Physiotherapy Meets Cognitive Health: Brain Boosting Through Exercise


As a physiotherapist, your task is to improve the physical health and mobility of your patients. But have you ever thought about how exercise and physical activity can also affect cognitive health?

The impact of exercise on the brain is becoming increasingly clear with advances in research, and it is important for us as healthcare providers to continue our education accordingly.

In this blog article, we will take a closer look at the relationship between physical activity and cognitive health. Additionally, you will receive some valuable tips on how you can help your patients improve their cognitive health by integrating exercise and physical activity into their therapy plans.


Let's take a look at:

  1. What Is Cognitive Health?
  2. What Role Do Exercise and Physical Activity Play?
  3. Practical Applications for Physiotherapists
  4. A Personal Experience Report


1. What Is Cognitive Health?

As professional physiotherapists, it is important for us to not only focus on the physical fitness of our patients, but also their cognitive health.

Cognitive health refers to a person's ability to process, store, and retrieve information. It also includes the ability to make decisions, solve problems, and concentrate. Good cognitive health is essential for a fulfilling and happy life. However, cognitive problems can significantly impact the quality of life for patients.

Some examples of cognitive problems are:

  • Memory loss
  • Difficulty with concentration
  • Reduced ability to learn new information

These problems can lead to difficulties for patients in managing their daily tasks, maintaining social relationships, and performing their work.


How do cognitive problems arise?

There are various factors that can affect cognitive health. Some of the most common causes include:

  1. Aging: As the brain ages, its ability to process, store, and retrieve information decreases. This can lead to memory problems, concentration problems, and an overall decline in cognitive abilities.
  2. Illnesses: Various diseases such as Alzheimer's, Parkinson's, or stroke can impair cognitive health.
  3. Injuries: A head injury or traumatic brain injury can lead to cognitive problems, especially if the brain damage is severe.
  4. Stress and anxiety: Chronic stress and anxiety can impair memory and concentration.
  5. Sleep disorders: Sleep disorders such as sleep apnea2 or insomnia can lead to cognitive problems as the body and brain do not get sufficient rest.

As a physiotherapist, you can support your patients in improving and protecting their cognitive health through exercise. How exactly to do this will be explained later. First, let's take a closer look at how physical activity promotes cognitive health.


2. What Role Do Exercise and Physical Activity Play?

Studies in recent years have repeatedly shown that regular exercise and physical activity play an important role in maintaining cognitive health. One example is the "Physical Exercise as a Preventive or Disease-Modifying Treatment of Dementia and Brain Aging" study published in the Journal of Alzheimer's Disease.

In this study, a meta-analysis of 16 randomized controlled trials was conducted to examine the influence of physical activity on the brain and cognitive functions. The results showed that regular physical activity reduces the risk of cognitive impairment and dementia and improves cognitive performance in older adults.


But how does this work exactly?

More exercise promotes the following three connections:

  • More energy for the brain: Physical activity increases blood flow to the brain, which in turn improves the brain's oxygen and nutrient supply. Better oxygen and nutrient supply is important for the health and function of the brain, as the brain requires a lot of energy to function.
  • Synapse formation: More exercise promotes the release of certain hormones such as growth hormone and Brain-Derived Neurotrophic Factor (BDNF), which stimulate the growth of brain cells and promote the formation of new synapses. These synapses are critical for transmitting information between different brain regions and form the basis of our learning and memory.
  • Less stress hormones: Physical activity can also help reduce stress and anxiety. Stress and anxiety can negatively affect the brain and even lead to cognitive problems. Physical activity can reduce the production of stress hormones such as cortisol and adrenaline, which in turn can help reduce stress and anxiety.


3. Practical Applications for Physiotherapists

Now that we've covered the theory, let's move on to practical implementation. A variety of sports and exercises can help support your patients' cognitive health. Depending on the issue, you can make the following recommendations and adjust the therapy plan accordingly:


Cycling Boosts Brain Power

Regular cycling has a positive impact on cognitive health. A study conducted by the University of Illinois in 2013 examined the effects of cycling on the brain in young adults. Participants cycled regularly for six months, and it was found that gray matter2 in the brain had increased, particularly in regions that are important for attention and processing speed.


Swimming Enhances Memory

Swimming also has positive effects on cognitive health. A study published in the Journal of Science and Medicine in Sport examined the effects of swimming on cognitive function in older adults. Participants were divided into two groups, with one group swimming for 50 minutes three times a week and the other group remaining inactive.

The results showed that the group that swam regularly had a significant improvement in their cognitive functions, especially in the areas of working memory and processing speed. Additionally, the swimming group also showed improved mood compared to the control group.

One possible explanation for these results is that swimming is a complex activity that requires both aerobic and anaerobic energy processes. This may help improve blood flow to the brain and promote the release of neurotrophins, which stimulate the growth of brain cells and the formation of new synapses.


Retro Sports For a Young Brain

Nothing screams the 80s like aerobics. This fitness training combines gymnastics with dance and has been inspiring people for decades. But aerobics not only lifts your mood, it also makes synapses happy.

A study by Erickson et al. (2011) found that older adults who regularly participated in an aerobic training program had an increase in hippocampus3 size of about 2% compared to a control group who did not engage in physical activity. The authors suggested that this increase in hippocampus size could be attributed to improved cognitive function, as the hippocampus plays a crucial role in memory formation and retention.


Balance Exercises

Exercises to improve balance can stimulate the brain by challenging the body's visual and vestibular4 system. They also help the brain form new neural connections, which make the brain more resilient to age-related damage and contribute to maintaining cognitive function.


Strength Training

Strength training can help improve blood flow to the brain, which helps more nutrients and oxygen reach the brain and support cognitive function. Studies have shown that strength training improves cognitive abilities such as working memory, attention, and concentration.


4. A Personal Experience Report


For this article, we sat down with Rainer Vogel. The senior from Hamburg had sought help a few years ago due to memory and reaction problems and unexpectedly found it with his physiotherapist. 


Now he shares his experiences with us:

"I was initially somewhat skeptical that physical exercises could actually contribute to improving my mental health, but I was willing to try anything.

My physiotherapist started with simple exercises to improve my hand-eye coordination and spatial perception. We started with simple ball games, which I found a bit cumbersome at first, but after a few weeks, I already noticed an improvement in my reaction time.

Next, we did exercises to improve my fine motor skills. I was given small objects that I had to hold and move in various combinations and positions. These exercises were challenging, but also very entertaining.

Another important part of our training program was strength training. My physiotherapist explained to me that strengthening my muscles would help my brain get more oxygen. I started with light weights and gradually worked my way up to heavier weights.

In addition to the physical exercises, my physiotherapist also gave me some cognitive exercises that I could do at home. I started with simple memory games and then worked my way up to more complex exercises.

I have been with my physiotherapist for almost two years now and I can already clearly see an improvement in my cognitive abilities. I feel mentally sharper and can concentrate better. My physical health has also improved as I am now stronger and fitter.

Overall, I am very grateful to my physiotherapist for helping me increase my cognitive abilities."



sleep apnea1: Breathing disorder that deprives the brain of enough oxygen; causes multiple arousal events during the night

gray matter2: Important part of the central nervous system that controls all brain functions

hippocampus3: Part of the brain, a relay station of the limbic system

vestibular4: Relating to the sense of balance


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