ABSTRACT
Background With urbanization and residential space expansion, ecological environment and human health issues have become hot social topics. Forest health, as a way of seeking health in nature, has begun to receive public attention in the context of the gradually increasing sub-healthy population and various psychological and physical diseases at a young age. Objective To systematically evaluate the effects of forest therapy on selected physical and mental health indicators. Methods Relevant research literature was retrieved from domestic and international databases (China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Service System, Web of Science, ScienceDirect, PubMed, Embase, and Cochrane Library), with a time range from database establishment to January 31, 2023. Relevant data were extracted for meta-analysis to explore the relationship between forest therapy and selected psychological and physiological indicators. Results A total of 85 articles were included, and the meta-analysis results showed that better scores of Profile of Mood States, Positive and Negative Affect Scale, Beck Depression Inventory, and State Trait Anxiety Scale were found in the forest group than those in the urban group (P<0.05); the levels of systolic blood pressure, diastolic blood pressure, heart rate, sympathetic nerve indicator [ln (LF/HF)], salivary cortisol, and serum inflammatory factors were lower in the forest group than in the urban group, while parasympathetic nerve indicator [ln (HF)] level was higher in the forest group than in the urban group (P<0.05). The results of subgroup analysis showed that the changes in heart rate (SMD=−1.62, 95%CI: −2.41, −0.82), ln (HF) (SMD=1.29, 95%CI: 0.73, 1.85), ln (LF/HF) (SMD=−1.49, 95%CI: −2.13, −0.86), and salivary cortisol (SMD=−0.53, 95%CI: −0.81, −0.25) were more significant when the duration of forest therapy was ≤ 0.5 h, the recovery effect on emotional state was better in the >0.5~3 h group (such as tension SMD=−2.40, 95%CI: −3.21, 1.59), and the reduction effects on systolic blood pressure (SMD=−0.53, 95%CI: −1.03, −0.03) and diastolic blood pressure (SMD=−0.42, 95%CI: −0.88, 0.04) were better in the >3 h group. Seated meditation showed better recovery effects on multiple indicators of Profile of Mood States (such as fatigue SMD=−2.26, 95%CI: −3.07, −1.45), while walking showed better recovery effects on physiological indicators such as blood pressure (systolic blood pressure SMD=−0.57, 95%CI: −1.07, −0.06; diastolic blood pressure SMD=−0.72, 95%CI: −1.36, −0.07) and heart rate (SMD=−1.51, 95%CI: −2.38, -0.64). Except for blood pressure, the health benefits of forest therapy in the younger age group were generally better than those in the middle-aged and elderly group. Conclusion Relaxed and comfortable psychological feeling is reported when practicing forest therapy; it can lower blood pressure and heart rate, regulate the autonomic nervous system; it can also reduce the release of stress hormones and lower serum levels of inflammatory factors, exerting an auxiliary recovery effect on cardiovascular and immune system disorders. At the same time, the therapy duration, form, and age of the subjects have a certain impact on the effects of forest therapy practice.
ABSTRACT
Background Female office workers are prone to fatigue due to work and life stress. The natural environment has a positive effect on health, but little research has focused on the effects of forest therapy on physical and mental health of female office workers. Objective To explore the effect of forest therapy on the mental health of fatigued female office workers. Methods In this study, two environments, urban and forest, were selected. A total of 12 subjects with fatigue were recruited and randomly divided into two groups, urban and forest, six subjects in each group, with mean ages of 24.7 and 28.4 years, respectively, all of whom were company employees. The Brief Mood Scale, the Chinese version of Stress Self-Rating Scale, and the Fatigue Self-Rating Scale were distributed to assess baseline psychological indexes of mood, fatigue, and stress status. Higher scores indicate higher levels of negative mood, fatigue, and stress, respectively. The forest group participated in an on-site experiment using forest therapy (forest walks and sits in a forest environment), and the urban group followed the same schedule as the forest group conducting walks and sits in an urban environment. Salivary cortisol was used as the physiological index. Baseline physiological indices were collected on the first day of the experiment, and the on-site forest therapy experiment and collecting physiological and psychological indices were conducted on the second day; physiological indices were collected in the morning before the walk and physiological and psychological indices were collected after the walk, physiological indices were collected in the afternoon before and during the sitting, and psychological indices were collected after the sitting. Subjects' mood and fatigue status were followed up one week after the activity. Mann-Whitney U test and Wilcoxon signed rank test were used to assess the changes of the indicators. Results As to the physiological indicator, the salivary cortisol concentrations before and after the morning walk in the forest group were lower than the corresponding baseline values (both P=0.043); and the decreases were 2.21 and 1.86 nmol·L−1 respectively. Differences between groups showed a trend towards a greater decrease in salivary cortisol concentrations in the forest group than in the urban group after walking and at the 15 th min of sitting (both P=0.068). Among the mood indicators, the forest group showed a greater decrease than the urban group in fatigue dimension after walking (P=0.065) and after sitting (P=0.024); the forest group showed a greater decrease than the urban group in vitality dimension after walking (P=0.054) and after sitting (P=0.045); and the forest group showed a greater decrease than the urban group in "total mood disorder" after sitting (P=0.054). Among the fatigue indicators, the forest group showed a greater decrease in "physical fatigue", "mental fatigue", "consequences of fatigue", and "general fatigue" after walking and sitting than the urban group (all P<0.05). Among the stress indicators, there were not statistically significance of "tension", "loss of control", and "total stress score" between the two groups after sitting (both P>0.05). After one week after the activity, there were not statistically significant differences of mood and fatigue between the two groups (both P>0.05). Conclusion Forest therapy has a regulating effect on symptoms of negative mood, and fatigue in fatigued female office workers, but the effects of a short-term forest therapy last for a limited duration.
ABSTRACT
Background The health effects of forest therapy have been widely recognized, while the previous studies mostly focused on a single activity mode of forest walks. The effects of different types of forest therapy activities remain unclear. Objective To explore the effects of short-term forest therapy on cardiopulmonary health, psychological health, and sleep quality, and the health effects of different types of forest therapy activities, aiming to provide population empirical study data for the development of forest therapy. Methods A self-control study was conducted in a national forest park in suburb of Beijing from August to September 2018. A total of 31 healthy college students were recruited as the study subjects, with a total forest stay for 3 days and 2 nights. During the period of study, each subject practiced walking therapy, sitting therapy with five senses experience (sitting therapy thereafter), and handmade work therapy, successively. Each type of forest therapy lasted about 2 h. Changes of blood pressure, oxygen saturation (SpO2), lung function, and fractional exhaled nitric oxide (FeNO) were estimated by measuring corresponding indicators before and after the forest therapy. Psychological health and sleep quality were assessed by Profile of Mood States and Pittsburgh Sleep Quality Index respectively at the same time. Mixed effects models were used to analyze the changes of these health indicators. The health effects of different types of forest therapy activities were further analyzed. Results The average age and body mass index of subjects in this study were (24.5±2.6) years and (20.7±1.7) kg·m−2, respectively. After a short-term forest therapy, the selected indicators of cardiopulmonary health, psychological health, and sleep quality of subjects were all improved. In particular, the pulse pressure (PP) and FeNO decreased by 3.02 mmHg and 1.10 ppb, respectively, while the SpO2 and peak expiratory flow (PEF) increased by 0.65% and 0.50 L·s−1, respectively, and the negative emotion and global sleep quality also presented significant positive changes (all P<0.05). Furthermore, different therapy activities presented differential effects in the health indicators. Walking therapy significantly improved pulmonary function, SpO2, and confusion (CON) emotion, in which the SpO2, forced expiratory volume in the first second (FEV1), and forced vital capacity (FVC) increased by 0.48%, 0.14 L, and 0.12 L, respectively, and the score of CON decreased by 0.97 (all P<0.05). Sitting therapy significantly reduced blood pressure and tension (TEN) emotion of subjects, including a decrease of the systolic blood pressure (4.45 mmHg), PP (4.19 mmHg), and the score of TEN (0.84) (all P<0.05). The diastolic blood pressure (DBP) increased slightly after handmade work therapy (ΔDBP=2.44 mmHg, P=0.016), but there were no significant changes in other indicators. Conclusion Short-term forest therapy could significantly improve cardiopulmonary health, psychological health, and sleep quality of young healthy individuals, and different types of forest therapy activities may have differential health effects.
ABSTRACT
Prosperity for all is impossible without health for all. In recent years, following with the development of national land greening, forest resources have greatly increased in China. It is one of the effective ways to realize the Healthy China strategy to develop and perfect forest rehabilitation and forest therapy with forest resources. Forest therapy has gradually become a new interdisciplinary science and a focus of public attention. This paper reviewed the development of forest therapy in some countries in the world, summarized the health effects of forest therapy on cardiovascular, respiratory, immune, and mental system, pointed out the limitations of the research work at present on forest therapy and population health, and discussed the outlook of forest therapy and population health in China.
ABSTRACT
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.