Mood and physiological effects of visual stimulation with images of the natural environment in individuals with depressive and anxiety disorders

BACKGROUND

Nature therapies are gaining attention as non-pharmacological treatments for depressive and anxiety disorders, but research on their effectiveness in patients is limited. This study investigates the mood-improving effects of visual stimulation with natural environmental images in patients with depressive and anxiety disorders.

METHODS

We conducted a randomized crossover comparison trial involving 60 right-handed adult participants with depressive or anxiety disorders and receiving outpatient treatment. Visual stimuli of natural environments consisted of green-themed nature images, while the control stimuli featured urban scenes dominated by buildings. The stimulation lasted for 3 min, during which orbital prefrontal brain activity was measured using a 2-channel Near-infrared Spectroscopy (NIRS) system, and heart rate variability was assessed using fingertip accelerated plethysmography.

RESULTS

Mood enhancement effects were observed in both the depressive and anxiety disorder groups following visual stimulation with nature images. In the depression group, orbital prefrontal oxygenated hemoglobin concentration significantly increased after visual stimulation with nature images, while there were no significant changes in the anxiety group. However, in the anxiety group, a correlation was found between reduced orbital prefrontal oxygenated hemoglobin in response to nature images and increased mood-enhancement. Furthermore, the severity of depressive symptoms did not significantly affect the intervention effects, whereas heightened anxiety symptoms was associated with a smaller mood enhancement effect.

DISCUSSION

Our study demonstrates the benefits of nature image stimulation for patients with depressive and anxiety disorders. Differential orbital prefrontal brain activity impacts notwithstanding, both conditions exhibited mood enhancement, affirming the value of nature image stimulation.

Relaxation Effect of Nature Sound Exposure on Gambling Disorder Patients: A Crossover Study

Objective: Gambling disorder (GD) has been associated with economic, social, mental, and physical problems. Alternative leisure activities or stress-relieving activities have been adopted as part of GD treatment. Moreover, it has been proven that activities utilizing the natural environment, such as shinrin-yoku, have a relaxing effect on healthy people. In this study, we examined the physiological and psychological responses of patients with GD to determine whether nature therapy could reduce their stress responses. Design: This study included 22 Japanese male participants who were found to be pathological gamblers, with a South Oaks Gambling Screen score of ≤5. We exposed the participants to the digital nature sounds of insects and city sounds of a scramble intersection. The nature and city sounds were presented in a counterbalanced order. Outcome measures: A two-channel near-infrared spectroscopy system was used to measure the changes in oxyhemoglobin (oxy-Hb) concentrations in the bilateral prefrontal cortex. The heart rate variability was measured to evaluate the autonomic nervous activity. Subjective evaluation was performed using the modified version of the semantic differential method and the Profiles of Mood States, Second Edition (POMS2). Results: The oxy-Hb level in the bilateral prefrontal cortex significantly decreased. No significant difference in the high-frequency (HF) and low-frequency/HF ratio was observed. The subjective evaluation indicated that the participants experienced increased comfort and relaxation and had more natural feelings. Nature sounds significantly decreased the POMS2 negative emotion subscale and total mood disturbance scores and increased the positive emotion subscale scores. Nature-based stimulus exposure induces physiological relaxation and other positive effects among individuals even with GD. Conclusion: Exposure to nature-based sounds induces physiological relaxation and other positive responses among individuals with GD. In patients with GD, nature sounds produce the same relaxation response as in healthy individuals. (Umin.ac.jp under registration number: UMIN000042368).

Physiological Effects of Visual Stimulation by a Japanese Low Wooden Table: A Crossover Field Experiment

The purpose of this study was to evaluate the physiological effects of visual stimulation by a unique Japanese low wooden table on the prefrontal cortex and autonomic nervous activities. A within-participants experiment with 26 male university students was conducted in a Japanese-style room. The visual stimuli were a low wooden table (WT) made of Japanese cypress and a low cloth-covered table (control) for an exposure time of 90 s. Near-infrared spectroscopy was used to measure the prefrontal cortex activity in the left and right prefrontal cortices as an indicator of oxyhemoglobin (oxy-Hb) concentration. Autonomic nervous activity was measured as an indicator of sympathetic (low-frequency/high-frequency component ratio, LF/HF), and parasympathetic (high-frequency components, HF) nervous activities were assessed by heart rate variability. Furthermore, the modified semantic differential method and the Profile of Mood States 2nd edition were used to measure psychological responses. Physiologically, the oxy-Hb concentration in the left prefrontal cortex and ln (LF/HF) were significantly lower during visual exposure to the WT than to the control. Psychologically, more comfortable, relaxed, and natural impressions, as well as improved mood states, were reported during visual stimulation to the WT than to the control. This study demonstrated that viewing a WT led to physiological relaxation and had a positive psychological effect on the participants.

Physiological adjustment effect of visual stimulation by fresh rose flowers on sympathetic nervous activity

Introduction

As modern societies are often stressful due to urbanization and artificialization, the physiological relaxing effects of natural environments or nature-derived stimuli on humans have attracted attention and scientific data are being accumulated. It is known that there is inter-individual variation in these effects. The study aim was to apply the law of initial values to investigate the physiological adjustment effect of viewing fresh roses on sympathetic nervous activity.

Methods

In this crossover study, a total of 214 high school students, office workers, healthcare workers, and elderly people were analyzed. The participants viewed fresh roses in a vase for 4 min. In the control condition, participants did not view any fresh roses during the period. To offset any order effect, participants received visual stimuli in the order of fresh roses then the control (no fresh roses) or the control and then fresh roses. ln (LF/HF) of heart rate variability (HRV) obtained from a-a interval measurements using an acceleration plethysmograph and used as an index of sympathetic nervous activity. The initial value was ln (LF/HF) of HRV during the control viewing (no fresh roses), and the change value was ln(LF/HF) of HRV during visual stimulation by fresh roses minus the control viewing.

Results and Discussion

The correlation between the two was assessed by determining Pearson's correlation coefficient r, which was significantly negative. A physiological adjustment effect was observed such that participants with high initial sympathetic nervous activity showed a decrease in activity after visual stimulation with fresh roses, whereas participants with low initial activity showed an increase.

Physiological and Psychological Responses of Viewing a Waterfall Image: A Crossover Study

Growing interest in the relaxation effect of nature has elicited demands for scientific verification of the various natural elements. This study investigated the physiological and psychological responses of 27 females in their 20 s to viewing a waterfall and urban images (control) presented via a large, high-resolution display for 90 s. High-frequency [HF] for parasympathetic nervous activity and the ratio of low-frequency (LF)/[LF + HF] for sympathetic nervous activity by heart rate variability and heart rate were recorded. Simultaneous changes in oxyhemoglobin concentration in the prefrontal cortex were recorded by near-infrared time-resolved spectroscopy. The modified semantic differential method and Profile of Mood States Second Edition were used to assess the psychological effects on the participants after viewing each image. The results showed that viewing the waterfall image, compared with viewing the urban image, (1) increased sympathetic nervous activity; (2) provided comfortable, relaxed, and natural impressions; (3) improved mood states. In conclusion, visual contact with a waterfall image physiologically activated sympathetic nervous activity and psychologically evoked positive moods and feelings.

Seasonal Differences in Physiological Responses to Walking in Urban Parks

The aim of the current study was to assess seasonal differences in physiological responses to walking in urban parks. In total, 51 Japanese male university students participated in this research. During each season, the participants walked for 15 min in an urban park and a city area, which was used as the control site. Heart-rate variability and heart rate were used as physiological indicators. The mean values of each indicator in a comparison between walking in an urban park and a city area were compared according to each season. In addition, to show the physiological effect of walking in an urban park, differences (between walking in an urban park and walking in a city area) were calculated. Then, differences according to each season were compared. The results showed that the participants had increased parasympathetic nervous system activity in all seasons except summer. Moreover, they had decreased sympathetic nervous system activity in spring and fall and decreased heart rate in all seasons. Compared with walking in urban parks in summer, walking in urban parks in spring, fall, and winter had a greater relaxation effect on parasympathetic and sympathetic nervous system activities; hence, the physiological effects of walking in urban parks vary based on season.

Association between the Psychological Effects of Viewing Forest Landscapes and Trait Anxiety Level

The aim of this study was to validate the psychological advantages of viewing forest landscapes. Moreover, the associations between trait anxiety levels and psychological responses were evaluated. A total of 650 university male students (age, 21.7 ± 1.6 years) viewed a scenery in a forested area and an urban area for 15 min. Furthermore, the Profile of Mood States questionnaire and State-Trait Anxiety Inventory were employed for the assessment of the psychological responses and the level of trait anxiety, respectively, of the participants. Results showed that compared with viewing a city area, viewing forest areas increased positive mood state, such as vigor, and decreased negative mood states. Furthermore, trait anxiety level and changes in the psychological responses such as depression–dejection, fatigue, and confusion after viewing forest landscapes were significantly correlated. The participants with high anxiety levels had greater reduction in negative mood state, including confusion, than those with low anxiety levels. In conclusion, viewing forest landscapes induced psychological relaxation, which was more evident in individuals with high anxiety levels.

Combined Effect of Walking and Forest Environment on Salivary Cortisol Concentration

We investigated the effects of walking in a forest environment on salivary cortisol concentrations. Seventy-four young male participants walked for 15 min in forested and urban environments, and saliva was collected before and after walking. Our previous study reported salivary cortisol concentrations after walking only. This study was aimed at clarifying the combined effects of walking and environment by comparing post-walking data with pre-walking data. Walking in a forest environment decreased mean cortisol concentration from 9.70 to 8.37 nmol/L, whereas walking in an urban environment barely changed mean cortisol concentration, from 10.28 to 10.01 nmol/L. Two-way repeated analysis of variance revealed a significant interaction effect between the environment and walking (p < 0.001) in addition to the main effects of each (p < 0.001 and p = 0.001, for walking and environment, respectively). For further analysis, the proportion of participants who exhibited decreased cortisol after forest-walking was compared with the previously reported proportion of participants who exhibited decreased cortisol after viewing forest landscapes. Although the proportion of positive responders was slightly higher after walking (69%) than it was after viewing (60%), this difference was not statistically significant (p = 0.093). The present study revealed a significant combined effect of walking and the environment on cortisol concentrations.

Psychological Benefits of Walking through Forest Areas

This study aimed to clarify the psychological benefits of brief walks through forest areas. In addition, we aimed to examine the associations between psychological responses and trait anxiety levels. Five-hundred-and-eighty-five participants (mean age, 21.7 ± 1.6 years) were instructed to walk predetermined courses through forest (test) and city (control) areas for 15 min. The Profile of Mood State (POMS) questionnaire and State-Trait Anxiety Inventory were used to assess participants’ psychological responses and trait anxiety levels, respectively. The results revealed that walking through forest areas decreased the negative moods of “depression-dejection”, “tension-anxiety”, “anger-hostility”, “fatigue”, and “confusion” and improved the participants’ positive mood of “vigor” compared with walking through city areas. Furthermore, a significant correlation was found between participants’ trait anxiety levels and their changes in the subscale of “depression-dejection” of POMS after walking through forest areas. A more effective reduction in the feeling of “depression-dejection” after walking through forest areas was observed for participants with high trait anxiety levels than for those with normal and low trait anxiety levels. This study showed the psychological benefits of walking through forest areas and identified a significant correlation between psychological responses to walking through forests and trait anxiety levels.

Physiological Effects of Viewing Bonsai in Elderly Patients Undergoing Rehabilitation

The benefits of various nature-derived stimuli that can be used for stress relief and relaxation has recently gained immense attention; however, there are very few studies about their influence on elderly patients. The present study aims to present the effects of viewing bonsai on autonomic nervous activity, prefrontal cortex activity, and subjective assessment findings of psychological relaxation in elderly patients undergoing rehabilitation. Fourteen participants aged 64⁻91 years (mean age ± standard deviation, 78.6 ± 9.6 years) participated in this study. Miniature potted 10-year-old Japanese cypress bonsai trees were used as visual stimuli. Participants viewed the bonsai for 1 min, and the control comprised of no experimental stimulus. Physiological effects on autonomic nervous activity were assessed by measuring the heart rate variability (HRV) and pulse rate. The effects on prefrontal cortex activity were determined using near-infrared spectroscopy, which involved assessment of oxyhemoglobin concentrations in the left and right prefrontal cortices. Subjective evaluations were achieved by the modified semantic differential method. Viewing bonsai resulted in a significant increase in parasympathetic nervous activity, a significant decrease in sympathetic nervous activity, and a significant increase in the perceptions of feeling "comfortable" and "relaxed." In conclusion, our findings indicated that viewing bonsai induces physiological and psychological relaxation.

Forest Walking Affects Autonomic Nervous Activity: A Population-Based Study

The present study aimed to evaluate the effect of walking in forest environments on autonomic nervous activity with special reference to its distribution characteristics. Heart rate variability (HRV) of 485 male participants while walking for ~15 min in a forest and an urban area was analyzed. The experimental sites were 57 forests and 57 urban areas across Japan. Parasympathetic and sympathetic indicators [lnHF and ln(LF/HF), respectively] of HRV were calculated based on ~15-min heart rate recordings. Skewness and kurtosis of the distributions of lnHF and ln(LF/HF) were almost the same between the two environments, although the means and medians of the indicators differed significantly. Percentages of positive responders [presenting an increase in lnHF or a decrease in ln(LF/HF) in forest environments] were 65.2 and 67.0%, respectively. The percentage of lnHF was significantly smaller than our previous results on HRV during the viewing of urban or forest landscapes, whereas the percentage of ln(LF/HF) was not significantly different. The results suggest that walking in a forest environment has a different effect on autonomic nervous activity than viewing a forest landscape.

Physiological Effects of Touching the Wood of Hinoki Cypress (Chamaecyparis obtusa) with the Soles of the Feet

We clarified the physiological effects of tactile stimulation of the soles of the feet with the wood of the Hinoki cypress (Chamaecyparis obtusa) based on measurements of prefrontal cortex and autonomic nervous activities. Nineteen female university-attending students (age: 21.2 ± 0.3 years) were included. Oxy-hemoglobin (oxy-Hb) concentrations in the prefrontal cortex were determined by using near-infrared time-resolved spectroscopy. The high frequency (HF) indicating parasympathetic nervous activity and the ratio of low frequency (LF)/HF indicating sympathetic nervous activity were measured using heart rate variability. To evaluate the psychological effects caused by contact with the materials, the modified semantic differential method was used. The soles of the participants' feet were touched to a 600 × 600-mm plate made of Hinoki, which was finished in non-coating and brushing for 90 s. A marble plate served as the control. Next, subjective evaluation tests were administered to the participants. Compared with touching marble, touching Hinoki significantly (1) decreased the oxy-Hb concentrations in the left and right prefrontal cortices, which indicates decreased prefrontal cortex activity, (2) increased ln(HF), which indicates increased parasympathetic nervous activity, (3) decreased ln(LF/HF) ratio, which indicates decreased sympathetic nervous activity. Additionally, (4) according to subjective evaluations, the participants perceived themselves as being more "comfortable," "relaxed," "natural," "warm," "uneven," "dry," and "soft" after touching Hinoki. Thus, our cumulative findings indicate that touching Hinoki with the soles of the feet induces physiological relaxation.

Physiological Effects of Visual Stimulation with Forest Imagery

This study was aimed to clarify the physiological effects of visual stimulation using forest imagery on activity of the brain and autonomic nervous system. Seventeen female university students (mean age, 21.1 ± 1.0 years) participated in the study. As an indicator of brain activity, oxyhemoglobin (oxy-Hb) concentrations were measured in the left and right prefrontal cortex using near-infrared time-resolved spectroscopy. Heart rate variability (HRV) was used as an indicator of autonomic nervous activity. The high-frequency (HF) component of HRV, which reflected parasympathetic nervous activity, and the ratio of low-frequency (LF) and high-frequency components (LF/HF), which reflected sympathetic nervous activity, were measured. Forest and city (control) images were used as visual stimuli using a large plasma display window. After sitting at rest viewing a gray background for 60 s, participants viewed two images for 90 s. During rest and visual stimulation, HRV and oxy-Hb concentration in the prefrontal cortex were continuously measured. Immediately thereafter, subjective evaluation of feelings was performed using a modified semantic differential (SD) method. The results showed that visual stimulation with forest imagery induced (1) a significant decrease in oxy-Hb concentrations in the right prefrontal cortex and (2) a significant increase in perceptions of feeling "comfortable," "relaxed," and "natural."

Diurnal Changes in Distribution Characteristics of Salivary Cortisol and Immunoglobulin A Concentrations

Salivary cortisol and secretory immunoglobulin A (S-IgA) are important biomarkers for environmental and public health research. The present study investigated the diurnal variations of these salivary biomarkers, with a focus on the change of distribution characteristics (i.e., skewness and kurtosis) of the concentrations. The participants in this study were 113 healthy young males. Salivary samples were collected in the morning (6:30–7:30 a.m.) and afternoon (1:00–4:00 p.m.). The skewness and kurtosis of salivary cortisol concentrations in afternoon samples (skewness = 1.06, kurtosis = 4.78) were significantly higher than those in morning samples (skewness = 0.49, kurtosis = 2.80). The differences in skewness and kurtosis of S-IgA concentrations were non-significant; however, the standard deviation and interquartile ranges for afternoon S-IgA concentrations were significantly smaller than those for morning S-IgA concentrations. Logarithmic transformation improved the distribution of afternoon cortisol values, making it an almost normal distribution, but the transformation showed no improvement in the distribution of morning cortisol or S-IgA values. The present study explored diurnal changes in the distribution characteristics of salivary cortisol and S-IgA. Consideration of a possible diurnal change in the distribution characteristics is needed when we compare the difference in these salivary biomarkers between different times of day.

Physiological Effects of Touching Coated Wood

This study examined the physiological effects of touching wood with various coating with the palm of the hand on brain activity and autonomic nervous activity. Participants were 18 female university students (mean age, 21.7 ± 1.6 years). As an indicator of brain activity, oxyhemoglobin concentrations were measured in the left and right prefrontal cortices using near-infrared time-resolved spectroscopy. Heart rate variability (HRV) and heart rate were used as indicators of autonomic nervous activity. The high-frequency (HF) component of HRV, which reflects parasympathetic nervous activity, and the low-frequency (LF)/HF ratio, which reflects sympathetic nervous activity, were measured. Plates of uncoated, oil-finished, vitreous-finished, urethane-finished, and mirror-finished white oak wood were used as tactile stimuli. After sitting at rest with their eyes closed for 60 s, participants touched the stimuli with their palm for 90 s each. The results indicated that tactile stimulation with uncoated wood calmed prefrontal cortex activity (vs. urethane finish and mirror finish), increased parasympathetic nervous activity (vs. vitreous finish, urethane finish, and mirror finish), and decreased heart rate (vs. mirror finish), demonstrating a physiological relaxation effect. Further, tactile stimulation with oil- and vitreous-finished wood calmed left prefrontal cortex activity and decreased heart rate relative to mirror-finished wood.

Physiological Effects of Nature Therapy: A Review of the Research in Japan

Humans have evolved into what they are today after the passage of 6-7 million years. If we define the beginning of urbanization as the rise of the industrial revolution, less than 0.01% of our species' history has been spent in modern surroundings. Humans have spent over 99.99% of their time living in the natural environment. The gap between the natural setting, for which our physiological functions are adapted, and the highly urbanized and artificial setting that we inhabit is a contributing cause of the "stress state" in modern people. In recent years, scientific evidence supporting the physiological effects of relaxation caused by natural stimuli has accumulated. This review aimed to objectively demonstrate the physiological effects of nature therapy. We have reviewed research in Japan related to the following: (1) the physiological effects of nature therapy, including those of forests, urban green space, plants, and wooden material and (2) the analyses of individual differences that arise therein. The search was conducted in the PubMed database using various keywords. We applied our inclusion/exclusion criteria and reviewed 52 articles. Scientific data assessing physiological indicators, such as brain activity, autonomic nervous activity, endocrine activity, and immune activity, are accumulating from field and laboratory experiments. We believe that nature therapy will play an increasingly important role in preventive medicine in the future.

Physiological effect of olfactory stimulation by Hinoki cypress (Chamaecyparis obtusa) leaf oil

BACKGROUND

In recent years, increasing attention has been paid to the physiological effects of nature-derived stimulation. The physiological relaxation effects caused by forest-derived olfactory stimuli have been demonstrated. However, there are no studies on the physiological effects of olfactory stimuli by Hinoki cypress (Chamaecyparis obtusa) leaves. We investigated the effects of olfactory stimulation by Hinoki cypress leaf oil on the left/right prefrontal cortex activity, assessed using near-infrared time-resolved spectroscopy (TRS), and on the autonomic nervous activity, assessed by measuring heart rate variability (HRV).

METHOD

Thirteen female university students (mean age, 21.5 ± 1.0 years) participated in the study. Physiological measurements were performed in an artificial climate maintained at 25 °C, 50% relative humidity, and 230-lx illumination. Hinoki cypress leaf oil was used as an olfactory stimulation with air as the control. The odor was administered for 90 s, while the subjects sat with their eyes closed. Oxyhemoglobin (oxy-Hb) concentrations were measured in the prefrontal cortex using TRS. The high-frequency (HF) component of HRV, which is an estimate of parasympathetic nervous activity, and the low-frequency (LF)/(LF + HF) ratio, which is an estimate of sympathetic nervous activity, were measured by electrocardiography. A modified semantic differential method was used to perform subjective evaluations.

RESULTS

Olfactory stimulation by Hinoki cypress leaf oil induced a significant reduction in oxy-Hb concentration in the right prefrontal cortex and increased parasympathetic nervous activity. The subjects reported feeling more comfortable.

CONCLUSION

These findings indicate that olfactory stimulation by Hinoki cypress leaf oil induces physiological relaxation.

Physiological and Psychological Effects of a Forest Therapy Program on Middle-Aged Females

The natural environment is increasingly recognized as an effective counter to urban stress, and "Forest Therapy" has recently attracted attention as a relaxation and stress management activity with demonstrated clinical efficacy. The present study assessed the physiological and psychological effects of a forest therapy program on middle-aged females. Seventeen Japanese females (62.2 ± 9.4 years; mean ± standard deviation) participated in this experiment. Pulse rate, salivary cortisol level, and psychological indices were measured on the day before forest therapy and on the forest therapy day. Pulse rate and salivary cortisol were significantly lower than baseline following forest therapy, indicating that subjects were in a physiologically relaxed state. Subjects reported feeling significantly more "comfortable," "relaxed," and "natural" according to the semantic differential (SD) method. The Profile of Mood State (POMS) negative mood subscale score for "tension-anxiety" was significantly lower, while that for "vigor" was significantly higher following forest therapy. Our study revealed that forest therapy elicited a significant (1) decrease in pulse rate, (2) decrease in salivary cortisol levels, (3) increase in positive feelings, and (4) decrease in negative feelings. In conclusion, there are substantial physiological and psychological benefits of forest therapy on middle-aged females.

Physiological and Psychological Effects of a Walk in Urban Parks in Fall

In recent times, attention has been focused on the role of urban green spaces in promoting human health and well-being. However, there is a lack of evidence-based research on the physiological effects of walking in urban green areas. This study aimed to clarify the physiological and psychological effects of walking in urban parks during fall. Twenty-three males (mean age 22.3 ± 1.2 years) were instructed to walk predetermined 15-min courses in an urban park and in a nearby city area (control). Heart rate and heart rate variability were measured to assess physiological responses, and the semantic differential method, Profile of Mood States, and State-Trait Anxiety Inventory were used to measure psychological responses. We observed that walking in an urban park resulted in a significantly lower heart rate, higher parasympathetic nerve activity, and lower sympathetic nerve activity than walking through the city area. In subjective evaluations, participants were more "comfortable," "natural," "relaxed," and "vigorous" after a walk in the urban park. Furthermore, they exhibited significantly lower levels of negative emotions and anxiety. These findings provide scientific evidence for the physiological and psychological relaxation effects of walking in urban parks during fall.

Physiological and Psychological Effects of Viewing a Kiwifruit (Actinidia deliciosa 'Hayward') Orchard Landscape in Summer in Japan

The physiological and psychological relaxation effects of viewing a kiwifruit (Actinidia deliciosa ‘Hayward’) orchard landscape were investigated. Seventeen Japanese adult females (46.1 ± 8.2 years) viewed a kiwifruit orchard landscape or a building site (control) for 10 min. The heart rate variability and heart rate were determined. The modified semantic differential method and the short-form Profile of Mood States were used to assess the psychological effects. Compared with viewing the building site, viewing the kiwifruit orchard landscape resulted in a significant increase in the parasympathetic activity, a marginally significant decrease in the heart rate, a significant increase in “comfortable”, “relaxed” and “natural” feelings and a significant improvement in mood states.

[Psychological Effects of Forest Therapy Program on Workers]

OBJECTIVES

To examine the psychological effects of forest therapy program on workers.

METHODS

The subjective symptoms index, a shortened version of the profile of mood states (POMS), and a semantic differential (SD) method were used to measure the psychological effects.

RESULTS

The evaluations were performed 3 days before, during, and 1, 3, and 5 days after the forest therapy. The following results were obtained: (1) the subjective symptoms improved before breakfast and continued for 5 days; (2) the mood evaluated using POMS improved before breakfast and continued for 3 days; and (3) “comfortable,” “relaxed,” and “natural” feelings evaluated using the SD method were enhanced before breakfast, lunch, and dinner during forest therapy.

CONCLUSIONS

These results provided scientific evidence of the psychological effects of forest therapy program on workers.

Effect of forest walking on autonomic nervous system activity in middle-aged hypertensive individuals: a pilot study

There has been increasing attention on the therapeutic effects of the forest environment. However, evidence-based research that clarifies the physiological effects of the forest environment on hypertensive individuals is lacking. This study provides scientific evidence suggesting that a brief forest walk affects autonomic nervous system activity in middle-aged hypertensive individuals. Twenty participants (58.0 ± 10.6 years) were instructed to walk predetermined courses in forest and urban environments (as control). Course length (17-min walk), walking speed, and energy expenditure were equal between the forest and urban environments to clarify the effects of each environment. Heart rate variability (HRV) and heart rate were used to quantify physiological responses. The modified semantic differential method and Profile of Mood States were used to determine psychological responses. The natural logarithm of the high-frequency component of HRV was significantly higher and heart rate was significantly lower when participants walked in the forest than when they walked in the urban environment. The questionnaire results indicated that, compared with the urban environment, walking in the forest increased “comfortable”, “relaxed”, “natural” and “vigorous” feelings and decreased “tension-anxiety,” “depression,” “anxiety-hostility,” “fatigue” and “confusion”. A brief walk in the forest elicited physiological and psychological relaxation effects on middle-aged hypertensive individuals.

Physiological and psychological effects of forest therapy on middle-aged males with high-normal blood pressure

Time spent walking and relaxing in a forest environment ("forest bathing" or "forest therapy") has well demonstrated anti-stress effects in healthy adults, but benefits for ill or at-risk populations have not been reported. The present study assessed the physiological and psychological effects of forest therapy (relaxation and stress management activity in the forest) on middle-aged males with high-normal blood pressure. Blood pressure and several physiological and psychological indices of stress were measured the day before and approximately 2 h following forest therapy. Both pre- and post-treatment measures were conducted at the same time of day to avoid circadian influences. Systolic and diastolic blood pressure (BP), urinary adrenaline, and serum cortisol were all significantly lower than baseline following forest therapy (p<0.05). Subjects reported feeling significantly more "relaxed" and "natural" according to the Semantic Differential (SD) method. Profile of Mood State (POMS) negative mood subscale scores for "tension-anxiety," "confusion," and "anger-hostility," as well as the Total Mood Disturbance (TMD) score were significantly lower following forest therapy. These results highlight that forest is a promising treatment strategy to reduce blood pressure into the optimal range and possibly prevent progression to clinical hypertension in middle-aged males with high-normal blood pressure.

Forest medicine research in Japan

There has been growing attention on the effects of forest on physiological relaxation and immune recovery, particularly in forest medicine research, from a perspective of preventive medicine. Japan is a world leader in the accumulation of scientific data on forest medicine research. In this review, we summarize the research that has been conducted in this area since 1992. We conducted field experiment, involving 420 subjects at 35 different forests throughout Japan. After sitting in natural surroundings, these subjects showed decrease in the following physiological parameters compared with those in an urban control group: 12.4% decrease in the cortisol level, 7.0% decrease in sympathetic nervous activity, 1.4% decrease in systolic blood pressure, and 5.8% decrease in heart rate. This demonstrates that stressful states can be relieved by forest therapy. In addition, it should be noted that parasympathetic nervous activity was enhanced by 55.0%, indicating a relaxed state. The results of walking experiments provided similar results. Li et al. demonstrated that immune function was enhanced by forest therapy in middle-aged employees who volunteered to participate in these experiments. Natural killer cell activity, an indicator of immune function, was enhanced by 56% on the second day and returned to normal levels. A significant increase of 23% was maintained for 1 month even after returning to urban life, clearly illustrating the preventive benefits of forest therapy. In an indoor room experiment, we conducted tests with the following: 1) olfactory stimulation using wood smell, 2) tactile stimulation using wood, and 3) auditory stimulation using forest sounds. These indoor stimulations also decreased the blood pressure and pulse rate, and induced a physiological relaxation effect. We anticipate that forest medicine will play an increasingly important role in preventive medicine in the future.

Effects of olfactory stimulation with rose and orange oil on prefrontal cortex activity

OBJECTIVES

People have been aware of essential oils, which are derived from plants, for a long time. Recently, we have become interested in physiological and subjective effects of daily exposure to essential oils. The primary aim of the present study was to clarify effects of olfactory stimulation with rose or orange oil on prefrontal cortex activity; subjective evaluations of relaxation were also determined.

SETTING AND INTERVENTIONS

Subjects were exposed for 90s to air impregnated with either rose or orange essential oil. As a control, subjects wore the same device but inhaled only unimpregnated air. The three stimuli were randomly presented to each subject.

MAIN OUTCOME MEASURES

Physiological effects were determined by near-infrared time-resolved spectroscopy and a modified semantic differential approach was used to determine subjective evaluations.

RESULTS

The study participants were 20 female university students (mean age 22.5±1.6 years). Olfactory stimulation by rose or orange oil induced: (1) a significant decrease in oxyhemoglobin concentration in the right prefrontal cortex and (2) an increase in "comfortable," "relaxed," and "natural" feelings.

CONCLUSION

These findings indicate that olfactory stimulation by rose or orange oil induces physiological and psychological relaxation.

Effects of stimulation by three-dimensional natural images on prefrontal cortex and autonomic nerve activity: a comparison with stimulation using two-dimensional images

Empirical evidence suggests that three-dimensional (3D) images of nature promote physiological relaxation in humans by providing more realistic effects compared with two-dimensional (2D) images. However, no studies have evaluated the physiological relaxation effects of nature-derived 3D images on prefrontal cortex and autonomic nerve activity. The present study aimed to clarify the physiological relaxation effects of visual stimulation by 3D flower images on prefrontal cortex and autonomic nerve activity. Nineteen male university students (22.2 ± 0.6 years) were presented with 3D and 2D images of the water lily for 90 s. Prefrontal cortex activity was measured using near-infrared spectroscopy, while autonomic nerve activity was measured using heart rate variability (HRV). Psychological effects were determined using a modified semantic differential method (SD). Compared with visual stimulation by 2D images, that by 3D images resulted in a significant decrease in oxyhemoglobin concentration in the right prefrontal cortex, lower sympathetic activity as calculated by the ratio of the low-frequency to high-frequency HRV component, and a significantly greater realistic feeling as evidenced by higher SD ratings. In conclusion, visual stimulation by realistic 3D floral images promotes physiological relaxation more effectively than the corresponding 2D image.

Effects of olfactory stimulation with perilla essential oil on prefrontal cortex activity

OBJECTIVES

To clarify the effect of olfactory stimulation with perilla essential oil on human prefrontal cortex activity using near-infrared time-resolved spectroscopy.

DESIGN

Single-center prospective study.

METHODS

Nineteen female university students (mean age, 21.6 ± 1.5 years) participated in the study. Perilla essential oil was used as an olfactory stimulant and air as a control. Oxyhemoglobin concentrations in the prefrontal cortex were measured by using near-infrared time-resolved spectroscopy when the participants were presented with the stimulant or control. Emotional effects were subjectively evaluated by using a modified semantic differential method.

RESULTS

Olfactory stimulation with the perilla essential oil significantly reduced the oxyhemoglobin concentration in the prefrontal cortex. No significant differences in the feelings of comfort or relaxation, which strongly reflect human mental status, were observed between the perilla essential oil and control periods.

CONCLUSIONS

Olfactory stimulation with perilla essential oil reduced prefrontal cortex activity, thereby inducing physiologic relaxation.

Physiological and psychological effects of walking in stay-in forest therapy

OBJECTIVE

To provide scientific evidence of the physiological and psychological effects of forest and urban environments on 47 young male adults undergoing stay-in forest therapy.

METHODS

Field experiments were conducted at four sites in Japan. At each site, 12 subjects participated in the experiment. The experiments were conducted in forest and urban environments, and the subjects' physiological and psychological responses to these environments were compared. On the first day, six subjects were sent to a forest area, and the other six were sent to an urban area as controls. The groups were switched the next day. Heart rate variability and heart rate were measured to assess physiological responses. The semantic differential method for assessing emotions, the reports of "refreshed" feeling, and the Profile of Mood States (POMS) were used to assess psychological responses. The physiological and psychological responses of each subject were recorded during and after walking, and the differences in indices were compared between the two environments.

RESULTS

The forest environment was associated with a higher parasympathetic nervous activity, a lower sympathetic nervous activity, and a lower heart rate than the urban environment. The subjective evaluation scores were generally in accordance with the physiological reactions and were significantly higher in the forest environment than in the urban environment. POMS measurements showed that the forest environment was psychologically relaxing and enhanced psychological vigor.

CONCLUSIONS

This study provided clear scientific evidence of the physiological effects of forest therapy. The results will contribute to the development of forest therapy research and support the inclusion of forest therapy in preventive medicine.

Physiological and psychological responses of young males during spring-time walks in urban parks

Background

It is widely believed that contact with the natural environment can improve physical and mental health. Urban green spaces may provide city residents with these benefits; however, there is a lack of empirical field research on the health benefits of urban parks.

Methods

This field experiment was performed in May. Seventeen males aged 21.2 ± 1.7 years (mean ± standard deviation) were instructed to walk predetermined 15-minute courses in an urban park and a nearby city area (control). Heart rate and heart rate variability (HRV) were measured to assess physiological responses. The semantic differential (SD) method, Profile of Mood States (POMS), and State-Trait Anxiety Inventory (STAI) were used to measure psychological responses.

Results

Heart rate was significantly lower while walking in the urban park than while walking in the city street. Furthermore, the urban park walk led to higher parasympathetic nervous activity and lower sympathetic nervous activity compared with the walk through the city street. Subjective evaluations were generally in accordance with physiological reactions, and significantly higher scores were observed for the ‘comfortable’, ‘natural’, and ‘relaxed’ parameters following the urban park walk. After the urban park walk, the score for the ‘vigor’ subscale of the POMS was significantly higher, whereas that for negative feelings such as ‘tension-anxiety’ and ‘fatigue’ was significantly lower. The score for the anxiety dimension of the STAI was also significantly lower after the urban park walk.

Conclusions

Physiological and psychological results from this field experiment provide evidence for the physiological and psychological benefits of urban green spaces. A brief spring-time walk in an urban park shifted sympathetic/parasympathetic balance and improved mood state.

The physiological and psychological relaxing effects of viewing rose flowers in office workers

Background

In recent years, the physiological relaxing effect brought by nature is becoming clear; however, many workers find it difficult to be exposed to nature in their working environment. Exposure to fresh flowers represents an opportunity to incorporate nature into their working lives. In this study, we examined the effects of exposure to roses on physiological and psychological variables (heart rate variability, pulse rate, and subjective responses) in office workers.

Results

The experimental site was Mizuho Information & Research Institute, Inc., in the Tokyo metropolitan area. Thirty-one male office workers were included in the present study. The subjects were exposed to thirty unscented pink roses (Rosa, Dekora) arranged in a cylindrical glass vase for 4 min. In the control condition, the subjects were not exposed to flowers. After the experiments, the subjects completed a questionnaire. The order of exposure was counterbalanced among subjects. Among subjects exposed to roses, the high-frequency component of heart rate variability was significantly higher than in controls. Similarly, 'comfortable,’ 'relaxed’ and 'natural’ feelings were more common in subjects exposed to roses.

Conclusions

Data from this study support the presence of physiological and psychological relaxing effects of being exposed to flowers on office workers.

Effect of stimulation by foliage plant display images on prefrontal cortex activity: a comparison with stimulation using actual foliage plants

BACKGROUND AND PURPOSE

Natural scenes like forests and flowers evoke neurophysiological responses that can suppress anxiety and relieve stress. We examined whether images of natural objects can elicit neural responses similar to those evoked by real objects by comparing the activation of the prefrontal cortex during presentation of real foliage plants with a projected image of the same foliage plants.

METHODS

Oxy-hemoglobin concentrations in the prefrontal cortex were measured using time-resolved near-infrared spectroscopy while the subjects viewed the real plants or a projected image of the same plants.

RESULTS

Compared with a projected image of foliage plants, viewing the actual foliage plants significantly increased oxy-hemoglobin concentrations in the prefrontal cortex. However, using the modified semantic differential method, subjective emotional response ratings (“comfortable vs. uncomfortable” and “relaxed vs. awakening”) were similar for both stimuli.

CONCLUSIONS

The frontal cortex responded differently to presentation of actual plants compared with images of these plants even when the subjective emotional response was similar. These results may help explain the physical and mental health benefits of urban, domestic, and workplace foliage.

[Physiological and psychological effects of viewing forest landscapes in a seated position in one-day forest therapy experimental model]

OBJECTIVES

To clarify the physiological and psychological effects of a one-day forest therapy.

METHODS

The experiments were conducted at three sites, each containing a forest area and an urban area in Japan. Twelve male students participated at each of the three venues (total, 36 subjects). The subjects were randomly assigned to visit either the forest or urban area and were instructed to view the scenery in a seated position for 15 min. Heart rate variability and heart rate were measured to assess physiological response. The semantic differential method, reports of "refreshed" feeling, "state anxiety" in the State-Trait Anxiety Inventory (STAI) and Profile of Mood States (POMS) were used to determine psychological responses.

RESULTS

Physiological data revealed that the subjects demonstrated significantly different responses to the forest and urban environments. For heart rate variability, the subjects showed a significantly higher ln(HF) and a lower ln(LF/HF) in the forest environment than in the urban environment. Heart rate decreased in the forest environment relative to that in the urban environment. The forest environment was perceived as significantly more "comfortable," "soothing," and "natural" than the urban environment after viewing. The score for "refreshed" feeling was also significantly higher. The score for the "state anxiety" in STAI was significantly reduced by viewing the scenery in the forested areas. The score for the "vigor" subscale of the POMS was significantly improved by viewing the scenery in the forested areas, whereas scores for negative feelings, such as "tension-anxiety" and "fatigue," were significantly reduced.

CONCLUSIONS

These results provided scientific evidence of the physiological and psychological effects of a one-day forest therapy.

[Elucidation of the physiological adjustment effect of forest therapy]

OBJECTIVES

The aim of this study was to elucidate the physiological adjustment effect of forest therapy based on the Law of Initial Value.

METHODS

The experiments were conducted in nine forest and urban areas in Japan during the period from 2011 to 2012. There were 12 male Japanese university students participating in each of the nine experiments (total, 108 participants). Of these, 98 subjects (mean age ± standard deviation, 21.4 ± 1.6 years) were analyzed. The subjects were instructed to view a real forest landscape or urban area for 15 min. The systolic blood pressure, diastolic blood pressure, and pulse rate of each subject were measured. We analyzed the correlation between the initial values (after city viewing) and the differences in values between the two environments (after forest viewing-after city viewing).

RESULTS

There was a negative correlation between the initial values and the differences in values between the two environments. The subjects whose initial systolic blood pressure, diastolic blood pressure, and pulse rate were high showed marked decreases in these parameters as their response after viewing the forest environment, whereas those whose initial systolic blood pressure, diastolic blood pressure, and pulse rate were low showed increases in these parameters as their response.

CONCLUSIONS

These results support the premise that the physiological effect of a forest environment can differ depending on a subject's initial response values. Moreover, it was clear that forest therapy caused physiological adjustment, normalizing blood pressure and pulse rate.

Physiological and psychological effects of walking on young males in urban parks in winter

Background

Interaction with nature has a relaxing effect on humans. Increasing attention has been focused on the therapeutic effects of urban green space; however, there is a lack of evidence-based field research. This study provided scientific evidence supporting the physiological and psychological effects of walking on young males in urban parks in winter.

Findings

Subjects (13 males aged 22.5 ± 3.1 years) were instructed to walk predetermined 15-minute courses in an urban park (test) and in the city area (control). Heart rate and heart rate variability (HRV) were measured to assess physiological responses. The semantic differential (SD) method, Profile of Mood States (POMS), and State-Trait Anxiety Inventory (STAI) were used to determine psychological responses.

Heart rate was significantly lower and the natural logarithm of the high frequency component of HRV was significantly higher when walking through the urban park than through the city area. The results of three questionnaires indicated that walking in the urban park improved mood and decreased negative feelings and anxiety.

Conclusions

Physiological and psychological data from this field experiment provide important scientific evidence regarding the health benefits of walking in an urban park. The results support the premise that walking in an urban park has relaxing effects even in winter.

Individual differences in the physiological effects of forest therapy based on Type A and Type B behavior patterns

Background

In recent years, the physiological relaxation effects of natural environments have been widely exploited, and although individual differences in the effects of forest therapy are known, assessment methods have not been clearly established. This study used a classification based on Type A and Type B behavior patterns to explain individual differences in physiological responses to forest environments.

Methods

We performed physiological experiments in 44 forest and urban (controls) areas. In total, 485 male university students (age, 21.8 ± 1.6 years) participated in the study. The subjects were asked to visit forest or urban environments randomly and observe each landscape for 15 min. The subjects’ pulse rates and blood pressures were tested to evaluate their physiological responses. The Kwansei Gakuin daily life questionnaire was used to identify Type A and Type B behavior patterns in subjects.

Results

The pulse rate was significantly lower in the Type B group after exposure to forest areas than after exposure to urban areas, whereas no significant difference was observed in the Type A group. In addition, the pulse rate was significantly lower in the low scoring subjects in the Type B group, which was consistent with changes in their diastolic blood pressure.

Conclusions

These results suggest that individual differences in pulse rate and blood pressure in response to forest environments can be explained by Type A and Type B behavior patterns.

Assessment of coronary artery bypass surgery by exercise thallium imaging

The purpose of this study was to assess the coronary artery bypass grafting (CABG) in exercise thallium-201 scintigraphy. The study was performed on 18 consecutive patients undergoing elective surgery. We compared the results of the scintigraphic examinations, 1 week before and 1 month postoperatively. Of the 47 bypass grafts, 20 (42. 6%) grafts contributed to the improvement of the ischemic areas and 38% of the bypass grafts did not change the scintigraphic patterns after surgery. Some bypass grafts had been performed on the stenotic arteries that dominated the areas which preoperatively showed normal exercise scintigraphic patterns yet were considered to worsen in the near future. Such grafts main contribution may be to protect and to increase the overall myocardial washout ratio for prevention of an enlargement of ischemic areas.

Influence of the ratio between radial artery inner diameter and sheath outer diameter on radial artery flow after transradial coronary intervention

To test the feasibility of using guiding catheters equal to or greater than 7 Fr in transradial coronary intervention (TRI), we measured the inner diameter of the radial artery (RA) and its flow using two-dimensional ultrasound and Doppler examinations before and after TRI in 250 Japanese patients. The incidence of severe flow reduction of the RA after TRI was 6.8% on average (7.2%, 4.7%, and 8.3% in patients with 6, 7, and 8 Fr sheaths used, respectively), which increased from 4.0% to 13.0% (P=0.0113) if the ratio of the RA inner diameter/sheath outer diameter was less than 1.0. The frequency of this ratio (> or = 1.0) for 7 and 8 Fr sheaths was 71.5% and 44.9% in male patients and 40.3 and 24.0% in female patients, respectively. We conclude that the use of guiding catheters equal to or greater than 7 Fr in the radial artery is feasible in selected patients.

Transradial coronary intervention in Japanese patients

The objectives of this study was to test the feasibility and safety of transradial coronary intervention (TRI) in Japanese patients. We compared the results of TRI in 1,791 lesions (1,360 patients) between November 1995 and December 1997 with those of transfemoral coronary intervention (TFI) in 966 lesions (793 patients) between April and October 1995. We also examined the radial artery pulse in 294 patients 1-2 weeks after TRI by palpation and Doppler examination. Arterial puncture, coronary artery cannulation, lesion, and patient success rates were similar in both groups. No significant difference was noted in the major complication rate. Local complications were significantly lower in the TRI group (0.3% vs. 3.3%, P < 0.001). Doppler studies of the radial artery were performed in 294 patients chosen at random. In the first 234 patients, the sheath was pulled out 3 hr after the procedure, and in the last 60 patients, immediately after the procedure; radial artery occlusion rates were 5% and 0%, respectively. In conclusion, TRI seems safe and feasible in Japanese patients.