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A Study on the Effects of Forest Therapy on Sarcopenia

11 september 2026 uppdaterad av: National Taiwan University Hospital

Purpose: The goal of this study is to investigate the effects of an 8-week Forest Based Intervention program on muscle strength, physical performance, and psychological well-being in older women with sarcopenia.

Duration: The program lasts for 8 weeks, with 2 sessions per week (16 sessions total). Each session is approximately 180 minutes.

Activities: Participants will take part in a structured program at the Caoling Shibi Forest Healing Base in Yunlin. The program includes forest trail walking, resistance training using elastic bands, stretching, and sensory activities such as aromatherapy and deep breathing.

Assessments: Researchers will evaluate physical indicators and psychological well-being before the program, immediately after, and at a 1-month follow-up.

Goal: We hope to determine if combining structured exercise with the forest environment can effectively improve the health and quality of life for older women with sarcopenia.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Detaljerad beskrivning

Background and Rationale: Sarcopenia is a common skeletal muscle disease in the elderly characterized by the loss of muscle mass, strength, and physical performance. While resistance training and nutrition are core management strategies, Forest Healing has been shown to reduce stress (cortisol), regulate the autonomic nervous system, and improve immune function. This study aims to validate a standardized "manualized" forest healing intervention for sarcopenia, utilizing a cross-border collaboration framework between Taiwan and South Korea.

Study Design & Environmental Monitoring: This is a single-arm, pre-post intervention study (quasi-experimental design) conducted at the Caoling Shibi Forest Healing Base (altitude 1,500-1,700m). A unique aspect of this trial is the quantification of environmental factors, including phytoncide concentrations, negative ions, and thermal comfort indices (PMV, PPD), to explore the mechanistic relationship between the forest environment and physiological adaptations.

Intervention Protocol: The standardized 180-minute sessions are designed to integrate physical conditioning with psychological relaxation. The technical protocol dictates:

Aerobic and Balance Training: Forest trail walking maintained at a Rating of Perceived Exertion (RPE) of 12-13.

Resistance Training: Elastic band exercises targeting upper and lower limbs (3 sets of 8-10 repetitions) at an RPE of 9-13.

Core Forest Therapy: Sensory awareness, aromatherapy, and deep breathing to promote parasympathetic activation.

Psychological Promotion: Facilitated group interactions and experience sharing to enhance social connection and intervention adherence.

Safety Protocol: To ensure participant safety in a mountainous terrain, the study has established a comprehensive three-tier medical safety mechanism. This includes on-site first aid by certified instructors, local AED medical services, and a dedicated emergency medical "green channel" established with the National Taiwan University Hospital, Yunlin Branch.

Studietyp

Interventionell

Inskrivning (Faktisk)

36

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Taiwan
      • Yunlin County, Taiwan, 640
        • National Taiwan University Hospital Yunlin Branch

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Beskrivning

Inclusion Criteria:

  • Female aged 55 years or older.
  • Meet the AWGS 2025 criteria for sarcopenia (low handgrip strength and low skeletal muscle mass index).
  • Able to walk independently or with assistive devices and safely participate in low-to-moderate intensity exercise training.
  • Willing to commit to the 8-week intervention (16 sessions total) and provide signed informed consent.

Exclusion Criteria:

  • History of major acute illness, hospitalization, or surgery within the past 3 months.
  • Severe cardiovascular, respiratory, or other systemic diseases that make moderate-intensity exercise unsafe.
  • Severe osteoarticular or neurological disorders that significantly impair walking or exercise safety.
  • Severe cognitive impairment that prevents understanding of study procedures or cooperation with the intervention.
  • Presence of implanted medical devices (e.g., pacemakers) that would interfere with bioelectrical impedance analysis (BIA).
  • Regular participation in structured resistance training or high-intensity exercise within the past 3 months.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Forest-Based Intervention Group

Participants will undergo an 8-week structured forest healing program (2 sessions/week, 16 sessions total) at the Caoling Shibi Forest Healing Base

. Each 180-minute session, led by certified instructors, includes forest trail walking (aerobic/balance), elastic band resistance training, nature-based sensory immersion (forest therapy), and group psychological support. The intervention follows a standardized manual focused on improving muscle strength and physical function.
Beteende: Forest-Based Intervention Program
An 8-week structured intervention (16 sessions total, 180 min each) conducted at the Caoling Shibi Forest Healing Base. The program integrates physical exercise (forest trail walking and elastic band resistance training) with nature-based sensory immersion (aromatherapy, deep breathing, and nature awareness). The intervention follows a manualized protocol led by certified instructors, specifically designed to improve muscle strength, physical function, and psychological well-being in older women.
Andra namn:
  • Forest Therapy

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Handgrip Strength
Tidsram: Baseline, 2 months, and 3 months.
Measured using a Smedley hand dynamometer for the dominant hand to evaluate maximum muscle strength. Handgrip strength is a key clinical indicator for sarcopenia diagnosis. Values are reported in kilograms (kg).
Baseline, 2 months, and 3 months.
Short Physical Performance Battery (SPPB)
Tidsram: Baseline, 2 months, and 3 months.

A standardized assessment of lower extremity function, including balance tests, gait speed tests, and five times chair stand tests.

Scale title: Short Physical Performance Battery (SPPB). Minimum value: 0, Maximum value: 12. Higher scores indicate better physical performance.
Baseline, 2 months, and 3 months.

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Skeletal Muscle Mass Index (SMI)
Tidsram: Baseline, 2 months, and 3 months.
Measured via Bioelectrical Impedance Analysis (BIA) using the ACCUNIQ BC380. It is calculated as Appendicular Skeletal Muscle mass divided by height squared to track muscle mass changes. Values are reported in kg/m2.
Baseline, 2 months, and 3 months.
Health-Related Quality of Life (SF-36)
Tidsram: Baseline, 2 months, and 3 months.

Assessed using the Taiwan version of the Short Form-36 Health Survey (SF-36) to evaluate the participant's physical and mental health status.

Scale title: 36-Item Short Form Health Survey (SF-36). Minimum value: 0, Maximum value: 100. Higher scores indicate better outcomes (better health-related quality of life).
Baseline, 2 months, and 3 months.
Geriatric Depression Scale (SGDS)
Tidsram: Baseline, 2 months, and 3 months.

The Taiwan short-form version (GDS-15) is used to evaluate changes in depressive symptoms among participants based on their feelings over the past week. The assessment consists of 15 questions.

Scale title: 15-item Geriatric Depression Scale (GDS-15). Minimum value: 0, Maximum value: 15. Higher scores indicate worse outcomes (more severe depressive symptoms).
Baseline, 2 months, and 3 months.
Pittsburgh Sleep Quality Index (PSQI)
Tidsram: Baseline, 2 months, and 3 months.

The Taiwan version is used to assess sleep habits and quality over the previous month, calculating a global total score.

Scale title: Pittsburgh Sleep Quality Index (PSQI). Minimum value: 0, Maximum value: 21. Higher scores indicate worse outcomes (poorer sleep quality).
Baseline, 2 months, and 3 months.
Positive and Negative Affect Schedule (PANAS)
Tidsram: Baseline, 2 months, and 3 months.

Used to measure changes in emotional states following the forest healing intervention based on actual feelings over the past week. The questionnaire consists of 20 items rated on a 1 to 5 scale.

Scale title: Positive and Negative Affect Schedule (PANAS). This assessment comprises two subscales.

  • For the Positive Affect subscale: Minimum value is 10, Maximum value is 50. Higher scores indicate better outcomes (higher levels of positive affect).
  • For the Negative Affect subscale: Minimum value is 10, Maximum value is 50. Higher scores indicate worse outcomes (higher levels of negative affect).
Baseline, 2 months, and 3 months.

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

National Taiwan University Hospital

Samarbetspartners

Chungnam National University

Utredare

  • Huvudutredare: Kai-Chieh Chang, MD, National Taiwan University Hospital

Publikationer och användbara länkar

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Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

13 maj 2026

Primärt slutförande (Faktisk)

24 augusti 2026

Avslutad studie (Faktisk)

24 augusti 2026

Studieregistreringsdatum

Först inskickad

2 juni 2026

Först inskickad som uppfyllde QC-kriterierna

2 juni 2026

Första postat (Faktisk)

8 juni 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

15 september 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

11 september 2026

Senast verifierad

1 juni 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • 202603112RINA

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