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McEwan K, Collett H, Nairn J, Bird J, Faghy MA, Pfeifer E, Jackson JE, Cook C, Bond A. The Feasibility and Impact of Practising Online Forest Bathing to Improve Anxiety, Rumination, Social Connection and Long-COVID Symptoms: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14905. [PMID: 36429623 PMCID: PMC9691063 DOI: 10.3390/ijerph192214905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/01/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Long-COVID affects over 144 million people globally. In the absence of treatments, there is a need to establish the efficacy of therapies that improve patient outcomes. Forest bathing has been demonstrated to improve physical and mental outcomes but there is no evidence in Long-COVID patients. Accordingly, this pilot study sought to determine the feasibility and effectiveness of online forest bathing in adults with Long-COVID. METHODS Feasibility was assessed by monitoring retention rates and participant feedback. In a waitlist controlled, repeated measures design, 22 Long-COVID patients completed weekly online surveys during a four-week waitlist control period, before engaging in four weekly online forest bathing sessions, completing post-intervention surveys following each session. RESULTS In terms of retention, 27% did not provide post-intervention data, reasons for non-adherence were: feeling too ill, having medical appointments, or having career responsibilities. Compared with the waitlist control period, there were statistically significant improvements in Anxiety (49% decrease), Rumination (48% decrease), Social Connection (78% increase), and Long-COVID symptoms (22% decrease). Written qualitative comments indicated that participants experienced feelings of calm and joy, felt more connected socially and with nature, and experienced a break from the pain and rumination surrounding their illness. CONCLUSIONS Online Forest bathing resulted in significant improvements in well-being and symptom severity and could be considered an accessible and inexpensive adjunct therapy for Long-COVID patients. Where people have limited access to in-person nature, virtual nature may offer an alternative to improve health and well-being outcomes.
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Affiliation(s)
- Kirsten McEwan
- College of Health, Psychology and Social Care, University of Derby, Kedleston Road, Derby DE22 1GB, UK
| | | | - Jean Nairn
- Woodlands Breathing, Edinburgh EH27 8BW, UK
| | - Jamie Bird
- College of Health, Psychology and Social Care, University of Derby, Kedleston Road, Derby DE22 1GB, UK
| | - Mark A. Faghy
- Biomedical Research Theme, School of Human Sciences, University of Derby, Derby DE22 1GB, UK
- Healthy Living for Pandemic Event Protection (HL–PIVOT) Network, Chicago, IL 60612, USA
| | - Eric Pfeifer
- Catholic University of Applied Sciences, Karlstr. 63, 79104 Freiburg, Germany
- Faculty of Psychotherapy Science, Sigmund Freud University Vienna, 1020 Vienna, Austria
| | - Jessica E. Jackson
- College of Health, Psychology and Social Care, University of Derby, Kedleston Road, Derby DE22 1GB, UK
| | | | - Amanda Bond
- Wild Edgewalker Forest Therapy, Jersey JE3 8AF, UK
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BENZARTI W, TOULGUI E, GHRAM A, RAHMANI C, AISSA S, GHANNOUCHI I, GARGOURI I, SAYHI A, KNAZ A, OUANES W, JEMNI S, BEN SAAD H. Impact of a pulmonary rehabilitation program on social disadvantage and physical activity data of postCOVID19 patients: A North-African pilot study. F1000Res 2022; 11:1226. [PMID: 37547787 PMCID: PMC10403745 DOI: 10.12688/f1000research.126301.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 08/08/2023] Open
Abstract
Background In addition to the cardiorespiratory, muscular, and neurological manifestations, coronavirus disease 2019 (COVID-19) alters patients' health-related quality of life (HRQoL), induces a large variety of psychiatric manifestations, and reduces mobility and motor activity. Several studies have raised the impact of a pulmonary rehabilitation program (PRP) on social disadvantage ( e.g., HRQoL, anxiety, depression) and physical activity of COVID-19 patients, but very few have been performed in low-income countries. This study aimed to investigate the impact of a PRP on post-COVID-19 HRQoL, hospital anxiety and depression (HAD), and physical activity in Tunisian post-COVID19-patients. Methods This was a cross-sectional study in an outpatient care setting. Patients with post-COVID-19 were included. They completed an interview (including three questionnaires) before and after a PRP (three sessions/week for four weeks, each session was 70 minutes in duration, PRP items: aerobic cycle endurance, strength training, and education). The VQ11 questionnaire assessed functional dimension, psychological dimension, relational dimension, and total score; HAD appraised depression and anxiety; and Voorrips physical activity assessed daily activity, physical activity, leisure activity, and total scores. Data were expressed as mean±standard deviation in PRP change (PRP change=after-PRP values - before-PRP values). Results In total, 14 moderate to severe post-COVID-19 patients (61±4 years) were included. The PRP significantly improved the i) functional, psychological, and relational dimensions, and the VQ11 total score by 1.79±1.58 (p=0.0033), 2.00±2.15 (p=0.0108), 1.57±1.50 (p=0.0077), and 5.36±3.97 (p=0.0015), respectively; ii) HAD anxiety and depression scores by 2.07±2.40 (p=0.0076), and 2.57±3.08 (p=0.0058); and iii) physical activity and total scores by 1.75±2.44 (p=0.0251), and 1.78±2.65 (p=0.0341), respectively. Conclusion The PRP improved HRQoL, HAD, and physical activity of Tunisian post-COVID-19 patients.
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Affiliation(s)
- Wafa BENZARTI
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Emna TOULGUI
- Department of Physical Medicine and Rehabilitation,, Sahloul Hospital,, Sousse, Tunisia
| | - Amine GHRAM
- Research laboratory “Heart failure, LR12SP09”, Hospital Farhat HACHED of Sousse, Sousse, Tunisia
| | - Chiraz RAHMANI
- Department of Physical Medicine and Rehabilitation,, Sahloul Hospital,, Sousse, Tunisia
| | - Sana AISSA
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Ines GHANNOUCHI
- Research laboratory “Heart failure, LR12SP09”, Hospital Farhat HACHED of Sousse, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Imene GARGOURI
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Amani SAYHI
- Research laboratory “Heart failure, LR12SP09”, Hospital Farhat HACHED of Sousse, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Asma KNAZ
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Walid OUANES
- Department of Physical Medicine and Rehabilitation,, Sahloul Hospital,, Sousse, Tunisia
| | - Sonia JEMNI
- Department of Physical Medicine and Rehabilitation,, Sahloul Hospital,, Sousse, Tunisia
| | - Helmi BEN SAAD
- Research laboratory “Heart failure, LR12SP09”, Hospital Farhat HACHED of Sousse, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
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Toulgui E, Benzarti W, Saad HB. Comments about the “Systematic Review: Physical Rehabilitation Therapy for Long COVID-19 Patient with Respiratory Sequelae”. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
I read with great interest the systematic review of Prabawa et al. “Physical Rehabilitation Therapy for Long COVID-19 Patient with Respiratory Sequelae: A Systematic Review”. The rational of this systematic review is very interesting, since it discusses the rehabilitation therapy for long coronavirus disease 2019 (COVID-19) syndrome with respiratory sequelae. In COVID-19, physical rehabilitation is a new management axis, and studies related to its impacts on COVID-19 patients’ data are scarce. In their paper, Prabawa et al. have included one Tunisian study (Benzarti W, et al. General practitioners should provide the cardiorespiratory rehabilitation’ ‘minimum advice’ for long COVID-19 patients. Lib J Med. 2022;17(1):2009101) published by the authors of this correspondence. However, three remarks related to the following points were noted: i) Citation of a wrong country of Benzarti et al., ii) Publishing a figure belonging to Benzarti et al. without obtaining the authors’ permission, and iii) Omission to develop a chapter for nutrition rehabilitation. The present Letter to Editor is an appeal for a more rigor when reporting data from previous publications (eg; avoid mistakes related to the country of the first author), and is a remain that permission is needed if some authors want to use a figure created by somebody else.
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