The Effects of Forest Therapy on Coping with Chronic Widespread Pain: Physiological and Psychological Differences between Participants in a Forest Therapy Program and a Control Group

Abstract

This study aimed to investigate the effects of a two-day forest therapy program on individuals with chronic widespread pain. Sixty one employees of a public organization providing building and facilities management services within the Seoul Metropolitan area participated in the study. Participants were assigned to an experimental group (n = 33) who participated in a forest therapy program or a control group (n = 28) on a non-random basis. Pre- and post-measures of heart rate variability (HRV), Natural Killer cell (NK cell) activity, self-reported pain using the visual analog scale (VAS), depression level using the Beck Depression Inventory (BDI), and health-related quality of life measures using the EuroQol Visual Analog Scale (EQ-VAS) were collected in both groups. The results showed that participants in the forest therapy group, as compared to the control group, showed physiological improvement as indicated by a significant increase in some measures of HRV and an increase in immune competence as indicated by NK cell activity. Participants in the forest therapy group also reported significant decreases in pain and depression, and a significant improvement in health-related quality of life. These results support the hypothesis that forest therapy is an effective intervention to relieve pain and associated psychological and physiological symptoms in individuals with chronic widespread pain.

The tree-species-specific effect of forest bathing on perceived anxiety alleviation of young-adults in urban forests

“…In addition, more studies suggested that the forest bathing effect on anxiety alleviation was accompanied by coniferous tree species, such as Japanese cypress (Chamaecyparis obtusa) (Lee et al 2014, Song et al 2015a, Zhang et al 2015, Song et al 2016) and pine (Pinus spp.) (Sonntag-Öström et al 2015a, b, Chun et al 2016, Han et al 2016). However, very little evidence can be found about the perceived anxiety by participants in the birch forest.…”

“…Given the fact that the tree species in our study were broad-leafed, we consider that there may exist some tree-species significance in the effect of forest bathing on perceived anxiety alleviation. Although few studies have focused on this issue, studies about forest bathing suggested that the significant effect on mental restoration also accompanied by hard-wood species of oak (Park et al 2007, Lee et al 2009, Han et al 2016) and maple (Lee et al 2014, Song et al 2015b, Han et al 2016). In addition, more studies suggested that the forest bathing effect on anxiety alleviation was accompanied by coniferous tree species, such as Japanese cypress (Chamaecyparis obtusa) (Lee et al 2014, Song et al 2015a, Zhang et al 2015, Song et al 2016) and pine (Pinus spp.)…”

“…Thus, oak and maple are usually planted together to generate the landscape in promoting perceived stress alleviation (Lee et al 2014, Han et al 2016). This concurs with our results about the difference between the oak and maple forests in the effect on anxiety perceptions for the employment worry and lesson satisfactory.…”

Effects of Forest Therapy on Depressive Symptoms among Adults: A Systematic Review

“…For articles published in English, nine studies [12,19,21,22,25,28,29,34,39] used POMS to assess the level of depression and three studies [28,29,39] used Semantic differential (SD) method. Other scales used by the studies included the Hamilton Rating Scales for Depression [20], Beck Depression Inventory (BDI) [16,20,24,31], positive and negative affect schedule (PANAS) [34]. For studies published in Korean, the POMS [15,23,26,27,32,38] and BDI [13][14][15]17,18,35] were the most commonly used scale.…”

“…Other scales used to measure depression were the Hospital Anxiety and Depression Scale (HADS) [38], Hamilton Rating Scales for Depression [17], Montgomery-Asberg Depression Rating Scales [17], Symptom Check List (SCL-90-R) [32], and Zung Self-Rating Depression Scale (SDS) [36]. Fourteen studies [13,15,[17][18][19][21][22][23][24][25][26]28,29,39] used both self-report, paper-and-pencil questionnaires, and physiological measures, while 14 studies [12,14,16,20,27,[30][31][32][33][34][35][36][37][38] used only selfreport, paper-and-pencil questionnaires. Physiological or objective measures included heart rate variability (HRV), blood pressure, heart rate, and amylase concentration.…”