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",isbn:"978-1-83962-501-5",printIsbn:"978-1-83962-500-8",pdfIsbn:"978-1-83962-502-2",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,hash:"4cbb2249cfca82e925cd46bee62b5b24",bookSignature:"Prof. Bernhard Resch",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/10487.jpg",keywords:"Neonatal Infections, Early Onset Sepsis, Late-Onset Sepsis, Respiratory Tract Infections, Gastrointestinal Infections, Bacterial Meningitis, Viral Meningitis, Encephalitis, Measles, Rotavirus, Varicella, Pneumococcal Invasive Infection",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"November 11th 2020",dateEndSecondStepPublish:"December 9th 2020",dateEndThirdStepPublish:"February 7th 2021",dateEndFourthStepPublish:"April 28th 2021",dateEndFifthStepPublish:"June 27th 2021",remainingDaysToSecondStep:"a month",secondStepPassed:!0,currentStepOfPublishingProcess:3,editedByType:null,kuFlag:!1,biosketch:"Professor of Pediatrics specialized in neonatal intensive care medicine and neonatal infections, deputy head of the Division of Neonatology at Medical University Graz, international well-known clinical researcher, editor, book author, and reviewer for all pediatric high ranking journals.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"66173",title:"Prof.",name:"Bernhard",middleName:null,surname:"Resch",slug:"bernhard-resch",fullName:"Bernhard Resch",profilePictureURL:"https://mts.intechopen.com/storage/users/66173/images/system/66173.png",biography:'Born in Graz, Austria, Prof. Resch received his medical degree at the Karl-Franzens-University Graz in 1988. Following post-doc studies at the Division of Neonatology, and the Department of Pediatric Surgery of the University Hospital Graz, he became consultant of Pediatrics in 1997 and consultant of Neonatal and Pediatric Intensive Care Medicine in 2000. Since 2004, he is Professor of Pediatrics and since 2008, Head of the Research Unit of Neonatal Infectious Diseases and Epidemiology of the Medical University Graz. Since 2012 he is Deputy Head of the Division of Neonatology of the Medical University of Graz. 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From chapter submission and review, to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review, and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. 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Various mental health organizations are engaged in the prevention, treatment and rehabilitation of persons with mental health problems and disorders. Unfortunately, physiotherapy is not always considered to be a significant profession within mental health because the role and the added value it offers can remain unclear among patients and other health care providers. However, physiotherapy is a recognized conventional profession within health care and can offer an extensive range of physical approaches (physical activity, exercise, movement, relaxation techniques and body and movement awareness). These approaches are aimed at symptom relief, the enhancement of self‐confidence and the improvement of quality of life. Additionally, they are relevant to rehabilitation programmes in mental health care.
\nThe goal of this chapter is to present an overview of why physiotherapy in mental health is necessary and what it can offer to fulfil requests for help and to increase the quality of life of persons with mental health problems. It describes physiotherapy methods and their applications in the fields of mental health and psychiatry.
\nMental health refers to cognitive and/or emotional well‐being. More concretely, it refers to how a person thinks, feels and behaves. Mental health can affect daily life, relationships, the ability to enjoy life and even physical health. Mental health involves finding a balance between life activities and efforts to achieve resilience. According to the World Health Organization (WHO) [1], mental health is ‘a state of well‐being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community\'. More concrete mental health includes different components of life; for example, in terms of relationships, having a good relationship with family and having supportive friends, with the ability to talk about feelings. For leisure time it is about having hobbies, doing exercises on regular basis and having regular holidays. Furthermore, it is important to follow a healthy lifestyle that includes, having healthy eating habits, not smoking or drinking and not taking no‐prescribed drugs and at least being able to achieve some goals in life [2]. Mental health is not merely the absence of a mental disorder. It exists on a continuum to include flourishing mental health, very good mental health, mean mental health, decreased mental health, mental health problems and mental health disorders [3].
\nIt is important to distinguish between mental health problems and mental health disorders. A mental health problem is a negative mental experience that is part of everyday life and interferes with emotional and/or social abilities. These problems are less severe than those associated with a mental health disorder. As previously mentioned, persons with mental disorders have a growing imbalance in their abilities. A mental disorder is defined as a syndrome characterized by a clinically significant disturbance in an individual\'s cognition, emotion regulation or behaviour [see Box 1]. It reflects a common or severe dysfunction in the psychological, biological or developmental process underlying mental functioning [4, 5].
\nCommon mental health disorders
\nCommon disorders refer to obsessive‐compulsive and related disorders, trauma and stressor‐related disorders, dissociative disorders, somatic symptom and related disorders, eating disorders, disruptive, impulse‐control and conduct disorders, substance‐related and addictive disorders and neurocognitive disorders
\nSevere mental health disorders: Severe mental disorders include schizophrenia, bipolar disorders, mood disorders.
\nFor the diagnostic criteria see:
\nWorld Health Organization: International classification [5]
\nAmerican Psychiatric Association: diagnostic [4]
One out of four persons might face a mental health disorder at a certain point in their life. Depression, anxiety, post‐traumatic stress disorder and other problems can be triggered by personal and lifestyle pressures such as bereavement, relationship breakdown or job loss. Drug or alcohol dependency, illness or long‐term physical disability can cause depression. This mental health disorder is the fourth most significant cause of disability worldwide.
\nMental health problems/disorders often begin with the thoughts and beliefs related to a (physical or mental) problem. These thoughts and beliefs are the source of emotions and feelings that act as a driver of actions/behaviours. Behaviours are a choice and have consequences at some point.
\nThe importance of the implementation of physiotherapy in both common and severe mental health disorders and psychiatry is underestimated, even if there is a tradition of more than 50 years in some countries (Belgium, Scandinavia, etc.), even if the attention to ‘the moving body’ increases in society and even if the moving body is an important issue that is integral to psychopathology. To overcome this problem, physiotherapists who were working in mental health and psychiatry applied in 2011 for recognition as a subgroup within the World Confederation of Physical Therapy [6]. The main goal of this subgroup is to bring the different physiotherapy interventions in mental health and psychiatry together to clarify the role of physiotherapy in this field. For that reason, the International Organization of Physical Therapy in Mental Health (IOPTMH) [7, 8] adapted the recommendations of the WHO [1] concerning mental health care using physiotherapy language (see Box 2).
\nTo improve [physiotherapy] mental health care
To organize specific [physiotherapy] care for different ages including children, adolescents and elderly and risk‐related groups as persons with eating disorders, psychotic disorders, etc.
To ensure access to primary [physiotherapy] care for people with mental health problems
To provide treatment in ‘community‐based [physiotherapy] services for persons with severe mental health problems.
[adaptation]
Not all physiotherapists realize that mental health is all the business of physiotherapy. However, it is well illustrated in the following quotation: ‘no health without mental health\'.
\nAs health care providers, physiotherapists are also involved in the prevention and promotion of health, including mental health. It is their responsibility to inform individuals adequately about mental health, eliminate misconceptions about mental illness and refer them when necessary to specialized professionals in mental health and psychiatry.
\nConsciously or unconsciously, colleagues will be confronted in their practice with individuals with frail mental health, chronic musculoskeletal disorders, chronic pain and psychosomatic disorders. In their stories, components of mental health are interwoven, and the patients deserve an appropriate physiotherapy intervention. In addition to these conditions, more severe physical diseases such as cardiovascular diseases, Parkinson\'s disease, rheumatoid arthritis, hypertension, Diabetes mellitus, metabolic syndrome, asthma, asthma/chronic obstructive pulmonary disorder (COPD), cerebrovascular diseases (stroke), obesity, epilepsy, cancer and other diseases are frequently accompanied with a ‘rollercoaster’ of emotions, feelings of anxiety and pain. After all, individuals with mental disorders have numerous physical health complaints (cardiovascular diseases, metabolic syndrome, obesity, osteoporosis, etc.) due to medication, sedentary behaviour or inactivity and consult primary health services.
\nIn summary, it all adds up for the health care providers to optimize access to physiotherapy for people with mental illness, give them the most appropriate treatment [9] and give additional thought to the mental health dimension of their patients’ physical conditions [10].
\nIn some countries, physiotherapists have a long tradition of using physiotherapy in mental health and developed specific approaches for common and severe disorders aimed at improving the quality of daily life. It is time to bring all the knowledge together to consolidate it and centralize the interventions with a view to offer appropriate care to a specific vulnerable but growing group in society. For these persons, specific interview, assessment and therapeutic skills are necessary. The interview is based on the principles of the bio‐psychosocial and motivational interview [11]. The story, including the context, life events and chronic stressors in relation to the health of each patient, is mapped. The assessment focuses on lifestyle in relation to the health, mood and anxiety features, illness behaviour and psychological well‐being.
\nThe IOPTMH developed a definition that generally describes the field of physiotherapy in mental health that is recognizable among most colleagues across the world. Physiotherapy in mental health is a specialty within physiotherapy. It is implemented in different health and mental health settings: psychiatry and psychosomatic medicine. It is Person-centered and provided for children, adolescents, adults and older people with common (mild, moderate) and severe, acute and chronic mental health problems, in primary and community care, inpatients and outpatients. Physiotherapists in mental health provide health promotion, preventive health care, treatment and rehabilitation for individuals, groups and in‐group therapeutic settings. They create a therapeutic relationship to provide assessment and services specifically related to the complexity of mental health within a supportive environment applying a model including biological and psychosocial aspects. Physiotherapy in mental health aims to optimize well‐being and empower the individual by promoting functional movement, movement awareness, physical activity and exercises, bringing together physical and mental aspects. It is based on the available scientific and best clinical evidence. Physiotherapists in mental health contribute to the multidisciplinary team and inter‐professional care [12, 13].
\nDepending upon the problem, the story of the patient, and the results of the observation/evaluation, the patient’s treatment goals will be established, and the physiotherapist can choose a more health-related approach or psychotherapeutic physiotherapy (see Figure 1). The physical health‐related approach aims to improve the global physical health of patients with psychiatric disorders. Physical activity can help to reduce cardiovascular disease and premature mortality in people with psychological problems. The psychosocial‐related approach emphasizes the acquisition of mental and physical proficiencies related to the body in motion and support of personal development to enhance people\'s ability to function independently in society. The psychotherapeutic‐related approach uses the body in movement as a gateway to ameliorate the social affective functioning of an individual. When using this approach, the physiotherapist creates a setting that favours the initiation and development of a process in the patient by employing specific working methods that aim to help patients to access their inner workings.
\nThe scope of physiotherapy in mental health.
In physiotherapy in mental health, a rationale for applying psychological models (e.g. cognitive behavioural therapy, acceptance and commitment therapy, etc.) is offered as a tool to strengthen physiotherapy interventions in the treatment of a wide variety of disorders in children, adolescents, adults and the elderly. The cognitive behavioural physiotherapy treatment approach consists of the identification of current and specific problems related to the moving human being. The physiotherapy goals are based on the SMART principles (Specific, measurable, acceptable/attainable, realistic/relevant and time bound). The treatment is I think it is patient-centered and the ultimate physiotherapy goal is to change unhealthy habits and promoting an active lifestyle and healthy posture. The focus lays on self‐management and relapse prevention. Different modalities (see Figure 2) such as cognitive techniques (cognitive restructuring, problem solving and cognitive functional training), behavioural (relaxation, pacing and graded exercise therapy and behavioural activation), supportive, educational and other techniques such as (bio‐) feedback, movement and body awareness and relapse prevention for children and adults are integrated into this treatment [14]. The acceptance and commitment physiotherapy approach is supporting the patient to clarify his/her values and helping them to take the necessary steps towards living a meaningful life despite the discomfort [15].
\nCognitive behavioural techniques in physiotherapy.
The physical health‐related approach aims to improve the global physical health of the person with mental health problems. Studies have shown that people with mental health problems are more susceptible to inactivity and are at risk of a sedentary lifestyle. In addition, the use of psychotropic drugs can result in the development of metabolic syndrome, obesity, osteoporosis and cardiovascular disease. The physical health‐related approach is consistent with the recent recommendations of the World Health Organization (WHO) about the relationship between individuals’ ‘physical inactivity’ and poor health and a serious threat to their quality of life [16].
\nClinical practice has highlighted the importance of tailoring physical activity to each person\'s individual abilities to influence the quality of life. The challenge is to motivate people to stay active throughout their daily life. People who do not continue to exercise lose their independence and do not maximize their potential in life. The American College of Sport Sciences [17, 18] offers guidelines. It is the task of the physiotherapist to integrate and adapt these guidelines to fit the context of a person with mental health problems [19–22].
\nThe psychosocial‐related approach emphasizes the acquisition of mental and physical skills related to the ‘moving body’ and support of people\'s ability to function independently in society and to improve their quality of life. The activities aim at learning, acquiring and training psychomotor, sensomotor, perceptual, cognitive, social and emotional proficiencies. Other elementary proficiencies are stressed, such as relaxation education, relaxation skills, stress management, breathing techniques, psychomotor and sensory skills and also cognitive, expression and social skills. Through exercises, patients acquire a broader perspective and can experience their own abilities. Moreover, the learning of the basic rules of communication is integrated [23]. The psychophysiological approach involves the use of physical activity to influence mental health problems such as in the treatment of depression and anxiety disorders [24–34]. In the literature, the benefits of physical activity for mental health are well accepted. Physical activity has a positive influence on mental well‐being, self‐esteem, mood and executive functioning. Through these effects, a downward spiral that leads to dejection can be stopped. Well‐balanced and regularly executed endurance activities (walking, biking, jogging and swimming) power training (fitness training) and mindfulness‐derived exercises) augment physical and mental resilience; improve the quality of sleep; enhance self‐confidence, energy, endurance and relaxation; and, in general, decrease physical complaints.
\nThe psychotherapeutic‐oriented physiotherapy approach uses the motor domain as a gateway to ameliorate social affective functioning. This approach puts less emphasis on the acquisition of skills but more on the awareness of psychosocial functioning and facilitating a process of change. Using movement activities, the physiotherapist creates a setting that favours the initiation and development of a process aimed at helping patients to gain greater insight into their own functioning. During these activities, patients are invited to venture outside their comfort zone, think outside the box, experience new things, become more in touch with their inner self and cope with numerous emotions (depressive feelings, fear, guilt, anger, stress, feelings of unease, estrangement and dissatisfaction) and negative thoughts (intrusion, obsession, morbid preoccupations and worrying). Moreover, they are confronted with their behaviour (i.e. impulses and lack of abilities) or cognitive symptoms (i.e. derealisation and lack of concentration). Through psychomotor therapy, an alternative perspective on experiences can be proposed. Experiencing the possibility that an alternative may exist triggers new emotions and experiences, and a discrepancy between reality and the patient\'s perception of reality emerges. Consequently, it is important to note that it is not the physical activity itself but the patient\'s experiences and inner perception that play the central role. The careful guidance and encouragement of the physiotherapist and the opportunity to experience feelings in a safe environment allow the patient to develop behaviour, which would not have developed otherwise. Although the underlying problems are not necessarily resolved, the therapist tries to improve problem management of the patient. The patient shares his behaviour, feelings, and thoughts with the therapist initially and, eventually, with his peers. More emphasis is placed on experiences and how reactions to these experiences function as a dynamic source of power [23].
\nPhysiotherapy is a specialized field in health care and is recognized as a conventional therapy. Physiotherapists who work in mental health are physiotherapists first and use interventions within the scope of general physiotherapy. In addition, due to the complex situation, physiotherapists who work in mental health require supplementary knowledge (e.g. psychopathology and psychological frames) and specific skills and competences (e.g. communication) to assess, treat, support and refer people with mental disorders effectively (see Figure 3).
\nOverview of physiotherapy interventions in mental health.
Psychomotor therapy is a type of body‐oriented therapy. The cornerstones of this approach are body awareness, movement and physical activities. However, psychomotor therapy encompasses ‘movement’ or ‘physical activity’ in a strict sense. It is based on the holistic view and, therefore, integrates cognitive, emotional, social and motor aspects into an individual\'s development. The starting point is a strong acknowledgement of the continuous and complex interactions between the different developmental domains. Moreover, the functioning of a child is not only always integrated into but also dependent upon a certain context [35]. Psychomotor therapy is offered in different disciplines, including mental health care, child psychiatry, youth care, special education and rehabilitation, as well as private practice. The wide variety of psychomotor therapy interventions can be categorized into two main areas: psychomotor functional training and psychotherapeutic‐oriented psychomotor therapy [35]. Although both approaches are aimed at supporting and aiding a child\'s personal development, the methods can be distinguished based upon the primary focus of the intervention. Psychomotor functional training is primarily aimed at improving the motor domain and includes activities that are aimed at learning, developing, practicing and training (psycho) motor, sensorimotor and perceptual abilities. In psychotherapeutic‐oriented psychomotor therapy, the motor domain is employed as a gateway to ameliorate the social and affective development of individual functioning. More concretely, specific goals are formulated such as learning to recognize bodily signals, regulate aggression, play cooperatively, enhance self‐confidence, reduce social anxiety, etc. The techniques that are employed include relaxation techniques [36], Sherborne Developmental Movement [37], movement and play situations, psychomotor family therapy [38, 39], physical activity, etc.
\nThe roots of Norwegian psychomotor physiotherapy began in the early 1950s and were the result of a collaboration between Trygve Braatøy, a psychoanalytically trained psychiatrist, and Aadel Bülow‐Hansen, an orthopaedic physiotherapist [40–42]. In addition to its focus on how the past continues to influence the present, the psychoanalytic approach develops the client\'s awareness of what can be done to correct the harmful effects of the past [43]. Indications for this physiotherapy approach are conditions associated with strain and functional disturbances in the musculoskeletal system as well as psychosomatic disorders. Symptoms are viewed as an expression of a disturbance in posture, respiration, muscle tension or autonomic functions, which are often related to emotional conflicts or mental problems [44]. In Norwegian psychomotor physiotherapy, the case report and the examination are central to documenting and evaluating respiration, posture, function, muscles and other soft tissues as well as automatic functions and reactions. The patient\'s body and self‐awareness are taken into consideration. These awareness concepts are based on the philosophy of phenomenology. The major finding of Braatøy and Bülow‐Hansen was that the entire body needs to be examined and treated instead of using a local approach. The basis of the examination is the whole person, and the key is the body [44]. Relaxation treatment has yielded limited results, unless breathing is taken into consideration. Although breathing is an important cornerstone of the approach, breathing exercises are seldom used. The observation of how the patient breathes during massage and exercise is a guideline for the level of intensity of the therapy [45], allowing the therapist to adjust continually to the patient\'s reactions [44, 46]. Breathing and feelings are considered to be interdependent factors. The body is approached as an integrated physical‐psychological phenomenon [44]. Changes in breathing could be a signal that the patient is reacting emotionally [44]. The patient\'s reaction to the examination also provides important information. In Norwegian psychomotor physiotherapy, the emphasis is on respiration because breathing can be viewed in relation to emotion and cognition. At the same time, breathing can contribute to the reduction of somatic disorders in stress‐related and/or psychosomatic disorders [47]. In summary, Norwegian psychomotor physiotherapy aims to release respiration through an interaction among breathing, the musculoskeletal system and emotions [44] and to develop flexibility, versatility and the stability of the person [48]. The treatment is successful when a process of bodily changes is not separated from emotional changes [48–50]. A treatment session is mostly individual in nature and may be short, being composed of active exercises in standing, sitting or lying positions only, or it may be long, consisting of massage of the recumbent body only [49, 50].
\nRelaxation as a therapeutic intervention is recommended in the treatment of stress and stress‐related problems. The term relaxation therapy is used to describe a number of techniques that promote stress and anxiety reduction by decreasing tension throughout the body and creating a peaceful state of mind [51]. This valued therapeutic approach is frequently used in mental health care, and physiotherapists in mental health care apply relaxation training as one of their interventions. Relaxation is used as prevention (to protect the body), as a treatment (for instance, to relieve stress in individuals with hypertension, tension headache, insomnia and panic) or as a coping skill (to relax the mind and to promote clear and effective thinking). Relaxation therapy consists of three phases: (1) to learn the relaxation technique, (2) to evaluate if there is a relaxation response (physiological and psychological) after some training session, and (3) in the third phase and when the technique becomes automatic, to use relaxation in situations that induce stress. Although there are different techniques [52, 53], physiotherapists have primarily used the modified Jacobson\'s progressive relaxation method by Bernstein and Borkovec [54–56], applied relaxation of Öst [57], Mitchell method [58] and autogenic training [59].
\nYoga, Tai Chi, mindfulness‐related exercises and Pilates are also used to cope with stressful situations.
\nThe mindfulness‐based stress reduction (MBSR) program, which is centred on the principles and practice of mindfulness meditation and the use of stress‐reduction skills, including sitting meditation, hatha yoga and a somatically focused technique called a ‘body scan’, which was developed to relieve suffering in patients with chronic pain [60, 61]. MBSR encourages the non‐judgemental awareness of one\'s cognitive and somatic experiences on a moment‐by‐moment basis. This decentred stance is thought to disconnect cognitive and affective mental events in an adaptive manner and might reduce the negative impact of thoughts and sensations that are associated with chronic pain [60, 61].
\nTai Chi has been practiced for centuries as a Chinese martial art that combines meditation, postures, slow and graceful movements, diaphragmatic breathing and relaxation. It can be regarded as an intervention that integrates physical, psychosocial, emotional, spiritual and behavioural elements and promotes mind‐body interaction [62, 63].
\nQi Gong (QG) is an ancient Chinese method that integrates body, energetic, respiratory and mental training with the aim of achieving optimal status of both the mind and the body. QG enhances physical, psychic and emotional rebalancing, thereby improving posture, respiration and concentration by low‐impact movements [64].
\nYoga is an mind-body therapy (MBT) that potentially fulfils the need for both exercise and coping skills in fibromyalgia syndrome (FMS) patients. Yoga varies greatly in terms of style and, beyond the physical poses that are identified with it, comprises meditation and breathing exercises [65–71].
\nThe Pilates method, which was developed in the 1920s by J. H. Pilates (Germany, 1880–1967), is a low‐impact, non‐aerobic fitness programme (stretching and strengthening exercises) that also integrates physiotherapy [72]. The original exercises were influenced by the two gymnastic systems that dominated rehabilitation at that moment, namely the German (Friedrich Jahn) and the Swedish (Per Hendrik Ling) systems. Pilates became a form of movement that combines characteristics of Eastern (mind control during exercises, relaxation, increasing of elasticity, movement starting from body centre and balance) and Western (forming strength, endurance and exercises with both global and local effects) systems. Today, the applied form of Pilates has been influenced by other mind‐body methods. Additionally, it involves not only the recovery of muscle strength and flexibility but also the correction of muscle imbalance and attention to body awareness, economical breathing, and neuromuscular coordination by executing fluent and precise movement. Pilates can lead to balancing of the body and the mind [72–75].
\nIn some countries, the Mensendieck system [76] and the Feldenkrais method [77, 78] are integrated into the physiotherapy in mental health. They are seen as educational approaches, rather than interventions. The Mensendieck system focuses on teaching patients to understand the concepts of bodily functioning using pedagogically designed exercises and aims to enable them to change suboptimal patterns of movement. The Feldenkrais method is a somatic educational system that was designed to improve the movement repertoire, aiming to expand and refine the use of the self through awareness to reduce pain or limitations in movement and promote general well‐being [77, 78].
\nPsychomotor physiotherapy for severe mental health problems is a method of treatment that uses systematically a wide variety of (adapted) physical activities as well as movement, body and sensory awareness to stimulate and to integrate motor, cognitive and affective competences within the psychosocial context. This approach aims to realize clearly formulated consent goals, which are relevant to the patient\'s mental health problems (depression, anxiety, schizophrenia, autism, eating disorder, etc.). This approach is based on evidence‐based research and 50 years of clinical practice. Today, it is an important standard adjunctive treatment for patients in residential treatment to optimize movement as well as the cognitive, affective and relational aspects of mind‐body functioning (i.e. the relationships between physical movements and cognitive and social‐affective aspects). The approach focuses on the somatic effects of physical activity and the physio‐psychological effects as the core of the treatment. The goal is to stimulate a positive self‐image and personal well‐being in a balanced social relationship using movement activities. This approach is well described in inpatient settings as a different group approach and can be imbedded within diverse psychotherapy settings. On the one hand, the focus is on discovering the present healthy capabilities of the subject (‘care\') using the moving body as the core to influence psychological, social and somatic functioning. On the other hand, the physiotherapy addresses the dysfunctional part of the subject. Depending upon the goals and the competence level of the patient, the therapist can choose among a more health‐related approach (to improve physical activity and to limit sedentary behaviour), a more psychosocial‐related approach (to learn skills that are not only physical but also cognitive and communicative) or a more psychotherapeutic‐related approach (to stimulate the patient to get in touch with his or her inner world). When persons with mental health problems are invited to (group) physical activities, they come out from their comfort zone and experience how they function. The combination of experience and insight drives changes and leads to new experiences. Specific approaches for eating disorders [78–83], schizophrenia [84–91], mood disorders [92–97] and depression and anxiety [23, 32–34] are developed.
\nBody awareness is a term that is frequently used in mental health and psychiatry. It refers to the ability to pay attention to ourselves and feel our sensations and movements online, along with the motivational and emotional feelings that accompany them in the present moment, without the mediating influence of judgemental thoughts [98].
\nBody awareness is the subjective, phenomenological aspect of proprioception and interoception that enters conscious awareness and is modifiable by mental processes, including attention, interpretation appraisal, beliefs, memories, as well as conditioned attitudes and effect [99]. Different approaches, including those within physiotherapy and beyond, reportedly enhance body awareness (yoga, Tai Chi, mindfulness‐based therapies, the Feldenkrais method, the Alexander method, different breathing therapies, etc.). Body awareness has become an umbrella term for different approaches. One such approach in physiotherapy is basic body awareness therapy [100].
\nBasic body awareness therapy was inspired by the French movement educator and psychotherapist J. Dropsy and further elaborated by Roxendal. The basic body awareness methodology (BBAM) is a Person-centered physiotherapeutic movement awareness training programme that is directed towards daily life movement [100–111]. It is used in multiple clinical settings, including primary health care, pain rehabilitation and psychiatric physical therapy, as well as in health promotion.
\nIt is founded upon a three‐dimensional approach to human movement: learning about and through movement and learning while being in movement [107]. Movement awareness in this methodology is defined as the sensitivity to movement nuances, awareness of one\'s own movements in relation to space, time and energy and identification of subtle movement reactions to internal and environmental conditions [100, 107]. Persons who are not aware or who have a lack of contact with the physical body and the emotional body (internal life) and who are not aware of the physical environment and their relationship to other people and persons who are cut off from reality, express this lack of awareness throughout their body. This can be observed as dysfunctional movements, for instance, movements that lack vitality, flow, rhythm and unity [100–102, 104–105]. From a broader perspective, the lack of awareness has negative consequences on movement quality, daily function, habits and health [100]. The phenomenological concepts of the body awareness methodology are relaxation, tension regulation, body contact, body consciousness, body image, body experience, body boundaries, body control, muscle consciousness, muscle control, body awareness and postural attunement [100, 111]. In general, body awareness combines a series of exercises that are related to posture, coordination, free breathing and awareness. Attending to both the patient\'s own performance and to the patient\'s experience during the exercises is a central element of body awareness that stimulates mental presence and awareness that aims to provide increased body consciousness. BBAT offers training situations that focus on healthy movement aspects, lying, sitting, walking, running, using the voice, relational movements and massage [105]. Embodied and mindful presence, awareness and movement quality represent keys to the therapeutic approach. Therapeutically, being in movement, exploring, experiencing, integrating, mastering and reflecting upon one\'s own movement coordination are critical to gaining more functional movement, strengthening the self and preparing for daily life [108]. It offers a strategy to equip the person to handle life more effectively. It is used in individual therapy but is foremost a group treatment. [100, 111]. Body awareness therapy refers to a group of movement awareness interventions that share a common perspective that focuses on the internal subjective experience of the body to promote physical, mental and emotional well‐being [110, 111].
\nThe psychosomatic approach differs from the somatic approach. The somatic approach involves the cells of the body and is based on the physical and biological aspects of the problem. The somatic approach is the traditional approach and usually addresses the symptoms of the problem. Psychosomatic means that a physical condition is caused or greatly influenced by psychological factors. The psychosomatic approach views illness as a form of communication between the conscious and the unconscious mind through the body. Illness is a person\'s way of adapting to the environment. It is a message that communicates a need for change. Based on the patient\'s perception, illness is consciously or unconsciously a legitimate way to avoid something unpleasant. Illness can be a subconscious defence mechanism. There are numerous situations that people would rather avoid than confront. The benefits of the illness are that they receive more attention, love and warmth from family members or friends when they are sick. Some patients are confronted with existential questions, including those relating to the purpose of life. Unable to answer these questions, some people turn their illness into their purpose in life. Everything begins to revolve around it. The scope of psychosomatic physiotherapy is broad, including the treatment of physical symptoms such as pain, fatigue, hyperventilation and distress in relation to psychosocial problems. Somatic symptoms and related disorders [4] are another category of illnesses that primarily are treated within psychosomatic physiotherapy. Medically unexplained symptoms are also categorized under this umbrella term. In all these cases, the therapist explores the relationships among social, psychological and behavioural factors with bodily processes and quality of life. It is obvious that the therapeutic relationship has an important role [112]. During this exploration, the patient is given the space to reflect on behavioural experiences and perceptions in a developmental process that focuses on the integration of thoughts, emotions and actions in relation to motor performance. With an awareness of the importance of addressing the physical complaint, the psychosomatic physiotherapist focuses specifically on the psychophysiological and behavioural characteristics of the client\'s motor performance‐related problem. The aim is to recognize and gain insight into the complex relationship between motor and psychological performance within a psychosocial context and positively influence disrupted internal and external regulation mechanisms. The psychosomatic‐oriented physiotherapist is inspired by cognitive behavioural interventions (see Figure 2) [113, 114], including graded activity and active pacing therapy. The therapist uses a number of specific awareness‐raising methods such as relaxation techniques, breathing and communication methods, (bio‐) feedback, problem solving strategies and stress management. The status of the patient is observed using the ‘SCEGS model’ (soma, cognitions, emotions, behaviour and social environment). Treatment objectives are formulated in terms of the SMART criteria. The relationships among the need for help as expressed by the patient, body language, body posture, movement and gestures are explored. In addition, verbal language is analysed. The balance between supporting load and supporting strength, tension and relaxation, and body and illness perception and reality is explored during the sessions.
\nMental health problems are the leading predictor of years lived with disability worldwide. Furthermore, without more intensified prevention and management, the burden is estimated to increase to a greater extent [115]. The consequences of mental health problems are devastating for the person and society as a whole and are compounded by physical health comorbidities with which most people with mental health problems are confronted [115, 116]. Physical health comorbidities are a major cause of the reduced life expectancy of 15–20 years in this population [118–120]. The relationship between mental health and physical activity is supported by a growing number of articles [92]. There is rigorous evidence now that physiotherapy improves mental and physical health in this vulnerable population [121]. Unfortunately, these efforts are becoming integrated into clinical practice at a slow pace. Physical activity is not always considered to be a worthwhile strategy. The benefits of physical activity are twofold, as people with mental health problems are also at an increased risk of a range of physical health problems, including cardiovascular diseases, endocrine disorders and obesity [115–124]. Physical activity influences cognition [122] and cardiorespiratory fitness [123] and reduces dropout [121] due to a wide range of mental health problems. The relationship between physical activity and mental health has been widely investigated. The health benefits of regular exercise are improved cardiovascular fitness, improved sleep, better endurance, a positive influence on metabolic syndrome and diabetes, stress relief, improved mood, increased energy and reduced tiredness. Exercise reduces anxiety, depression, negative mood and social isolation and improves self‐esteem, cognitive functions and quality of life [115–124].
\nOld age psychiatry consists of two groups: dementia syndrome ( Alzheimer, frontotemporal degeneration, vascular dementia) and functional psychiatric disorders (depression, addiction, mood disorders, personality disorders and schizophrenia). Elderly people experience declining physical activity levels and functional capabilities, loss of dependence, decreasing social contacts, increasing problems with mental health, loss of adaptive capabilities and quality of life. The most frequently observed characteristics in old age psychiatry are apathy ( lack of motivation and interest), depression (fear, hopelessness, sad, low self‐esteem, guilty,etc.), aggression (aggressive resistance, verbal and physical aggression), psychomotor agitation (aimless walking, pacing up and down, restlessness, repetitive actions and sleep disorders) and psychotic features (illusions, false identifications and hallucinations) [4].
\nExercise helps to improve general daily activity, cognition and independency; increase cardiorespiratory fitness, strength and balance; reduce osteoporosis, sarcopenia, falls and risk factors for falls; increase quality of life and social activities; and reduce social isolation, loneliness, fear and institutionalization [125–127].
\nToday, there is a professional need in society for a physiotherapeutic approach to treat people who are suffering from chronic musculoskeletal and mental health problems. The general aims of physiotherapy in mental health are summarized in Box 3.
\n“Promoting, advising, teaching, warning, motivating maintaining, working, treating, assessing”
\nTo promote human well‐being and autonomy in people with physical health needs that are associated with a mental illness or learning disability and/or to use physical approaches safely to influence mental health.
\nTo offer advice on the prevention of stress and physical problems as well as quality‐improvement techniques.
\nTo teach on topics relating to exercise, relaxation and communication.
\nTo warn people about the side effects and to advise people on the use of quality‐improvement techniques.
\nTo motivate people to engage in healthy living habits.
\nTo maintain (or to regain) physical mental and social skills to preserve the ability to function and the quality of life.
\nTo work with the senses and motor skills of children with bodily and behavioural difficulties.
\nTo treat physical and psychosomatic problems.
\nTo assesstreatment effectiveness and patient satisfaction.
In contrast to other fields in medicine, mental health consists of a labyrinth of conventional, complementary and alternative therapies and approaches [128]. A person with fluctuating mental health is more receptive to alternative approaches. Conventional health caregivers have to guide the patient in the search for optimal help. For that reason, physiotherapy interventions in mental health should at least satisfy four criteria. The nature of the interventions should be described clearly. The claimed benefits of the services must be stated explicitly. These benefits must be scientifically validated. Individual effects that might outweigh the benefits must be ruled out empirically. Collaboration and connections with other mental health care specialists within and outside physiotherapy are necessary to broaden the field of physiotherapy in mental health (see Box 3), avoid isolation, build a quality framework and cope with future challenges. In mental health care, boundaries between specialities have become increasingly more blurred. Intensive specialization of physiotherapy has been called into question. The demands to collaborate at the interdisciplinary (i.e. mutual contact between care providers) and transdisciplinary (various caregivers are at each other\'s domain) levels have increased. The inclusion of ideas from the social sciences and humanities in mental health care has become increasingly more important [129]. In the future, therapists will need to obtain informed consent for each treatment. Each therapist will need to explain that the proposed method has value for the patient and provide information about what, why, where, when and how he or she will proceed and what the potential outcomes are. Dialogue with the patient is important for the outcome and patient satisfaction. By definition, interventions in mental health are complex, given the nature of mental health and illness. Physiotherapists who work in mental health are well‐trained therapists with knowledge of mental health (allegiance to theory) and motivation skills and have empathy (therapist‐client alliance). The quality of the therapeutic relationship or alliance is important for the outcome of the physiotherapy treatment. Interventions require careful planning and sufficient resources to implement the programme as planned. Interventions are individually adapted according to the individual\'s psychophysical functioning, needs and wishes. The source of the most advanced knowledge of physiotherapy in mental health is a combination of scientifically derived knowledge and knowledge gained through years of experience (professional practice) (see Box 3). The different physiotherapy approaches are cost‐effective and secure. Furthermore, they do not have side effects. They involve the patient and provide practical skills and insight for use in daily life. After a physiotherapy observational and/or evaluation assessment, the approaches focus on functional and (mental) health promotion. The patient\'s voice becomes increasingly more important. This chapter provides additional insight into why physiotherapy education needs to give more attention to the field of mental health in the curriculum. Currently, from the patient perspective, it is not acceptable for physiotherapists, as health care providers, to not have any or have limited courses on mental health during their education. Many excellent colleagues in primary care are not well prepared to work with persons with mental health, not because of their illness but because of their lack of information on how to address the illness.
\nThe general description of a net zero energy building that can be found in the documentation is: “Net Zero Energy Building (NZEB) is a residential or industrial building with substantially decreased energy needs by productivity improvements, so that the balance of power requirements can be provided by sustainable technology.” Even so, the researchers note that the “absolute zero energy structure” can be described in many forms, both on the parameter and the standard [1]. This description showed that energy conservation would be one of the techniques to achieve a net zero energy building output. The need for energy efficiency methods in NZEBs was already highlighted in several research sources. For example references of [2]. Focus were put on the preference for power conservation in the development of the NZEB and established the principle: ‘first take up demand, then supply,’ which implies that, in attempt to reach a net zero energy balance in buildings, it is important, first, to reduce power usage and power losses by energy conservation steps, lighting, ventilation, passive solar energy, high-efficiency appliances, thermal comfort, passive cooling, etc., instead and then using green electricity options to fulfill the energy requirements of buildings. Energy efficiency usually provides cost effective solutions for lowering electricity demand that significantly reduces the scale and thus the expense of the clean energy systems required and associated distributed technology [3].
This chapter aims to analyze synergy among power efficiency and on-site solar energy supply to move toward certain net zero energy quality. The results are taken based on the creation of the Building Integrated Solar Power System and the evidence from two other well-known field researches. The purpose of this study is to demonstrate that energy conservation and sustainable energy production are inseparable solutions and that the inadequacy of each of them has an enraging effect on the ability to reach a net zero energy target.
Energy modeling is commonly used to estimate future energy consumption or the production of electricity in various industries. Two main types are generally reported in the literature: top-down and bottom-up [3]. Top-down methods utilize collated macroeconomic variables, including historical patterns, to create large-scale relationships between sectors in the economy [4]. The bottom-up studies depend on forecasts focusing on comprehensive technical and cost details from different sub-sectors, reflecting the total energy use of a nation or segment of the market [5]. Although bottom-up methods usually have even more comprehensive and consistent outcomes, the exposure and processing of disaggregated data needed for these models are sometimes tricky and often impossible.
Some studies develop the findings of a regional bottom-up approach that enables energy simulation of building energy usage and on-site solar energy generation with GIS techniques utilizing a variety of geographic information systems (GIS) techniques. GIS platform provides a broad range of methods for capturing, processing, extracting, and visually presenting geographically related results.
This modeling exercise’s principal goal is to measure the full feasible hypothetical technological ability of building-integrated solar energy to satisfy the building energy needs and achieve a net zero value of building energy efficiency. The model assumes significant technical (and policy) advances to realize this solar energy promise by 2025. The simulation method, which is discussed in this article, consists of 3 key steps in tandem with various data sources. Although the author’s BISE design is the key empirical tool for the findings provided in this section, the other two key components include only some of the data required to draw application provides and are thus defined in far less depth in this study. The mathematical descriptions of such models can be derived from the references seen in Figures 2 and 3. BISE method estimates the capacity for building-integrated solar energy supply, together with the findings on building energy usage from 3CSEP-HEB and BUENAS simulations, providing the ability to draw insights as to how much of these energy requirements can be fulfilled by solar energy in various regions and building styles.
3CSEP model of the HEB was established by the team of researchers (including the author of this chapter) at the Tarbiat Modares University to estimate the future usage of thermal energy building between 2015 and 2050 under a variety of policy-driven scenario. The design’s central concept is a performance-based method for building energy consumption research, which views the buildings as a comprehensive structure rather than a collection of individual operating systems. In this method, the input variables of the main model has been the actual final energy efficiency of ideal houses (for each field, weather region, building size, vintage house) per square meter of its floor space obtained by the team of researchers from a variety of different sources recorded in [5]. Some rather building energy intensity levels are then compounded by the corresponding building floor space figures to measure the total energy usage independently for space heating, cooling and heat water in various countries, temperature zones, based treatment and vintages. That floor space has a different measurement formula for industrial and residential buildings that considers typical development activities such as relocation, reconstruction, and new growth, guided by demographic trends and economic growth shifts. This model integrates three scenarios, that imply specific levels of policy commitment in the area of energy performance construction and, accordingly, varying types of buildings energy efficiency in the national housing stock:
The deep capacity paradigm presupposes an aggressive expansion of quality standards in energy conservation in buildings globally. Building energy efficiency is at the standard of passive design energy output (15–30 kilowatt hour/sqm for air conditioning based on the location).
Strong performance scenario is poor continuity of current government patterns and small developments in energy quality construction in some developing countries. Built energy efficiency is at the standard of local building codes (100–200 kilowatt hour/sqm for air conditioning systems based on the location).
Cold performance scenario suggests that the existing state of energy performance in buildings would stay constant throughout the studied span without implementing new policy tools or technical changes relevant to energy efficiency and conservation.
An in depth scenario has been used mainly to study the net zero energy building capacity because it implies substantial increase in power quality required to meet the NZE purpose. The effects of the energy usage from such a scenario are further compared to the projections of the BISE method’s built in solar power capacity, as mentioned following.
The BUENAS model presents the conclusion for energy usage in applications and illumination in the construction industry in order, which along with the findings of the heat energy use of such a 3CSEP-HEB method, render it possible to quantify the overall energy consumption in buildings.
Lawrence Berkeley National Lab (LBNL) has established the BUENAS model for the end-use energy market scenario in the United States. This plan was sponsored by the Joint Marking of three Association Department.
This model approach produces outcomes for more than ten countries and the European Union with 27 members as a common area, including different energy-consuming goods (excluding appliances, such as TVs, laptops, etc.) in the domestic, commercial and industrial markets. The energy consumption prediction approach in BUENAS is focused on three main factors:
Two main scenarios mean the differences between the two models: Business as usual and best practice scenario. Under its scenario, energy consumption development is guided by market behavior and intensity. At the same time performance, is “frozen”, the BP case focuses on catching future impacts of improvement-related policies, predicting that all governments can reach aggressive output goals by 2015. Standards will also have strengthened in 2020, ensuring whether the same degree of progress is attained in 2020 as in 2015 or which a particular goal, known as the new “best possible technology,” is met by 2020.
The author of this chapter, which considers different geographic, structural, morphological and climate conditions variables, has developed an alternative approaches Building Integrated Solar Energy model to assess the extent to which energy consumption could be met.
The BISE framework’s primary goal is to analyze the highest allowable technical capacity and dynamics of solar power provided by built-in hybrid solar technologies. For this purpose, detailed climate data were taken from the NASA repository for some key variables (ambient temperature, top atmospheric irradiation, global irradiation, humidity data, wind speed, etc.).
The BISE method’s additional advantage is exposure to high-resolution climate details, analyzing it via an advanced measurement method, extracting estimates for the future solar thermal and electrical performance of solar technology, and visualizing the estimates. This has been generalized for each area, outdoor environment, and site plan employing the roof area’s various estimations to implement solar systems. The usable roof area is calculated by adding roof-to-floor ratios to the correlating floor area figures from the 3CSEP model as well as other access considerations extracted from the reference to compensate for the shaded areas and the gaps filled by roofing facilities. The RTR levels at each zone and buildings style are obtained by Geographic information systems datasets on regional urban development areas produced by Esmaeili Shayan [3] as well as further analyzed by the authors of this chapter utilizing Geographic information spatial analysis and zoning statistical techniques (see [3]). The spatial analysis’s main objective is “to meet the demands and relationship issues, taking into consideration the spatial location of the phenomenon under investigation in a direct manner” [6].
While the roof area calculations primarily are using the floor area findings of the 3CSEP method as source evidence, the BISE method’s configuration is quite close to that of the 3CSEP model in terms of areas, housing styles, temperature zones, and vintage architecture and simulation horizons. These elements of the layout are listed in more depth below.
In place to encourage a link between the results of the BISE and the 3CSEP designs, the analysis is carried out for whatever divisional division as presented in [7]. These areas of the country have included the following: Western Europe (WEU), Middle East (MEA), Centrally Organized Asia (CPA), Pacific OECD (PAO), Latin America and the Caribbean (LAC), Sun-Saharan Africa (AFR), former the Soviet Union (FSU), North America (NAM), Eastern Europe (EEA), South Asia (SAS), Other Pacific (PAS).
The initial GIS data details were gathered for each hour of each year for 5 years from 2001 to 2005, and the 5-year estimate was determined for each level. Such data collection was used in the 2005 base year selected for compatibility with the 3CSEP model. The methodology considers every period and every year from 2005–2050.
The Building Integrated Solar Energy model argument predicts that solar heat generated by PV/T systems can also be used for water and space heat generation. In contrast, solar electricity is used for lighting, space cooling, and appliances.
The Building Integrated Solar Energy model distinguishes between different types of buildings (residential: single- or multifamily; public and industrial: school, office, hotels and cafes, retail, health care, other housing, or buildings), vintages (retrofitting, modern, new, existing, and advanced retrofitting), seasonal conditions which are the same as the 3CSEP model.
The Building Integrated Solar Energy design focuses primarily on building-integrated on-site solar power. These systems can usually be broadly classified into two categories: solar thermal and photovoltaic (PV) systems. The latter produces heat, while the latter generates power. As the house needs both, maximizing the development of solar energy on the construction sites may demand the configuration of both kinds of processes. This might induce the “battle on the roof” (not enough space on the roof for both PV and solar collectors to meet energy demands) and lead to increased costs, esthetic problems, and a boost in the energy of the solar systems [3]. While solutions to this challenge currently exist by integrating solar systems with other innovations (e.g., photovoltaic + heat pump), since this chapter emphasizes exclusively on solar power, a thermal + photovoltaic hybrid solar system is perceived to be one of the most “fully solar” approaches to this problem. A solar hybrid photovoltaic/thermal system (PV/T system) is a mixture of photovoltaic (PV) panels and solar thermal elements. PV/T is a system that allows PV cells as a heated substrate to transform radiation into electric power; the solar thermal collector converts solar heat into electricity and removes waste heat from the PV module. These elements’ goal is to use the heat produced in the PV panel to generate not only electrical but also thermal energy [8]. Such a hybrid setup generates an electrical utilization of the system as heat extraction and utilization reduces the systems’ temperature and thus improve their performance. Configuration of photovoltaic plus thermal systems provides an opportunity to significantly increase the generation of solar energy for various end-uses compared to separate systems in the same roof area. As this chapter focuses on estimating the maximum possible technical potential of renewable energy in building structures, photovoltaic plus thermal technology was considered to be the most efficient model-long exercise workable alternative. In order to evaluate the hypothetical technological potential of built-in solar power, it is expected that photovoltaic plus thermal systems will be mounted on the available roof places during the construction or renovation of structures, beginning with some of those feasibility studies in 2014 then slowly expanding the number of installations before they become standard practice for all retrofits and housing developments by 2025.
The Building Integrated Solar Energy model assumes that thermal and electrical solar power production are modeled differently that use the same hourly in days’ radiation exposure measured on 1 m2 of the solar system site, but specific thermal and electrical formulations and performance variables and losses of different systems (see [3]).
The Building Integrated Solar Energy model calculates the amount of solar renewable energy (electrical and thermal) produced in any buildings on an everyday hourly basis by BIPV/T systems, which is further compiled on a monthly basis. The present version of the product suggests the absorption of generated solar energy power within one period (month or more) at the rate of each city, buildings form, and temperature area, that makes it possible to equate the monthly amounts with the monthly projections of construction power consumption under the shallow scenario for space cooling, water heating and space heating and also with the Bottom-Up Energy Analysis System case formulation for home appliances. This scenario did not include industrial buildings. Consequently, the expectation that nearly 50 percent of cost savings attributed to energy efficiency changes in all end-uses should be reached by 2050 has been created. To achieve monthly results for equipment and lighting, it was presumed that these users would consume the same quantity of electricity every month. Monthly study results determined by the Building Integrated Solar Energy framework for the possible use of solar thermal energy have been evaluated by comparing to the construction energy consumption statistics for water heating and space heating. In contrast, the possible use of solar power for appliances and lighting, cooling was contrasted. Such a similarity forms the basis for assessing the extent to which advanced energy-efficient buildings with energy technologies can move toward the net-zero emissions energy systems target.
The novelty of the Building Integrated Solar Energy model integrates a comprehensive measurement process (acceptable for calculating the efficiency of the particular solar system) for hourly solar energy production per 1 m2 of the surface of the solar system and comprehensive coverage of the effects. The shayan model incorporates various forms of solar radiation, considering the tilting of the device (going to assume optimal tilting), the orientation of the earth, altitude, time of year, and location of the sun. The approach described here for measuring the energy obtained by one square meter of the solar system every hour has been modified from [1, 8, 9, 10, 11]. There are many measurement benchmarks in the method. First, the total roof size was calculated in each area, outdoor environment, and building, which is mainly contributed by applying the accessibility variables.
where AR is area of roof and FRratio is floor of roof ratio and AF is area of floor. The Area Calculator (can be free use in:
The complex shape rooftop [3].
Receiving energy from the sun is based on radiation. If the consumer is in the northern hemisphere, the sun’s rays will be on the south side, and if objects are on the north side of the roof, they will cast shadows on the solar system. For various seasons, this impact would be different. Eq. 2 shows the space available for the use of the solar system.
where
Second, hourly solar radiation obtained by 1 m2 of the solar system area is measured, considering the various forms of usable solar radiation.
Complete radiation is one of the parameters for calculating the radiant energy of the sun. Global radiation depends on the variability of radiation and reflection in the environment. The following factors are: beam radiation, diffuse radiation, and reflective surface radiation. If
The installation location of the solar system and the solar angles can affect the performance of the system. If this angle deviates from the vertical, the intensity of the radiation will also decrease. According to the definition,
In order to emphasize the value of energy conservation for solar-powered NZEBs under the BISE model, the results for solar energy balances (i.e., solar energy supply vs. any building energy use) were compared to two 3CSEP scenarios: Deep conservation and medium efficiency categories for each of 11 countries, temperature areas, and based treatment. The essential purpose of such a study is to evaluate the effect on the solar fraction of the energy efficiency level change (i.e., the portion of building energy consumption that can be offset by solar energy output) in various regions and buildings. As noted above, extreme scenario presupposes very ambitious changes in energy quality (Approximately passive household energy efficiency), while moderate scenario assumes standard building energy output that can be attained by 2050 if existing government patterns proceed without significant innovations modifications.
The deep scenario results were combined with the energy use estimates of the appliances and lighting from the BUENAS model’s BAU scenario with a 50% reduction in their energy intensities by 2050 to illustrate potential improvements in energy efficiency from these end-uses.
The result shows that the odds of meeting the net zero energy target in certain types of buildings are significantly smaller under the medium scenario than under the Extreme one. Tables also reveal that emerging regions can attain the NZE production over a more significant number of months than existing ones. The reason can be twofold: lower energy consumption in developing-country buildings due to more restricted access to modern energy infrastructure and a much greater abundance of solar energy supplies than in developed countries, most of which are concentrated in the northern hemisphere. This also demonstrates that in emerging regions (SAS, PAS, MEA, LAC, and AFR), the gap between the room and water heating energy usage is negligible. In these cases, electricity requirements for such end uses of most building styles (with some exceptions) in these regions can theoretically be fulfilled during the year by solar power supply only.
Full coverage can only be reached in other, primarily low-rise building forms (e.g., retail or single-family buildings) in all the months of 2050 in developing areas. The highest-rise structures, usually represented by multifamily and office buildings, display the lowest NZE capacity in developing regions among other building forms.
The number of months in which solar thermal is not adequate to satisfy the thermal energy demand in these buildings ranges from Low to high , depending on the location. PAO indicates the most significant potential for satisfying solar thermal energy demand across developing regions: Under the deep scenario, 100 percent thermal energy consumption coverage will be reached across all months and in all types of buildings. The great abundance of solar energy can explain this for most of the year in this area.
Results for the medium scenario explicitly demonstrate a substantial rise in the number of months, at least for developing countries, when thermal energy demands need additional energy sources and on-site solar power generation. Some of the situations in these countries, where a large amount of building energy consumption may be met with solar energy during the deep scenario for much of the months, would have some months in the medium scenario where it is not feasible. In the Medium case, only five building forms in PAO, single-family buildings in CPA, and residential buildings in WEU show the possibility in replacing thermal energy consumption with solar in all months.
Developing regions have ample solar power to meet solar heat thermal energy requirements during the year for most types of buildings, even with modest levels of energy efficient construction. In these countries, energy issues are still observed in some styles of tall and modern buildings. This is difficult to achieve monthly zero-energy ratios during the year (e.g., office and hospital buildings in SAS, PAS, and MEA, multifamily and school buildings in MEA).
As for electrical capacity, the disparity between scenarios in developed regions is more apparent—in the intermediate scenario, the number of months in which all electricity requirements can be met with solar energy than in the deep scenario in virtually all regions and building styles (exceptions are some categories of houses in the PAS and single-family homes throughout the LAC area, where maximum coverage age is possible in all cases during the month of the year).
Under the deep scenarios, emerging areas display a strong probability of supplying the bulk of building forms with ample solar electricity volumes. Nonetheless, the results for two high-rise building forms in MEA and office buildings in LAC indicate that solar power will not be adequate to satisfy the energy the building needs over the months. The mixture of thermal and electrical results provides an understanding in which regions and forms of buildings NZE efficiency can only be accomplished with solar energy based on the 2050 monthly energy balance. These cases would include:
All styles of construction at PAS.
The single-family PAO, SAS, EEU, CPA, MEA, LAC, and AFR buildings.
SAS, LAC, AFR market constructions.
The ‘other’ SAS, MEA, LAC, and AFR buildings.
LAC educational institutions and hotels and restaurants AFR.
LAC multifamily homes.
The findings set out in this document are predictions for (Figure 2) potential energy consumption in buildings by 2050 for different regions; building forms and end users and (Figure 3) the highest possible technological capacity for producing solar energy from advanced construction technologies.
For single-family buildings in 2050 in kilowatt hours per square meter of floor space, shown in deep versus medium conditions and the use of thermal energy versus solar thermal output [3].
Thermal energy usage vs solar thermal energy output in 2050 for industrial & public buildings, kWh / m2 of floor space, Extreme vs intermediate scenarios [3].
This chapter’s key purpose was to compare the effects of building energy usage under two conditions with different levels of building energy efficiency to the amount of solar energy, which can theoretically be produced by advanced hybrid technology from the rooftops of these buildings. While solar energy capacity measurements have been conducted for each hour, the relation between solar energy supply and the building energy consumption is made monthly (due to the lack of more accurate statistics on building energy usage at the global and national level). It is estimated that generated solar energy will be accumulated at the construction site within 1 month at the level of each area, building type, and climate zone.
Five key messages can sum up the outcomes of such a comparison:
Synergies between energy conservation and on-site solar energy generation play a key role in bringing electricity output from building to net zero energy level.
Via “strong” energy conservation steps, the same volume of solar energy will support a more significant share of electricity demand, minimize the need for more energy from fossil fuels, and thus trigger greenhouse gases.
To exploit the net-zero energy performance capacity of all building services, including lighting and appliances, should be confirmed. New and updated buildings’ thermal energy efficiency must meet passive house standards (about 15–30 kWh/m2 depending on location and type of building). As for lighting and appliances, even halving their use of electricity by 2050 would not be enough to enable maximum solar coverage of the respective electricity needs in some regions (particularly developed ones).
Developing countries are seeing greater solar energy efficiency in buildings because of the availability of solar energy resources and lower electricity requirements. However, energy conservation is also critical in these regions to offset the substantial rise in energy usage anticipated in certain regions in the immediate future.
Low-rise buildings usually have a higher capacity to meet a significant portion of their solar energy requirement than high-rise ones. Yet modest energy efficiency standards make reaching the NZE target more difficult in most styles of buildings.
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