Search

Purpose: Nature has been found to improve and promote health and prevent disease. Nature-based rehabilitation (NBR) delivered as part of neurorehabilitation is a developing approach. Yet to date the research is sparse. Following an acquired brain injury (ABI), people often experience impairments that cause limitations in activity and participation in daily life, which can impact the quality of life long-term. NBR delivered in neurorehabilitation has previously been explored from the perspective of occupational therapists and physiotherapists, however, to date patients' experiences are yet to be explored. This study aims to explore patients' experiences and perspectives of NBR delivered as part of standard neurorehabilitation. Methods: This qualitative study had a constructivist and phenomenological design. Semi-structured focus group interviews were carried out across three healthcare settings in Denmark with 17 participants. Data was analysed using content analysis. Results: The analysis generated three categories: 1. Outdoor versus indoor environment, 2. The natural environment as a co-therapist, and 3. Interrelatedness. Conclusion: The study provides insight into participants' experiences of NBR. They reported that interacting with the natural environment as part of neurorehabilitation enhanced activity. Moreover, being in nature increased their self-efficacy, sense of autonomy, community spirit, cooperation, and joy, and led to a feeling of peace. IMPLICATIONS FOR REHABILITATION: Nature-based rehabilitation (NBR) delivered as part of neurorehabilitation provides an alternative to indoor rehabilitation. The natural environment offers multisensory stimulation, sensory-motor training, and opportunities for mental restoration. NBR promotes social engagement, cooperation, and feelings of being in the same boat and may increase autonomy, self-efficacy, activity, and participation. NBR can be designed and delivered in a way where the natural environment and the intervention promote individual and group rehabilitation. The benefits of NBR in neurorehabilitation for patients appear to be an underexposed topic, and the intervention may provide an opportunity for improving rehabilitation for patients with acquired brain injury. [ABSTRACT FROM AUTHOR]

This study investigated the efficacy of a 10-session nature-based therapeutic intervention for people with post-concussion symptoms. The intervention involved physical and vestibular exercises, sensory training, relaxation, and psychoeducation, all of which were integrated with the natural environment in a forest therapy garden. This study was designed with a passive control period followed by the intervention (n = 30). The Mental Fatigue Scale (MFS) was the primary outcome measure. The secondary outcome measures were the Warwick–Edinburg Mental Wellbeing Scale and the short version of the Quality of Life after Brain Injury. A Likert scale was used to examine the mental strain of the sessions themselves. The MFS (primary outcome) exhibited a significant decrease with a medium-sized effect from before to after the intervention. The secondary outcomes exhibited significant increases from the beginning to the end of the intervention. All outcomes were sustained at follow-up ten weeks later. No significant difference was found from the control period. This study indicates that the described nature-based intervention is a feasible treatment for reducing prolonged post-concussion symptoms. However, it should be studied more in-depth to understand the impact of the natural environment and to validate the results on a larger representative population. [ABSTRACT FROM AUTHOR]

Exercise is an effective component in rehabilitation of a range of chronic conditions. There is a growing interest in the use of exercise-based nature interacted rehabilitation (EBNIR), but an overview of current evidence is missing. The objective of this scoping review was to map existing exercise-based rehabilitation interventions conducted with incidental or intentional nature interaction focusing on its populations, types of outcomes, and theoretical rationale for people with physical and mental disabilities. This scoping review identified peer-reviewed publications, registered upcoming trials and grey literature. To map all available knowledge, a comprehensive search of selected databases (MEDLINE; EMBASE; CINAHL; Cochrane; Web of Science; Pedro) from inception to October 2022. Data were synthesized in a thematic presentation guided by TIDieR, supplemented by a checklist developed for this study accounting nature incidental or intentional interaction. Twelve studies including 856 participants met the inclusion criteria. Eleven were completed trials and one was registered in clinicaltrials.gov to be run in 2023. A total of 856 patients were enrolled in the 12 studies (range 18–262, median 50). The included studies had great variation. The incidental or intentional interacted exercise-based interventions consisted of outdoor walks, neck exercises and surfing interventions in patients with physical or mental health conditions. This scoping review presents an overview of limited and diverse evidence within the field of EBNIR, in patients with physical or mental health conditions. Our review provides an overview that will be helpful in the design of future EBNIR trials. [ABSTRACT FROM AUTHOR]

Introduction: Nature-based therapy (NBT) has shown positive effects on different health-related outcomes and is becoming a more frequent approach in various rehabilitative interventions. Economic evaluations are widely used to inform decision makers of cost-effective interventions. However, economic evaluations of NBT have not yet been reviewed. The aim of this review was to uncover existing types and characteristics of economic evaluations in the field of nature-based therapeutic interventions. Methods: In this scoping review available knowledge about the topic was mapped. A comprehensive search of selected databases (MEDLINE; EMBASE; CINAHL; Scopus; Cochrane; PSYCinfo; Web of Science) and grey literature was conducted in November 2021. Data was synthesised in a thematic presentation. Results: Three papers met the inclusion criteria, containing differences in design, types and dose of nature-based therapeutic interventions, outcome measures and target groups (n = 648). The papers showed tendencies toward a good treatment effect and positive economic effect in favour of NBT. Conclusions: Three different cohort studies have tried calculating the economic impact of NBT indicating a good effect of the NBT. The evidence on the economic benefits of NBT is still sparse though promising, bearing the limitations of the studies in mind. Economic evaluation of NBT is a new area needing more research, including high-quality research studies where the economic evaluation model is included/incorporated from the beginning of the study design. This will enhance the credibility and usefulness to policy makers and clinicians. [ABSTRACT FROM AUTHOR]

Being in nature and doing nature-based activities has been shown to reduce stress-related illnesses such as trauma and post-traumatic stress disorders. In 2016, the crisis shelter Danner in Denmark decided to implement a programme based on the therapeutic use of nature as a recovery method for their residents: women and children exposed to domestic violence. This was done in collaboration with the research group of University of Copenhagen. This paper describes the objectives of the project, the development of an educational programme and the implementation of nature-based therapy. The Danish model for qualifications in education developed by the Danish Ministry of Education was the overall structural framework for the programme. The education programme contained four overall elements: (1) a theoretical part on the nature–health relationship; (2) performance and development of practical nature activities in collaboration with staff; (3) case stories about the challenges of implementing nature-based therapy for the residents in the crisis shelter; and (4) the implementation phase of nature-based therapy at Danner. Developing qualifications related to the use of nature-activities and the use of nature-environment might be useful for social workers and strengthen their competences in their work with battered women and children. [ABSTRACT FROM AUTHOR]

Objective: This study concerned optimization of an evidence-based crisis shelter garden as a setting for everyday activities and nature-based therapy. The study hereby tested the design guidelines that the garden is based on. Background: Design guidelines for gardens intended to support health are becoming increasingly specialized, targeting different user groups. This study contributes to the knowledge concerning health-supporting garden design at crisis shelters for women and children who are exposed to domestic violence. Method: The study included a post-occupancy evaluation (POE) consisting of landscape analyses, observation of physical traces, and interviews as well as a subsequent participatory design process. Results: The landscape analyses and the observation of physical traces indicated a minimal level of maintenance and recurrent use being limited to a few areas of the garden. The interviews added nuance and new issues to these results, resulting in the following themes: maintenance, accessibility, safety, therapeutic setting and free space, many ways to play, and social and private spheres. The participatory design process led to an optimization of the garden, including changes to its physical design related to making the garden safer, positively distractive, and more versatile in terms of activities. Improvements were also made regarding policy for use, maintenance, and informing users. Conclusion: The design guidelines were tested, and the evidence was strengthened, adding nuance and new issues to consider during further development of the guidelines. Both the POE and the participatory design process were confirmed as crucial aspects of evidence-based health design. [ABSTRACT FROM AUTHOR]

There is growing evidence of the health benefits of visiting green spaces. However, research indicates that individuals with mobility disabilities visit green spaces less frequently than the able-bodied population. The aim of this study was to examine the experiences and related constraints of individuals with mobility disabilities visiting green spaces. The study's qualitative research design employed group and individual interviews, which were analysed using interpretative phenomenological analysis and social geographical theory. The results indicate that, generally speaking, the interviewees valued green spaces highly. The serenity of and possibility for close physical contact with a green space were preferred and promoted experiences of insideness and identification with the space. Conversely, lack of accessibility led to feelings of exclusion and outsideness. To increase both the accessibility and positive experience of any green space, it is advisable to include the user group in the study design process. [ABSTRACT FROM AUTHOR]

Serving in the military leads to mental diseases, such as post-traumatic stress disorder (PTSD), for a percentage of soldiers globally. The number of veterans with PTSD is increasing and, although medication and psychological treatments are offered, treatment results could be improved. Historically, different forms of nature-based therapy have been used for this target group. However, in spite of anecdotally good results, studies measuring the effect of this form of therapy are still lacking. The aim of this study is to explore how veterans with PTSD manage their everyday lives during and after a ten-week nature-based intervention in a therapy garden. Methods: Eight veterans participated in qualitative interviews, which were conducted during a one-year period and were analyzed using interpretative phenomenological analysis (IPA). Results: Five themes emerged from the IPA analysis: Bodily symptoms; relationships; building new identities; the future; and lessons learned. All the participating veterans gained a greater insight into and mastering of their condition, achieved better control of their lives, and developed tools to handle life situations more appropriately and to build a new identity. This improved their ability to participate in social activities and employment. Conclusion: The results should be considered in the future treatment of veterans with PTSD. [ABSTRACT FROM AUTHOR]

This study focused on migrants taking part in a urban agricultural vocational program called Växtplats Rosengård at Botildenborg in Malmö, Sweden. A semi-structured interview study was conducted with 14 trainees to explore whether a sense of belonging could be experienced during the 10-week vocational training program. Two main themes of "environmental and organizational context" and "cultivation and nurture" emerged, which illustrated that a sense of belonging and place attachment could be experienced. The sense of belonging was created by an inclusive and supportive environment that allowed for creativity through the planting, growing, and nurturing of plants. The program provided a connection to migrants' home countries by allowing planting of recognized vegetation; and by enabling and supporting the practicing of the language of the new country in which the migrants had arrived. Based on the findings, five key mechanisms related to fostering a sense of belonging in newly arrived migrants are discussed and proposed as potentially transferrable to similar contexts. [ABSTRACT FROM AUTHOR]