Struthers Nicole A, Guluzade Nasimi A, Zecevic Aleksandra A, Walton David M, Gunz Anna
Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, 1151 Richmond St., London, ON, N6A 3K7, Canada.
School of Kinesiology, Faculty of Health Sciences, Western University, 1151 Richmond St., London, ON, N6A 3K7, Canada.
Environ Res. 2024 Oct 1;258:119421. doi: 10.1016/j.envres.2024.119421. Epub 2024 Jun 13.
Nature-based interventions (NBIs) are activities, strategies, or programs taking place in natural settings, such as exercising in greenspaces, to improve the health and well-being of people by integrating the benefits of nature exposure with healthy behaviours. Current reviews on NBIs do not report the effects on different groups of physical health conditions. The purpose of this systematic review and meta-analysis was to identify and synthesize the evidence of the effect of NBIs on physical health outcomes and biomarkers of physical health conditions. Overall, 20,201 studies were identified through searching MEDLINE, Embase, CINAHL, SPORTDiscus, and CENTRAL databases up to June 7, 2024. Inclusion criteria were: 1) randomized controlled intervention studies; 2) population with a physical health condition; 3) NBIs vs. different intervention or no intervention; and 4) measuring physical health outcomes and/or biomarkers. Twenty-six studies were included in the review, 15 of which contributed to the meta-analysis. Compared to control groups, NBIs groups showed significant improvements in: diastolic blood pressure (MD -3.73 mmHg [-7.46 to -0.00], I = 62%) and heart rate (MD -7.44 bpm [-14.81 to -0.06], I = 0%) for cardiovascular conditions, fatigue (SMD -0.50 [-0.82 to -0.18], I = 16%) for central nervous system conditions, and body fat percentage (MD -3.61% [-5.05 to -2.17], I = 0%) for endocrine conditions. High effect heterogeneity was found in several analyses and the included studies had moderate-to-high risk of bias (RoB). The non-significant outcomes showed a direction of effect in favour of NBI groups for cardiovascular, central nervous system, endocrine, musculoskeletal, and respiratory conditions. This review found some beneficial effects in favour of NBIs for health outcomes in at least three condition groups though RoB and inconsistent effects limited some interpretations. NBIs are promising therapies that healthcare professionals can consider integrating into clinical practice.
基于自然的干预措施（NBIs）是在自然环境中开展的活动、策略或项目，例如在绿地中锻炼，通过将接触自然的益处与健康行为相结合，来改善人们的健康和福祉。当前关于基于自然的干预措施的综述未报告其对不同身体状况群体的影响。本系统综述和荟萃分析的目的是识别并综合基于自然的干预措施对身体健康结果和身体健康状况生物标志物影响的证据。总体而言，截至2024年6月7日，通过检索MEDLINE、Embase、CINAHL、SPORTDiscus和CENTRAL数据库，共识别出20201项研究。纳入标准为：1）随机对照干预研究；2）患有身体疾病的人群；3）基于自然的干预措施与不同干预或无干预对比；4）测量身体健康结果和/或生物标志物。26项研究被纳入综述，其中15项对荟萃分析有贡献。与对照组相比，基于自然的干预措施组在以下方面显示出显著改善：心血管疾病方面的舒张压（平均差 -3.73 mmHg [-7.46至-0.00]，I² = 62%）和心率（平均差 -7.44次/分钟 [-14.81至-0.06]，I² = 0%）；中枢神经系统疾病方面的疲劳（标准化均数差 -0.50 [-0.82至-0.18]，I² = 16%）；内分泌疾病方面的体脂百分比（平均差 -3.61% [-5.05至-2.17]，I² = 0%）。在多项分析中发现了较高的效应异质性，纳入的研究存在中度至高度偏倚风险（RoB）。未显著的结果显示出在心血管、中枢神经系统、内分泌、肌肉骨骼和呼吸系统疾病方面，效应方向有利于基于自然的干预措施组。本综述发现，尽管偏倚风险和不一致的效应限制了一些解释，但基于自然的干预措施在至少三个疾病组的健康结果方面有一些有益影响。基于自然的干预措施是有前景的治疗方法，医疗保健专业人员可考虑将其纳入临床实践。
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