Effects of forest bathing on pre-hypertensive and hypertensive adults: a review of the literature

The aim in this literature review was (1) to explore the physiologically and psychologically therapeutic benefits of forest bathing on adults suffering from pre-hypertension or hypertension, and (2) to identify the type, duration, and frequency of an effective forest bathing intervention in the management of pre-hypertension and hypertension, so as to provide directions for future interventions or research. The electronic databases PubMed, Cochrane Library, CINAHL, PsyINFO, and the China Academic Journals (CAJ) offered through the Full-text Database (CNKI) were searched for relevant studies published from the inception of the databases to April 2019. Of the 364 articles that were identified, 14 met the criteria for inclusion in this review. The synthesis of the findings in the included studies revealed that forest bathing interventions were effective at reducing blood pressure, lowering pulse rate, increasing the power of heart rate variability (HRV), improving cardiac-pulmonary parameters, and metabolic function, inducing a positive mood, reducing anxiety levels, and improving the quality of life of pre-hypertensive or hypertensive participants. Forest walking and forest therapy programs were the two most effective forest bathing interventions. Studies reported that practicing a single forest walking or forest therapy program can produce short-term physiological and psychological benefits. It is concluded that forest bathing, particularly forest walking and therapy, has physiologically and psychologically relaxing effects on middle-aged and elderly people with pre-hypertension and hypertension.

A comparative study of the physiological and psychological effects of forest bathing (Shinrin-yoku) on working age people with and without depressive tendencies

BACKGROUND@#In recent years, many of Japanese workers have complained of fatigue and stress, considering them as risk factors for depression. Studies have found that "forest bathing" (Shinrin-yoku) has positive physiological effects, such as blood pressure reduction, improvement of autonomic and immune functions, as well as psychological effects of alleviating depression and improving mental health. In this study, we investigate the physiological and psychological effects of "forest bathing" on people of a working age with and without depressive tendencies.@*METHODS@#We conducted physiological measurements and psychological surveys before and after forest bathing with subjects who participated in day-long sessions of forest bathing, at a forest therapy base located in Hiroshima Prefecture. After excluding severely depressed individuals, the participants were classified into two groups: those with depressive tendencies (5 ≤ K6 ≤ 12) and those without depressive tendencies (K6 < 5) for comparative study. The evaluation indices measured were systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate (PR), autonomic functions, and profile of mood states (POMS).@*RESULTS@#Of the 155 participants, 37% had depressive tendencies, without any differences observed between males and females. All participants showed significant decrease in SBP, DBP, and in negative POMS items after a forest bathing session. Before the session, those with depressive tendencies scored significantly higher on the POMS negative items than those without depressive tendencies. After forest bathing, those with depressive tendencies demonstrated significantly greater improvement in many of POMS items than those without depressive tendencies, and many of them no longer differed between those with and without depressive tendencies.@*CONCLUSIONS@#Examining the physiological and psychological effects of a day-long session of forest bathing on a working age group demonstrated significant positive effects on mental health, especially in those with depressive tendencies. Not applicable; this is not a report of intervention trial.

Medical empirical research on forest bathing (Shinrin-yoku): a systematic review

AIMS@#This study focused on the newest evidence of the relationship between forest environmental exposure and human health and assessed the health efficacy of forest bathing on the human body as well as the methodological quality of a single study, aiming to provide scientific guidance for interdisciplinary integration of forestry and medicine.@*METHOD@#Through PubMed, Embase, and Cochrane Library, 210 papers from January 1, 2015, to April 1, 2019, were retrieved, and the final 28 papers meeting the inclusion criteria were included in the study.@*RESULT@#The methodological quality of papers included in the study was assessed quantitatively with the Downs and Black checklist. The methodological quality of papers using randomized controlled trials is significantly higher than that of papers using non-randomized controlled trials (p < 0.05). Papers included in the study were analyzed qualitatively. The results demonstrated that forest bathing activities might have the following merits: remarkably improving cardiovascular function, hemodynamic indexes, neuroendocrine indexes, metabolic indexes, immunity and inflammatory indexes, antioxidant indexes, and electrophysiological indexes; significantly enhancing people's emotional state, attitude, and feelings towards things, physical and psychological recovery, and adaptive behaviors; and obvious alleviation of anxiety and depression.@*CONCLUSION@#Forest bathing activities may significantly improve people's physical and psychological health. In the future, medical empirical studies of forest bathing should reinforce basic studies and interdisciplinary exchange to enhance the methodological quality of papers while decreasing the risk of bias, thereby raising the grade of paper evidence.

10-4 Shumadian forest hammam as a medical SPA concept / 日本温泉気候物理医学会雑誌

Objectives: In our investigation we had a goal to present and measure the effect of the authentic outdoor medical SPA programs “Shumadian Forest hammam”, “Cigota Cross SPA golden pine forest hammam” and “Tara hammam as 75+, ageing well program” that combine phytoncides, heliotherapy, mineral springs water, zero distance food, tradition and heritage of the Serbian people, on the health of the people Material and Methods: Our investigation was designed to measure the effects of Medical SPA programs proposed by experts team of Medical SPA Association of Serbia. One of the programs “Cigota Cross SPA Golden pine forest hammam” has been designed for the healthy women age 50 + for the promotion of healthy life style, better quality of life and preventing disease. Program encompass several leisure activities: 1 hour walking through the wild nature (woods and fields, collecting herbs and flowers), 10 minutes of kneipp therapy, (walking through the spring water) 30 minutes of meditation below the oak three, listening birds song, 10 minutes of breath excercise, 10 minutes of folk dance therapy along with music therapy from shepards pipe, Next 30 minutes takes time to prepare and consume the brunch tailored by zero distance food protocols and according the mood food questionnaire, Natural spring water (4 x 200 ml or more) has been consumed during the program protocol. At the end the attendants were involved in selfness workshop (how to make their own herbal ball from collected herbs and flowers, for self massage during additional 30 minutes.   The traveling by bus to the destination from the meeting point, and backward was 45-50 minutes.   The measurement of physiological parameters was conducted by pulse oxymeter device twice before entering the bus from the meeting point and from the program destination.   The Manchester colour wheel test and aromadiagnostic test, as nonverbal mood profile state tests were performed after the pulse oxymeter measurement   The GHQ has been performed the day before the program, to select healthy attendants.   The Burn out test, Life satisfaction test, stress scale, and POMS24 scale were performed the day before the program and before entering the bus after the program.   All of 30 participants have completed the program procedure. Results: We have calculated overall score from the tests before and after the program and we have found that there are higher scores of overall oxygen saturation after the program, lower score of Burn out tests, lower score of stress test. POMS24 test shows lower score of TMD,   The Manchester colour wheel, and aromadiagnostic tests indicate the changes towards more balanced emotional state. Conclusion: Our pilot investigation showed that there is measurable positive effect of authentic forest hammam medical SPA programs on the holistic health of the attendants. Summarizing the results of our pilot investigation we did not explore them by comprehensive statistical methods. That part of investigation will be organized after more thorough investigation in our future work.

10-4Shumadian forest hammam as a medical SPA concept / 日本温泉気候物理医学会雑誌

<b>Objectives:</b> In our investigation we had a goal to present and measure the effect of the authentic outdoor medical SPA programs “Shumadian Forest hammam”, “Cigota Cross SPA golden pine forest hammam” and “Tara hammam as 75+, ageing well program” that combine phytoncides, heliotherapy, mineral springs water, zero distance food, tradition and heritage of the Serbian people, on the health of the people<BR><b>Material and Methods:</b> Our investigation was designed to measure the effects of Medical SPA programs proposed by experts team of Medical SPA Association of Serbia. One of the programs“Cigota Cross SPA Golden pine forest hammam” has been designed for the healthy women age 50 + for the promotion of healthy life style, better quality of life and preventingdisease.<BR><b>Program encompass several leisure activities:</b> 1 hour walking through the wild nature (woods and fields, collecting herbs and flowers), 10 minutes of kneipp therapy, (walking through the spring water) 30 minutes of meditation below the oak three, listening birds song, 10 minutes of breath excercise, 10 minutes of folk dance therapy along with music therapy from shepards pipe, Next 30 minutes takes time to prepare and consume the brunch tailored by zero distance food protocols and according the mood food questionnaire, Natural spring water (4 x 200 ml or more) has been consumed during the program protocol. At the end the attendants were involved in selfness workshop (how to make their own herbal ball from collected herbs and flowers, for self massage during additional 30 minutes.<BR>  The traveling by bus to the destination from the meeting point, and backward was 45-50 minutes.<BR>  The measurement of physiological parameters was conducted by pulse oxymeter device twice before entering the bus from the meeting point and from the program destination.<BR>  The Manchester colour wheel test and aromadiagnostic test, as nonverbal mood profile state tests were performedafter the pulse oxymeter measurement<BR>  The GHQ has been performed the day before the program, to select healthy attendants.<BR>  The Burn out test, Life satisfaction test, stress scale, and POMS24 scale were performed the day before the program and before entering the bus after the program.<BR>  All of 30 participants have completed the program procedure.<BR><b>Results:</b> We have calculated overall score from the tests before and after the program and we have found that there are higher scores of overall oxygen saturation after the program, lower score of Burn out tests, lower score of stress test.POMS24 test shows lower score of TMD,<BR>  The Manchester colour wheel, and aromadiagnostic tests indicate the changes towards more balanced emotional state.<BR><b>Conclusion: </b>Our pilot investigation showed that there is measurable positive effect of authentic forest hammam medical SPA programs on the holistic health of the attendants.<BR>Summarizing the results of our pilot investigation we did not explore them by comprehensive statistical methods. That part of investigation will be organized after more thorough investigationin our future work.

Effects of Rooftop Forest-like Field on Elderly People Requiring Care / 日本温泉気候物理医学会雑誌

<B>Purpose</B><BR>  The purpose of this study is to clarify the impressions that elderly people requiring care have when exposed to a “rooftop forest-like field.”<BR><B>Methods</B><BR><B>Experimental sites</B> : (1) The rooftop forest-like area: It covers an area of 122 m<SUP>2</SUP> on the 3rd story rooftop of a health service facility. It has 140 cm undulations, and a murmuring stream 7 m long and 58 cm deep flowing through the center. Fifty-one species of trees and 33 species of weeds, herbs, and grasses have been planted. Nearby is a mountain from which some birds come to the area. This mountain formed the background to this landscape. (2) The outdoor parking area: Control area was an area of 170 m<SUP>2</SUP> next to the same facility. Cars were prevented from entering during the study.<BR><B>Subjects:</B>The subjects were 30 females aged from 71 to 95 (mean ± SD: 81.7 ± 5.6). They were residents of the facility or attended to the facility for day care. They were divided into two groups, A and B, consisting of 15 females each. The groups were matched for age and cerebral vascular disorders (CVD). No patients with dementia were included. <B>Experimental design</B> : On the first day of The experiment, group A was sent to the rooftop forest-like area, and group B was sent to the open-air parking area. On the second day, each group went to the other area to eliminate the order effect. The subjective impression was measured using the semantic differential (SD) method. Patients sat still in a wheelchair and watched the scenery for 7 minutes and then answered the questionnaire.<BR><B>Results and Discussion</B><BR>  The rooftop forest-like field was perceived as a “beautiful,” “refreshing,” “orderly,” “enjoyable,” “comfortable” “secure,” “healthy,” “calm,” “soothing,” “friendly,” “quiet,” and a “holy” area. It was similar to the impression made by natural coniferous forests or natural rice fields. More than 80% of subjects expressed subjective relaxed state, as “most enjoyable,” “most comfortable,” and “most secure” as their impressions of the rooftop forest-like area. The impression of rooftop forest like area was characterized by high scores for both space and sensory factors using the SD method. Compared with previous reports, this forest-like area may have a relaxing effect on elderly people requiring care which is subjectively perceived.<BR><B>Conclusion</B><BR>  It was demonstrated that the rooftop forest-like field was perceived as a “comfortable”, “healthy”, and “relaxing” space by elderly people requiring care.