthcare staff stands out [32]. Similarly, the current healthcare system gives greater importance to pharmacological treatment [46], leaving other types of interventions such as physical activity in the background.
