Effects of Types of Horticultural Activity on the Physical and Mental State of Elderly Individuals

Kokedama and essential oils had a relaxing psychophysiological effect on Taiwanese women during the COVID-19 pandemic

BACKGROUND

During the COVID-19 pandemic, we designed an indoor nature activity program for citizens with a relaxing effect similar to forest bathing to promote their physical and mental health. We integrated an indoor horticultural activity (Kokedama) with the breathing of Pseudotsuga menziesii (P. menziesii) and Lavandula angustifolia (L. angustifolia) essential oils (EOs) with the goal of creating a nature-inspired environment in an indoor setting where participants would feel as if immersed in a forest atmosphere.

METHODS

Taiwanese women participated in the experiment, using two Saturday mornings, one Saturday in a university classroom in the city center; and the other Saturday in a workshop in a Suburban Park. Intra-group comparisons were used to assess the Physiological responses to urban and suburban environmental stimuli and measured self-reported psychological responses. We recorded parameters associated with heart-rate variability and brainwaves. We also administered the State-Trait Anxiety Inventory-State (STAI-S) questionnaire before and after the participants had completed the entire program.

RESULTS

After the participants had breathed the P. menziesii and L. angustifolia EOs, the levels of some physiological parameters increased (standard deviation of normal-to-normal intervals, normalized high frequency, and high alpha wave) and those of others decreased (normalized low frequency, low- to high-frequency ratio power, high beta wave, and gamma wave). These findings were corroborated by the data from the STAI-S questionnaires.

CONCLUSIONS

The psychophysiological data from this study provide significant scientific evidence for the health benefits of an indoor nature activity program in women.

Which horticultural activities are more effective for children's recovery from stress and mental fatigue? A quasi-experimental study

Introduction

Studies have established the benefits of horticultural therapy and activities for human health and well-being. Nonetheless, limited research has been conducted on the potential restorative advantages and distinctions between different types of horticultural activities in terms of stress reduction.

Methods

This study employed a quantitative research method to investigate the stress recovery benefits of five horticultural activities (flower arrangement, sowing and transplanting seeds, kokedama crafting, pressed flower card making, and decorative bottle painting with dried flowers) and one reference activity (short composition writing) for children. The experiment was conducted in a children's activity center's multi-purpose classroom with 48 elementary students aged 9-12 years. The subjects first took a stress test to induce stress and then engaged in horticultural activities for 20 min. Physiological stress was assessed using electrocardiograms and electroencephalograms as feedback indicators. Psychological and emotional changes were determined using the Positive and Negative Affect Schedule for Children and Self-Assessment Manikin scales.

Results

The results demonstrated that horticultural activities greatly reduced physiological fatigue, and their recovery benefits were significantly greater than those of the reference activity. The recovery effects from different horticultural activities were similar across physiological indicators, although flower arrangement and sowing and transplanting seeds exhibited relatively robust recovery benefits. The heart rate and α-EEG-based generalized estimating equation revealed that horticultural activities offered significantly better relative recovery at each time phase of operation than the reference activity, with girls showing a 3.68% higher relative recovery value than boys. Flower arrangement and kokedama crafting offered better physiological recovery for students with prior horticultural experience, and these two activities received the highest scores in terms of positive effects and the "pleasure" dimension. Students believed that participating in horticultural activities resulted in a noteworthy increase in personal confidence and a greater sense of achievement.

Conclusion

The study suggests that horticultural activities that involve real and vibrant plants or natural materials and are more attractive have more stress-relieving benefits. We conclude that horticultural activities are beneficial leisure activities that aid in stress relief for children and that it is important to consider the attributes of activities when developing horticultural programs for elementary students.

Effects of Linpan nature therapy on health benefits in older women with and without hypertension

Background

Nature therapy can significantly benefit the physiology and psychology of middle-aged and older people, but previous studies have focused on forest environments. The restoration potential of rural environments in urban fringe areas, which are more accessible to older people on a daily basis, has not been fully studied. This study assessed the effects of nature therapy on the physical and mental health of older women in a rural setting (locally known as Linpan) in the urban fringe area of Chengdu, China.

Methods

We recruited a total of 60 older women (65.3 ± 5.5 years old) living in cities for 3 days of nature therapy in the winter (30 subjects) and spring (30 subjects), including 20 hypertensive patients.

Results

The results showed that the overall blood pressure, pulse and sleep dysfunction rating scores of the participants were significantly lower than the pretest levels, and the finger blood oxygen saturation, mid-day salivary alpha-amylase and cortisol were increased post-treatment. Increases in these biomarker indicates and increase in stress. There were significant differences in the changes in systolic blood pressure between the hypertension group (HTN) and the normal group (normal) (HTN decreased by 8.8%, normal decreased by 5.4%), salivary alpha-amylase content (HTN decreased by 0.3%, normal increased by 16.9%), and sleep dysfunction rating scores (HTN decreased by 59.6%, normal decreased by 54%). The decreases in systolic blood pressure and pulse in the winter group were higher than those in the spring group by 1.8 and 4.4%, respectively, while the increases in salivary alpha-amylase content and salivary cortisol content were lower than those in the spring group by 11.7 and 11.2%, respectively, and the decrease in sleep dysfunction rating scores was lower than that in the spring group by 7.1%.

Conclusion

Our study concluded that nature therapy based on various health activities in the Linpan has significant health effects on older women. It can regulate blood pressure and pulse in older women, relieve cardiovascular disease, improve sleep quality. Meanwhile, older women with high blood pressure experienced a more significant effect than the healthy group.

Horticultural therapy for stress reduction: A systematic review and meta-analysis

Introduction

Horticultural therapy has been increasingly accepted as a non-pharmacological stress reduction treatment. Previous studies have demonstrated its therapeutic effects, with the effect varying according to the populations, settings, and interventions of horticultural therapy. This study aimed to provide a comprehensive review of the current literature regarding the effectiveness of horticultural therapy in reducing stress.

Methods

We selected databases including PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, and VIP Data as our data source, and the original search was completed in January 2023.

Results

Our results showed significantly increased effects of horticultural therapy on psychological indicators compared to a control group, but an insignificant effect on physiology indicators. The result of the subgroup analysis demonstrated that the stress-reducing effects of horticultural therapy were related to the characteristics of the population and indoor and virtual areas were the most effective setting for horticultural therapy. At the same time, a total duration of 100-500 minutes provided better effects of stress reduction.

Discussion

We also developed a theoretical framework based on a "Participants-Settings-Interventions" structure for horticulture therapy in terms of its stress-reduction effects, to provide a reference for future horticultural therapy activities.

Effectiveness of horticultural therapy in aged people with depression: A systematic review and meta-analysis

Background

Depression, an increasing global crisis, has affected many people's daily life, especially for older adults. Horticultural therapy has been widely used in non-pharmacological treatment for patients with depression, with a body of studies demonstrating its therapeutic effects. However, a lack of systematic reviews and meta-analyses makes it difficult to get a holistic picture of this research field.

Objectives

We aimed to evaluate the reliability of the previous studies and the effectiveness of horticultural therapy (including the intervention of environmental settings, activities, and duration) on older adults with depression.

Methods

This systematic review was conducted under the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) guidelines. We searched relevant studies in multiple databases, and the original search was finished on 25 September 2022. We included studies using randomized controlled trials (RCTs) or quasi-experimental designs.

Results

We yielded a total of 7,366 studies and finally included 13 which involved 698 aged people with depression. Results from meta-analysis indicated significant effects of horticultural therapy on reducing depressive symptoms for the older adults. Besides, we found different outcomes among various horticultural interventions (such as environmental setting, activities, and duration). Depression reduction was more effective in care-providing settings than in community settings; participatory activities were more effective in reducing depression than observational activities; intervention of 4–8 weeks might represent the optimal course of treatment compared to interventions more than 8 weeks in duration.

Conclusion

We came up with a comprehensive set of recommendations based on the meta-analysis: aged people in care-providing settings with depression could get the most benefit from horticultural therapy by participating in participatory activities for 4–8 weeks.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022363134, identifier CRD42022363134.

Relaxing Effects of Breathing Pseudotsuga menziesii and Lavandula angustifolia Essential Oils on Psychophysiological Status in Older Adults

We evaluated the effects of breathing Pseudotsuga menziesii (P. menziesii) and Lavandula angustifolia (L. angustifolia) essential oils (EOs) during a horticultural activity on older adults. A total number of 92 older adult (71.2 ± 7.7 years old) participants were guided through a leaf printing procedure. In the meantime, water vapor and EOs were diffused in an orderly manner. The heart rate variability-related parameters as well as the brain waves were recorded. In addition, we also collected data for the State-Trait Anxiety Inventory-State (STAI-S) questionnaires before and after the whole indoor natural activity program. The physiological parameters including standard deviation of normal to normal intervals, normalized high frequency (nHF), and high alpha wave increased while the normalized low frequency (nLF), the ratio of LF-to-HF power, high beta wave, and gamma wave decreased following the breathing of P. menziesii and L. angustifolia EOs. These changes indicated a relaxing effect of breathing both EOs during a horticultural activity on older adults. Our results demonstrated a beneficial effect of P. menziesii EO which is as good as a well-known relaxant L. angustifolia EO. This notion was supported by the results of STAI-S. Here we developed an indoor natural activity program for older adults to promote physical and mental health.

The effect of horticultural therapy on depressive symptoms among the elderly: A systematic review and meta-analysis

Objective

This systematic review and meta-analysis aimed to assess the effectiveness of horticultural therapy on depressive symptoms in the elderly and determine the potential moderators of the intervention effect.

Methods

In early June 2022, randomized controlled trials and Quasi-experimental studies were searched on Web of Science, PsycINFO, CINAHL, EMBASE, Medline, PubMed, CNKI, WANFANG DATA, and CQVIP. Three independent authors proposed the following inclusion criterion for this study: the elderly with applied horticultural therapy intervention compared to non-HT intervention. From a total of 3,068 records, only 34 studies met the inclusion criteria. After the full-text screening, 13 studies were included in the analysis. An assessment of the risk of bias was conducted using RoBINS-I and RoB 2 tools. The comprehensive Meta-Analysis 3.3 tool was used for the meta-analysis.

Results

Meta-analysis suggested that mean depression scores of elderly people who underwent horticultural therapy intervention were significantly lower than those who did not receive HT therapy. More significant effects were found for the elderly with mean age equal to or over 75 years instead of younger than 75 years, in randomized controlled trials instead of quasi-experimental studies, for studies with more than 20 participants receiving horticultural therapy at the same time and place instead of equal to or fewer than 20 horticultural therapy participants.

Conclusions

This evidence supported that horticultural therapy had a significant positive effect on the depressive symptoms outcomes for the elderly. Therefore, our data revealed that horticultural therapy could be considered as a part of therapy in depressive symptoms reduction programs. Due to the high degree of heterogeneity and the limited number of studies, a future review is warranted to determine the effects of horticultural therapy on depressive symptoms reduction in the elderly.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=272464, identifier: CRD42021272464.

Horticulture therapy affected the mental status, sleep quality, and salivary markers of mucosal immunity in an elderly population

Horticultural therapy (HT) has been reported to be beneficial to mental and physical health. This study investigated the effects of HT on the psychological status and mucosal immunity of elderly individuals. Twenty-four participants aged 70-93 were recruited from residential facilities and adult day-care services. Six different HT activities were designed and guided by licensed instructors who performed saliva collection and helped the participants complete the questionnaires before and after each activity. The sleep quality scores were collected during the 6 weeks of HT activities. Saliva was collected and analyzed to determine the concentrations of immunoglobulin A (IgA), lactoferrin, chromogranin A (CgA), α-amylase (AA) and total protein (TP). Comparisons of the questionnaire scores between preactivity and postactivity showed that feelings of satisfaction and happiness were significantly enhanced after each activity. In addition, sleep quality was significantly improved after the 6-week course of HT activities. Regarding mucosal immunity, the preactivity IgA and IgA/TP were significantly increased at week 3 and week 6; in addition, the ratio of lactoferrin/TP was significantly decreased at week 6 compared to week 1. The postactivity AA and CgA levels were significantly enhanced at weeks 2, 3 and 5 compared to the corresponding preactivity levels. In conclusions, HT activities significantly improved the happiness, satisfaction, well-being and sleep quality of the elderly. Moreover, mucosal immunity proteins, including IgA, lactoferrin, CgA and AA, were significantly increased.

Electroencephalography (EEG)-Based Neural Emotional Response to Flower Arrangements (FAs) on Normal Elderly (NE) and Cognitively Impaired Elderly (CIE)

Background: The purpose of this study is to explore the differences and similarities of EEG -based neural emotional response toward flower arrangements (FAs) between the normal elderly (NE) and cognitively impaired elderly (CIE) in arranging flowers. Methods: The study participants included 16 elderly individuals: eight elderly people with normal cognitive function and eight elderly people with cognitive dysfunction. They were divided into two groups to arrange flowers, and six mood indicators (Engagement, Excitation, Focus, Interest, Relaxation and Stress) were measured with EEG before and after the experiment. Results: The similarities were that there was no significant difference in Excitement, Relaxation and Stress between pre-test and post-test for NE and CIE. The differences were that there was a significant difference on Engagement and Interest in CIE, and they both increased, but there was no difference with respect to them in NE. While there was a significant difference on the Focus of NE, it was decreased, but there was no difference for it with respect to CIE. Conclusions: A similarity on EEG-Based Neural Emotional Responses to flower arrangements between NE and CIE was that they both felt relaxation. The differences were that the Focus of NE decreased and the Interest and Engagement of CIE increased. CIEs were more interested and engaged in FAs.

Process Design for Optimized Respiration Identification Based on Heart Rate Variability for Efficient Respiratory Sinus Arrhythmia Biofeedback

Respiratory sinus arrhythmia (RSA) is a phenomenon in which the heart rate (HR) changes with respiration, increasing during inspiration and decreasing during expiration. RSA biofeedback training has an effect in relieving negative mental conditions, such as anxiety and stress. Respiration is an important indicator affecting the parasympathetic activation within the body during RSA biofeedback training. Although there are existing studies that consider individual differences when selecting optimized respiration using heart rate variability, the studies that use the high frequency components of HRV, which is an indicator of parasympathetic activation, are insufficient. For this reason, this paper proposes a process to identify optimized respiration for efficient RSA feedback, consisting of three steps: (1) application, (2) optimization, and (3) validation. In the application phase, we measured PPG data against various respiratory cycles based on the HF components of HRV and calculated the proposed heart stabilization indicator (HSI) from the data. Then, we determined the optimized respiration cycle based on the HSI in the optimization step. Finally, we analyzed seven stress-related indices against the optimized respiration cycle. The experimental results show that HSI is associated with the parasympathetic nervous system activation, and the proposed method could help to determine the optimal respiratory cycle for each individual. Lastly, we expect that the proposed design could be used as an alternative to improving the efficiency of RSA biofeedback training.

Attention and Emotional States during Horticultural Activities of Adults in 20s Using Electroencephalography: A Pilot Study

Since indoor, sedentary lifestyles became prevalent in society, humans have lost a sustainable connection to nature. An intervention utilizing outdoor horticultural activities could address such a challenge, but their beneficial effects on the brain and emotions have not been characterized in a quantitative approach. We aimed to investigate brain activity and emotional changes in adults in their 20s during horticultural activity to confirm feasibility of horticultural activity to improve cognitive and emotional states. Sixty university students participated in 11 outdoor horticultural activities at 2-min intervals. We measured brain waves of participants’ prefrontal cortex using a wireless electroencephalography device while performing horticultural activities. Between activities, we evaluated emotional states of participants using questionnaires. Results showed that each horticultural activity showed promotion of brain activity and emotional changes at varying degrees. The participants during physically intensive horticultural activities—digging, raking, and pruning—showed the highest attention level. For emotional states, the participants showed the highest fatigue, tension, and vigor during digging and raking. Plant-based activities—harvesting and transplanting plants—made participants feel natural and relaxed the most. Therefore, this pilot study confirmed the possibility of horticultural activity as a short-term physical intervention to improve attention levels and emotional stability in adults.

Horticultural Activity Type, Psychological Well-Being, and Fruit and Vegetable Intake

The purpose of this study was to explore the effect of the frequency of participation in horticultural activity types on psychological well-being and fruit and vegetable intake. The study sought to understand the mediating effect of psychological well-being between the frequency of types of horticultural activities and the frequency of fruit and vegetable intake. Convenience sampling was used to collect 400 valid data through a self-administered questionnaire that inquired about the frequency of four horticultural activity types (indoor plant activities, outdoor plant activities, arts/crafts activities, and excursions), the measure of psychological well-being, and the frequency of fruit and vegetable intake. The results showed that a higher frequency of indoor and outdoor plant activity positively affected psychological well-being. Psychological well-being played a partial mediation role between indoor plant activity and vegetable and fruit intake and a full mediation role between outdoor plant activity and vegetable and fruit intake. The plant-related arts/crafts activities and excursions were not associated with psychological well-being or vegetable and fruit intake.

Effects of Elastic Band Exercise on Functional Fitness and Blood Pressure Response in the Healthy Elderly

Purpose: This study investigated the effects of 12 weeks of moderate intensity elastic band exercise (EBE) on functional fitness and blood pressure parameters in the elderly. Methods: 27 healthy older adults were randomly assigned to an exercise group (n = 15, age: 75.1 ± 1.4 years) and a control group (n = 12, age: 72.3 ± 1.4 years). Participants performed EBE for 60 min, three times a week, over the course of three months. The EBE consisted of incremental resistance and aerobic exercises designed to improve whole body fitness. Functional fitness and resting cardiovascular parameters were assessed before and after the exercise training program. Results: Grip strength, sit and reach, and one-leg stance improved significantly in the exercise group, while no significant improvements were found in chair stand and timed up and go (p < 0.05). Cardiovascular parameters including systolic blood pressure, diastolic blood pressure, mean arterial pressure, and pulse pressure significantly decreased in the exercise group relative to the control group (p < 0.05). Conclusions: Findings of the present study suggest that safe, inexpensive, and easily accessible EBE program with circuit training components play a significant role in improving upper and lower body fitness, as well as cardiovascular fitness, in the elderly.