{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T18:15:08Z","timestamp":1788459308198,"version":"build-2803163510"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate short-term physiological and psychological changes associated with participation in a community-based Kurort Health Walking program conducted in a forest environment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>This study was conducted as part of a public health program in Saikai City, Nagasaki, Japan. A total of 90 participants who attended certified Kurort Health Walking courses between March 2024 and March 2025 were included. Physiological parameters, including systolic and diastolic blood pressure and pulse rate, and psychological status were assessed before and after the walking session. Autonomic nervous activity was evaluated using heart rate variability indices, including the low-frequency\/high-frequency ratio and high-frequency power, measured at four time points before, during, and after the walk. Mood states were assessed using validated questionnaires.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Systolic and diastolic blood pressure decreased significantly after the walking session (p\u2009&lt;\u20090.001). Neither the low-frequency\/high-frequency ratio nor high-frequency power showed significant changes across the measurement points. Negative mood states decreased significantly, whereas positive mood states, including vigor, friendliness, pleasure, and relaxation, increased, and anxiety decreased after walking (p\u2009&lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Participation in the community-based Kurort Health Walking program was associated with short-term changes in physiological and psychological measures. However, because this study did not include a control group, the independent contributions of the forest environment, physical activity, and other contextual factors could not be distinguished.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0357733","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T17:30:56Z","timestamp":1788456656000},"page":"e0357733","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Physiological and psychological outcomes of a community-based Kurort Health Walking program: A before\u2013after study"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6203-3737","authenticated-orcid":true,"given":"Saori","family":"Miura","sequence":"first","affiliation":[{"name":"Graduate School of Biomedical Sciences, Nagasaki University","place":["Sakamoto, Nagasaki, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Horikawa","sequence":"additional","affiliation":[{"name":"St. Mary\u2019s College","place":["Kurume, Fukuoka, Japan"],"department":["Faculty of Nursing"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kana","family":"Morizono","sequence":"additional","affiliation":[{"name":"Graduate School of Biomedical Sciences, Nagasaki University","place":["Sakamoto, Nagasaki, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miyu","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Graduate School of Biomedical Sciences, Nagasaki University","place":["Sakamoto, Nagasaki, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Torii","sequence":"additional","affiliation":[{"name":"Junshin Gakuen University","place":["Minami-ku, Fukuoka, Japan"],"department":["Faculty of Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromi","family":"Kuroda","sequence":"additional","affiliation":[{"name":"Graduate School of Biomedical Sciences, Nagasaki University","place":["Sakamoto, Nagasaki, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emi","family":"Matsuura","sequence":"additional","affiliation":[{"name":"Graduate School of Biomedical Sciences, Nagasaki University","place":["Sakamoto, Nagasaki, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"pone.0357733.ref001","unstructured":"United Nations, Department of Economic and Social Affairs. 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