{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T17:19:34Z","timestamp":1783790374423,"version":"3.55.0"},"reference-count":51,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2017,8,9]],"date-time":"2017-08-09T00:00:00Z","timestamp":1502236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The present study investigated changes in autonomic nervous system activity and emotions after a short (2 h) forest bathing program in the Xitou Nature Education Area (XNEA), Taiwan. One hundred and twenty-eight (60.0 \u00b1 7.44 years) middle-aged and elderly participants were recruited. Physiological responses, pulse rate, systolic and diastolic blood pressure, heart rate variability (HRV), and psychological indices were measured before and after the program. We observed that pulse rate, systolic and diastolic blood pressure were significantly lower after the program, which indicated physiological benefits from stress recovery. The Profile of Mood States negative mood subscale scores of \u201ctension-anxiety\u201d, \u201canger-hostility\u201d, \u201cfatigue-inertia\u201d, \u201cdepression-dejection\u201d, and \u201cconfusion-bewilderment\u201d were significantly lower, whereas the positive mood subscale score of \u201cvigor-activity\u201d was higher. Furthermore, participants exhibited significantly lower anxiety levels according to the State-Trait Anxiety Inventory. However, changes in sympathetic and parasympathetic nerve activity were nonsignificant. Our study determined that the short forest bathing program is a promising therapeutic method for enhancing heart rate and blood pressure functions as well as an effective psychological relaxation strategy for middle-aged and elderly individuals.<\/jats:p>","DOI":"10.3390\/ijerph14080897","type":"journal-article","created":{"date-parts":[[2017,8,10]],"date-time":"2017-08-10T02:33:58Z","timestamp":1502332438000},"page":"897","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":160,"title":["Effects of Short Forest Bathing Program on Autonomic Nervous System Activity and Mood States in Middle-Aged and Elderly Individuals"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7099-4026","authenticated-orcid":false,"given":"Chia-Pin","family":"Yu","sequence":"first","affiliation":[{"name":"School of Forestry and Resource Conservation, National Taiwan University, Taipei 10617, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Min","family":"Lin","sequence":"additional","affiliation":[{"name":"School of Forestry and Resource Conservation, National Taiwan University, Taipei 10617, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Jer","family":"Tsai","sequence":"additional","affiliation":[{"name":"School of Forestry and Resource Conservation, National Taiwan University, Taipei 10617, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Chieh","family":"Tsai","sequence":"additional","affiliation":[{"name":"Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei 10617, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Tourism and Leisure Management, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2017,8,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1126\/science.1150198","article-title":"Health and urban living","volume":"319","author":"Dye","year":"2008","journal-title":"Science"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S38","DOI":"10.1016\/j.ypmed.2011.11.012","article-title":"A global view on the development of non communicable diseases","volume":"54","author":"Wagner","year":"2012","journal-title":"Prev. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1080\/00222216.2000.11949878","article-title":"The role of social marketing in leisure and recreation management","volume":"32","author":"Bright","year":"2000","journal-title":"J. Leis. Res."},{"key":"ref_4","unstructured":"Driver, B.L., Brown, P.J., and Peterson, G.L. (1991). The paragraphs about leisure and recreation experience preference scales: Results from two inventories designed to assess the breadth of the perceived psychological benefits of leisure. Benefits of Leisure, Venture Publishing."},{"key":"ref_5","unstructured":"Verduin, J.R., and McEwen, D.N. (1984). Adults and Their Leisure: The Need for Lifelong Learning, Charles C. Thomas Publisher Ltd."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1080\/02827580902903341","article-title":"Restorative effects of viewing real forest landscapes, based on a comparison with urban landscapes","volume":"24","author":"Lee","year":"2009","journal-title":"Scand. J. For. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.puhe.2010.09.005","article-title":"Effect of forest bathing on physiological and psychological responses in young Japanese male subjects","volume":"125","author":"Lee","year":"2011","journal-title":"Public Health"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s12199-008-0068-3","article-title":"Effect of forest bathing trips on human immune function","volume":"15","author":"Li","year":"2010","journal-title":"Environ. Health Prev. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.puhe.2006.05.024","article-title":"Psychological effects of forest environments on healthy adults: Shinrin-yoku (forest-air bathing, walking) as a possible method of stress reduction","volume":"121","author":"Morita","year":"2007","journal-title":"Public Health"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Im, S.G., Choi, H., Jeon, Y.-H., Song, M.-K., Kim, W., and Woo, J.-M. (2016). Comparison of effect of two-hour exposure to forest and urban environments on cytokine, anti-oxidant, and stress levels in young adults. Int. J. Environ. Res. Public Health, 13.","DOI":"10.3390\/ijerph13070625"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2521","DOI":"10.3390\/ijerph120302521","article-title":"Physiological and psychological effects on high school students of viewing real and artificial pansies","volume":"12","author":"Igarashi","year":"2015","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"6657","DOI":"10.3390\/ijerph120606657","article-title":"Physiological and psychological effects of viewing a kiwifruit (Actinidia deliciosa \u2018hayward\u2019) orchard landscape in summer in Japan","volume":"12","author":"Igarashi","year":"2015","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1093\/ecam\/nel114","article-title":"Yoga as a complementary treatment of depression: Effects of traits and moods on treatment outcome","volume":"4","author":"Shapiro","year":"2007","journal-title":"Evid. Based Complement. Altern. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1046\/j.1365-2648.2002.02103.x","article-title":"The short-term effects of myofascial trigger point massage therapy on cardiac autonomic tone in healthy subjects","volume":"37","author":"Delaney","year":"2002","journal-title":"J. Adv. Nurs."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"123","DOI":"10.2114\/jpa2.26.123","article-title":"Physiological effects of shinrin-yoku (taking in the atmosphere of the forest)\u2014Using salivary cortisol and cerebral activity as indicators","volume":"26","author":"Park","year":"2007","journal-title":"J. Physiol. Anthropol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3109\/10641963.2011.618195","article-title":"The effect of cognitive behavior therapy-based \u201cforest therapy\u201d program on blood pressure, salivary cortisol level, and quality of life in elderly hypertensive patients","volume":"34","author":"Sung","year":"2012","journal-title":"Clin. Exp. Hypertens."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Han, J.-W., Choi, H., Jeon, Y.-H., Yoon, C.-H., Woo, J.-M., and Kim, W. (2016). The effects of forest therapy on coping with chronic widespread pain: Physiological and psychological differences between participants in a forest therapy program and a control group. Int. J. Environ. Res. Public Health, 13.","DOI":"10.3390\/ijerph13030255"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"7235","DOI":"10.3390\/ijerph120707235","article-title":"The prefrontal cortex activity and psychological effects of viewing forest landscapes in autumn season","volume":"12","author":"Joung","year":"2015","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_19","unstructured":"Li, Q. (2012). Effect of the forest environment on physiological relaxation using the results of field tests at 35 sites throughout Japan. Forest Medicine, Nova Science Publishers Press."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s12199-009-0091-z","article-title":"Trends in research related to \u201cshinrin-yoku\u201d (taking in the forest atmosphere or forest bathing) in Japan","volume":"15","author":"Tsunetsugu","year":"2010","journal-title":"Environ. Health Prev. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2845","DOI":"10.1007\/s00421-011-1918-z","article-title":"Acute effects of walking in forest environments on cardiovascular and metabolic parameters","volume":"111","author":"Li","year":"2011","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1007\/s12199-009-0086-9","article-title":"The physiological effects of shinrin-yoku (taking in the forest atmosphere or forest bathing): Evidence from field experiments in 24 forests across Japan","volume":"15","author":"Park","year":"2010","journal-title":"Environ. Health Prev. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"291","DOI":"10.14214\/sf.213","article-title":"Physiological effects of forest recreation in a young conifer forest in Hinokage town, Japan","volume":"43","author":"Park","year":"2009","journal-title":"Silva. Fennica."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"135","DOI":"10.2114\/jpa2.26.135","article-title":"Physiological effects of shinrin-yoku (taking in the atmosphere of the forest) in an old-growth broadleaf forest in Yamagata prefecture, Japan","volume":"26","author":"Tsunetsugu","year":"2007","journal-title":"J. Physiol. Anthropol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.landurbplan.2013.01.014","article-title":"Physiological and psychological effects of viewing urban forest landscapes assessed by multiple measurements","volume":"113","author":"Tsunetsugu","year":"2013","journal-title":"Landsc. Urban. Plan."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1080\/02827580802055978","article-title":"Physiological effects of shinrin-yoku (taking in the atmosphere of the forest) in a mixed forest in Shinano town, Japan","volume":"23","author":"Park","year":"2008","journal-title":"Scand. J. For. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/j.jjcc.2012.08.003","article-title":"Therapeutic effect of forest bathing on human hypertension in the elderly","volume":"60","author":"Mao","year":"2012","journal-title":"J. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"4247","DOI":"10.3390\/ijerph120404247","article-title":"Elucidation of a physiological adjustment effect in a forest environment: A pilot study","volume":"12","author":"Song","year":"2015","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Lee, J., Tsunetsugu, Y., Takayama, N., Park, B.-J., Li, Q., Song, C., Komatsu, M., Ikei, H., Tyrv\u00e4inen, L., and Kagawa, T. (2014). Influence of forest therapy on cardiovascular relaxation in young adults. Evid. Based Complement. Altern. Med.","DOI":"10.1155\/2014\/834360"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.ufug.2015.02.004","article-title":"Effect of a forest therapy program and the forest environment on female workers\u2019 stress","volume":"14","author":"Jung","year":"2015","journal-title":"Urban. For. Urban. Green."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1177\/147323000603400204","article-title":"The effects of exercise in forest and urban environments on sympathetic nervous activity of normal young adults","volume":"34","author":"Yamaguchi","year":"2006","journal-title":"J. Int. Med. Res."},{"key":"ref_32","first-page":"45","article-title":"A forest bathing trip increases human natural killer activity and expression of anti-cancer proteins in female subjects","volume":"22","author":"Li","year":"2008","journal-title":"J. Biol. Regul. Homeost. Agents"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1177\/039463200802100113","article-title":"Visiting a forest, but not a city, increases human natural killer activity and expression of anti-cancer proteins","volume":"21","author":"Li","year":"2008","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/03946320070200S202","article-title":"Forest bathing enhances human natural killer activity and expression of anti-cancer proteins","volume":"20","author":"Li","year":"2007","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.landurbplan.2011.03.005","article-title":"Relationship between psychological responses and physical environments in forest settings","volume":"102","author":"Park","year":"2011","journal-title":"Landsc. Urban. Plan."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1265\/jjh.66.670","article-title":"Psychological relaxation effect of forest therapy: Results of field experiments in 19 forests in Japan involving 228 participants","volume":"66","author":"Tsunetsugu","year":"2011","journal-title":"Jpn. J. Hyg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"9","DOI":"10.12974\/2309-6128.2013.01.01.2","article-title":"Influence of forest walking on blood pressure, profile of mood states, and stress markers from the viewpoint of aging","volume":"1","author":"Horiuchi","year":"2013","journal-title":"J. Aging Gerontol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"15222","DOI":"10.3390\/ijerph121214984","article-title":"Physiological and psychological effects of a forest therapy program on middle-aged females","volume":"12","author":"Ochiai","year":"2015","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2532","DOI":"10.3390\/ijerph120302532","article-title":"Physiological and psychological effects of forest therapy on middle-aged males with high-normal blood pressure","volume":"12","author":"Ochiai","year":"2015","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/1880-6805-33-8","article-title":"Physiological and psychological responses of young males during spring-time walks in urban parks","volume":"33","author":"Song","year":"2014","journal-title":"J. Physiol. Anthropol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/1880-6805-32-18","article-title":"Physiological and psychological effects of walking on young males in urban parks in winter","volume":"32","author":"Song","year":"2013","journal-title":"J. Physiol. Anthropol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Lee, I., Choi, H., Bang, K.-S., Kim, S., Song, M., and Lee, B. (2017). Effects of forest therapy on depressive symptoms among adults: A systematic review. Int. J. Environ. Res. Public Health, 14.","DOI":"10.20944\/preprints201703.0077.v1"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Bowler, D.E., Buyung-Ali, L.M., Knight, T.M., and Pullin, A.S. (2010). A systematic review of evidence for the added benefits to health of exposure to natural environments. BMC Public Health, 10.","DOI":"10.1186\/1471-2458-10-456"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"14216","DOI":"10.3390\/ijerph121114216","article-title":"Physiological and psychological effects of a walk in urban parks in fall","volume":"12","author":"Song","year":"2015","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_45","unstructured":"Africa, J., Logan, A., Mitchell, R., Korpela, K., Allen, D., Tyrv\u00e4inen, L., Nisbet, E., Li, Q., Tsunetsugu, Y., and Miyazaki, Y. (2014). The Natural Environments Initiative: Illustrative Review and Workshop Statement, Harvard School of Public Health."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2687","DOI":"10.3390\/ijerph120302687","article-title":"Effect of forest walking on autonomic nervous system activity in middle-aged hypertensive individuals: A pilot study","volume":"12","author":"Song","year":"2015","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1265\/jjh.69.122","article-title":"Forest medicine research in Japan","volume":"69","author":"Miyazaki","year":"2014","journal-title":"Nihon Eiseigaku Zasshi"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1161\/01.RES.59.2.178","article-title":"Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog","volume":"59","author":"Pagani","year":"1986","journal-title":"Circ. Res."},{"key":"ref_49","unstructured":"McNair, D., Lorr, M., and Droppleman, L. (1971). Profile of Mood State Manual, Educational and Industrial Testing Service."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Spielberger, C.D. (1983). Manual for the State-Trait Anxiety Inventory: STAI. (form y), Consulting Psychologist Press.","DOI":"10.1037\/t06496-000"},{"key":"ref_51","unstructured":"Ministry of the Interior (2017, June 04). Newsletter of the National Statistics, Available online: http:\/\/www.moi.gov.tw\/stat\/news_content.aspx?sn=11735."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/14\/8\/897\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:41:54Z","timestamp":1760208114000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/14\/8\/897"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,9]]},"references-count":51,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2017,8]]}},"alternative-id":["ijerph14080897"],"URL":"https:\/\/doi.org\/10.3390\/ijerph14080897","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,9]]}}}