Effects of short-term forest therapy on selected physical and mental health indicators of young healthy individuals
方法 采用自身前后对照的研究设计，于2018年8—9月间，以北京市郊区某国家森林公园为研究地点，以31名健康大学生为研究对象，探讨森林中停留3天2夜前后研究对象身心健康变化情况。研究期间每位研究对象均先后体验漫步疗法、静坐疗法配合五感体验（简称静坐疗法）以及作业疗法3种森林疗养活动，每种活动均持续约2 h。测量研究对象进入森林前后的血压、血氧饱和度（SpO2）、肺功能和呼出气一氧化氮（FeNO），分别采用简明心境状态量表和匹兹堡睡眠质量指数量表对研究对象的心理情绪和睡眠质量指标变化进行评估，并分析不同类型森林疗养活动对研究对象上述心肺健康和心理情绪指标的影响。采用混合效应模型分析短期森林疗养及不同类型森林疗养活动前后研究对象健康指标的改变。
结果 本次研究对象的平均年龄为（24.5±2.6）岁，平均体重指数为（20.7±1.7）kg·m−2。短期森林疗养后，研究对象心肺健康、心理情绪和睡眠质量均有所改善。研究对象的脉压差（PP）和FeNO分别下降3.02 mmHg和1.10 ppb，SpO2和呼气流量峰值（PEF）分别提高0.65%和0.50 L·s−1，负向情绪得分和睡眠质量量表总得分均呈明显的积极改变（均P<0.05）。不同疗养方式对不同健康指标的影响有所不同。漫步疗法对SpO2、肺功能和慌乱（CON）情绪指标呈明显的改善作用，其中SpO2提高0.48%，第1秒用力呼气量（FEV1）上升0.14 L，用力肺活量（FVC）上升0.12 L，CON指标降低0.97分（均P<0.05）。静坐疗法可以降低研究对象血压和紧张（TEN）情绪得分，其中收缩压（SBP）下降4.45 mmHg，PP下降4.19 mmHg，TEN指标下降0.84分（均P<0.05）。作业疗法后舒张压（DBP）小幅度上升（ΔDBP=2.44 mmHg，P=0.016），其他指标改变无统计学意义。
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) (allP<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.