Exercise-based rehabilitation in and with nature: a scoping review mapping available interventions

Abstract

Introduction Exercise is an effective component in rehabilitation of a range of chronic conditions. There is a growing interest in the use of exercise-based nature interacted rehabilitation (EBNIR), but an overview of current evidence is missing. The objective of this scoping review was to map existing exercise-based rehabilitation interventions conducted with incidental or intentional nature interaction focusing on its populations, types of outcomes, and theoretical rationale for people with physical and mental disabilities. Methods This scoping review identified peer-reviewed publications, registered upcoming trials and grey literature. To map all available knowledge, a comprehensive search of selected databases (MEDLINE; EMBASE; CINAHL; Cochrane; Web of Science; Pedro) from inception to October 2022. Data were synthesized in a thematic presentation guided by TIDieR, supplemented by a checklist developed for this study accounting nature incidental or intentional interaction. Results Twelve studies including 856 participants met the inclusion criteria. Eleven were completed trials and one was registered in clinicaltrials.gov to be run in 2023. A total of 856 patients were enrolled in the 12 studies (range 18–262, median 50). The included studies had great variation. The incidental or intentional interacted exercise-based interventions consisted of outdoor walks, neck exercises and surfing interventions in patients with physical or mental health conditions. Conclusions This scoping review presents an overview of limited and diverse evidence within the field of EBNIR, in patients with physical or mental health conditions. Our review provides an overview that will be helpful in the design of future EBNIR trials.

Assessment of park paths and trails to promote physical accessibility among wheelchair users in Saudi Arabia

“…In addition, it prevents several serious illnesses, including osteoporosis, and vitamin D insufficiency. Therefore, improving accessibility to outside nature enhances engaging in physical activity and exercise, which has a great impact on quality of life and general health and wellbeing ( Busk et al, 2023 ; Manferdelli et al, 2019 ).…”

Effects of Hiking-Dependent Walking Speeds and Slopes on Spatiotemporal Gait Parameters and Ground Reaction Forces: A Treadmill-Based Analysis in Healthy Young Adults

“…Indeed, studies have demonstrated that the efforts required to overcome the challenges faced during uphill and downhill walking are correlated with enhanced cardiovascular health [3,4], increased muscle activation [7,8], and the management of chronic conditions like diabetes [6], obesity [5], COPD [13] and osteoarthritis [66]. In addition, healthcare professionals, including physical therapists and rehabilitation specialists, can utilize spatiotemporal parameters to adjust and optimize rehabilitation programs [28,29] by improving certain functional abilities (e.g., muscle strength) or identifying specific gait abnormalities and tracking changes over time. Understanding ground reaction force and GRF patterns may also facilitate the implementation of intervention programs to improve weight distribution and reduce joint stress, thus alleviating asymmetries or excessive joint loading.…”

“…where W = walking speed and S = slope of the terrain Knowing the effects of hiking speeds and terrain's slopes interplay on gait kinematics, and kinetics is essential for promoting safety [24,25], optimizing performance, designing appropriate trails [26], and equipment (e.g., footwear [27]), enhancing recreation and fitness experiences, supporting rehabilitation [28,29], and minimizing environmental impact [30]. This information may also be valuable to individuals who, either because they face limited access to physical environments or want to diversify their exercise routines, prefer to exercise in controlled indoor conditions using a treadmill.…”