5 Modifiable Lifestyle Factors that Influence Patient Recovery

There are a number of elements that affect an individual’s health and well-being, five of which are modifiable personal lifestyle factors that can be controlled in various ways to facilitate improved physiological, mental, emotional, and spiritual wellness. Let’s take a look at each of these and how they can influence a patient’s overall health and recovery.

Sleep and Relaxation

Prolonged sleep deprivation is associated with increased inflammatory markers such as IL-6 and C-reactive protein (CRP).1 Patients who present for physical therapy could experience higher levels of pain if they’re chronically sleep deprived with no real tissue pathology causing the increased pain.

Both short sleep (less than four hours) and long sleep (more than 10 hours) have been associated with decreased global cognitive function.2 This is particularly important for patients receiving neuro-physical therapy with concurrent speech therapy. Decline in the processing of information can significantly affect participation in therapy and thus recovery.

Exercise and Movement

Most of us have heard the saying that “motion is lotion.” The benefits of exercise and movement have been demonstrated time and again in research studies. These include:

  • Improved joint mobility, muscle strength and flexibility, cardio-pulmonary conditioning, and antioxidant capability.
  • Lower inflammatory markers.
  • Better fasting insulin levels and biomarkers of insulin resistance. Oxidative stress induced by being too sedentary appears to impair mitochondrial function, whereas oxidative stress induced by exercise may have beneficial effects on mitochondrial function and biogenesis.
  • Lowered cortisol, which is a major stress hormone and a potent stimulator of increased blood sugar. Standing desks and treadmill desks favorably modulate cortisol levels compared to sitting desks.


Nutrition plays an important role in the treatment and management of chronic diseases. The GI tract is the largest immune organ, containing more than 80 percent of the body’s immune cells. This means that the food that we eat plays a big role in how we feel physically and emotionally.

Besides the three food groups of carbohydrates, fats, and proteins, phytonutrients are powerful defenders of health. Phytonutrients are components of plants that stimulate enzymes to clear toxins, boost the immune system, improve cardiovascular health, promote healthy estrogen metabolism, and stimulate death of cancer cells. They are found in fruits, vegetables, whole grains, legumes, herbs, spices, nuts, seeds, and teas.


Over half of Americans report feeling stressed during the day, and U.S. employers spend approximately $300 billion annually on healthcare and missed days of work due to employee stress.3,4

If excessively or chronically exposed to cortisol, the primary stress hormone, the immune system can become too suppressed, leading to illness. Psychosocial stress may be an important antecedent of osteopenia and osteoporosis.5 Chronic stress decreases brain-derived neurotrophic factor (BDNF), which is a risk factor for cognitive impairment.6 Tell-tale signs of chronic stress include fatigue, sleeplessness, irritability, and frequent infections and illnesses.


Aging adults with lower social engagement are more likely to experience cognitive decline and impairment.7 Poor social relationships are associated with a 29 percent increased risk of heart disease and a 32 percent increased risk of stroke compared to those with strong
social connections.8

Loneliness is associated with increased levels of inflammation, including higher levels of CRP, IL-6, and fibrinogen.9 However, those with strong social relationships have a 50 percent increased likelihood of survival against chronic disease.10

Keep Patients Informed

Educating patients about these modifiable lifestyle factors and encouraging them to take steps towards positive change can help decrease dependence on pharmaceutical drugs, lower healthcare costs, and promote healthy lives.


  1. https://academic.oup.com/sleep/article/30/9/1145/2696861
  2. https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-023-05434-z
  3. https://www.stress.org/workplace-stress
  4. https://www.stress.org/stress-research
  5. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2019.00200/full
  6. https://www.frontiersin.org/articles/10.3389/fncel.2019.00363/full
  7. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-12567-5
  8. https://nap.nationalacademies.org/download/25663
  9. https://www.frontiersin.org/articles/10.3389/fnbeh.2021.801746/full
  10. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000316