Preprint The Psychological Benefits of Forest Bathing in Individuals with Fibromyalgia and CFS/ME: A Pilot Study, 2023, Serrat et al

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EndME

Senior Member (Voting Rights)
I just had to share this study, it's way too funny and a good example of the quality of psychological research. I'm not using the usual formatting here as there's no use to it.

It starts of funnily with being published in the European Journal of Forest Research.

Some of my favorite snippets are

"In this pilot study conducted in Spain by López-Pousa et al. (2015), 30 individuals with FM were included and randomly allocated to a group of aerobic exercise-based program (i.e., 1.25-kilometre walks during six days in a time-frame of 2 weeks) in a mature (n = 15) or in a young forest (n = 15). Although both groups showed decreases in FM symptoms, the group that performed the walk in the mature forest showed greater improvements in terms of r in days with intense pain, insomnia and more days of well-being."

Patient selection criteria:
"All participants were recruited using social media posting (mainly through an inclusive hiking club association called CIM project -Associació Esportiva Projecte Inclusiu CIM-). The activity was free to all individuals with FM and CFS/ME and participation of their families was also encouraged."

https://www.researchsquare.com/article/rs-3088899/v1
 
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There is a possibility that these findings are real and useful, though not for the psychological reasons I presume they're crediting (haven't looked at paper).

Although new and a bit contentious, particular wavelengths of near-infrared radiation are proposed to have positive effects on the mitochondrial electron transport chain. From memory it was around 940 nm, resulting in improved inner membrane cytochrome c oxidase availability and function in the ETC, and associated mitochondrial melatonin production for ROS handling.

The type and colour of overhead leaves have been suggested to filter other wavelengths (some of which may have null or opposite effects and degrade the ETC antioxidant mechanisms).

See —

Nasa's Tour of the Electromagnetic Spectrum: Reflected Near-Infrared Waves
YouTube: Sunlight: Optimize Health and Immunity (Light Therapy and Melatonin) at timepoint 1 and timepoint 2

The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes (2018, Environmental Research) PDF via PubMed

Also —

Longitudinal transmittance of visible and near-infrared light in the wood of 21 conifer species (2022, IAWA Journal)
Leaf reflectance and transmission properties 350–2500 nm: Implications for vegetation indices (2017, Journal of Near Infrared Spectroscopy)

Photobiomodulation of Cytochrome c Oxidase by Chronic Transcranial Laser in Young and Aged Brains (2022, Frontiers in Neuroscience)
Cytochrome c oxidase-modulatory near-infrared light penetration into the human brain: Implications for the noninvasive treatment of ischemia/reperfusion injury (2020, IUBMB Life)
What Lies at the Heart of Photobiomodulation: Light, Cytochrome C Oxidase, and Nitric Oxide—Review of the Evidence (2020, Photobiomodulation, Photomedicine, and Laser Surgery)
Inhibitory modulation of cytochrome c oxidase activity with specific near-infrared light wavelengths attenuates brain ischemia/reperfusion injury (2018, Nature Scientific Reports)
 
Walking in a grove of mature trees which hosts such a range of living organisms, from white flies to deer, it makes me feel I am part of the web of life. It's spiritual nourishment, essential.

Maybe the specific molecular processes in the brain that happen when one is immersed in nature will be known, though I would rather see the time and money put into habitat restoration, which is a path to a more stable climate.

Meanwhile I feel a benefit each time I walk in a forested area with few or no people.So no group forest bathing for me. When I read the phrase "forest bathing" in my mind's eye I see a group of naked people shivering in the shade of huge trees.

Another confounding variable, it must be said I grew up next door to a virgin woods and took my refuge and adventures there, so it is hard to separate out the good and persistent childhood experiences from current effects of forest walking.
 
I thought Forest Bathing was done naked, just like normal bathing in a bath. Perhaps I'm wrong. If it isn't done naked it is essentially just people going for a walk in a forest, and there has been oodles of research on the benefits of going for a walk under various circumstances.
 
EndME said:
I'm not using the usual formatting here as there's no use to it.
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If quality of the research was the criteria by which we judged whether the usual formatting should be applied, the 'usual formatting' would not be at all usual.

FM is a highly prevalent rheumatic syndrome (2–8% of the general population), usually diagnosed between 20 and 50 years old (Häuser et al. 2015). It is characterized by chronic, diffuse musculoskeletal pain, fatigue, sleep disorders, high levels of distress and comorbidity with anxiety and depressive disorders (Clauw 2014). FM has recently been considered a functional somatic disorder, evolving from a primary pain disorder with a neurobiological basis to a broader biopsychosocial disorder (Wolfe and Rasker 2021). Although there is no curative treatment for this disease, pain education, cognitive behavioral therapy and therapeutic exercise are considered adequate approaches to manage FM symptoms, with an evidence level of 1A(Malfliet et al. 2019).

FM is usually comorbid with other central sensitization syndromes such as CFS/ME(Kato et al. 2006; Yunus 2007; Castro-Marrero et al. 2017) in over 50% of the cases(Faro et al. 2014). CFS/ME is a disabling and complex illness that affects approximately 1% of the population (Lim et al. 2020)and is characterized by persistent post-exertional fatigue and substantial symptoms related to cognitive, immune and autonomic dysfunction, including sore throat, muscle pain, joint pain, weakness, sleep disturbance, memory loss, and poor concentration (Brurberg et al. 2014; Cortes Rivera et al. 2019). This medical condition negatively impacts individuals’ quality of life, including their psychological, emotional and social well-being (NICE 2021).
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I thought the descriptions of the two conditions was interesting. Fibromyalgia is at once a rheumatic syndrome but also a functional somatic disorder "evolving from a primary pain disorder with a neurobiological basis to a broader bio psychosocial disorder". CFS/ME is just described as a medical condition - perhaps the NICE Guideline, which is referenced, affected how CFS/ME is seen by these authors.

What's really disturbing is the complacency apparent in the statement about the lack of curative treatment for fibromyalgia, but, never mind, "cognitive behavioural therapy and therapeutic exercise are considered adequate approaches" to manage the symptoms. There's more than a whiff of misogeny in this paper.

The treatment was a single 3 hour excursion to walk in forests (the reference to 6 days was about another, previously done, study). It was free, family participation was encouraged. People reported feeling more positive about things, but pain was not improved (and there was a loss of two participants between the pre- and post- intervention measures).
With a single treatment, there is no assessment possible of whether this intervention could be undertaken regularly, or what the impact of such an approach might be.

All participants were recruited using social media posting (mainly through an inclusive hiking club association called CIM project -Associació Esportiva Projecte Inclusiu CIM-).
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Selection must have surely been biased by the recruitment method. No controls.

I'm sure that it was a pleasant activity, and I expect that there was a useful social aspect to it. My background is in forestry, I'm very much in favour of people spending time in forests. But yes, this paper is junk science.
 
The benefit of spending time in nature is real although I'm not sure if it has any meaningful effect on an illness.

In a pine/cypress forest that I got to sometimes, the air takes on a new quality of being fresh. I suspect this effect could be due to antiinflammatory compounds released by the trees.

And in general seeing nature makes me happy and is calming.
 
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Haven't we discussed this forest bathing malarkey before?

I'd love nothing better than to go & spend time in a forest, nature makes me happy calms me if i'm anxious etc, but sadly the exertion of doing so makes me more ill, so....
 
Not sure about the 'bathing' in mindfulness thing but there could be other benefits. Maybe. Just stumbled across the concept of the aerobiome in a magazine article.

Seems like it's a relatively new thing to be studied. In negative terms it's about pollution, in positive terms it's helpful microbes floating about in clean air and being breathed in and being beneficial. Apparently, like gut microbes they can be important to tuning our immune system

Having said that, I live well away from pollution and the nearest forest is literally spitting away. Not that I would spit into the trees but sine a walk is out of the question it's nice to be able to at least touch them. But while this is all very pleasant and calming and what have you, I can't say it's doing anything obvious for my physical health. Unless, I suppose, I'd be even worse if I lived in a less beneficial environment
 
The FB activity consisted of a 3km silence walk in 3 hours, with the realization of three 10-minute stops (i.e., before starting the walk, in the middle and at the e it) with practices of deep breathing and mindful awareness of the five senses in nature.
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So only the very mildest ME/CFS could participate given it's 3 hours on your feet walking with only a 10 minute break in the middle where you were expected to do mindfulness stuff.

Note the questionnaire were filled in an hour before starting, and within 24 hours after finishing - so before any PEM is likely to set in for those with ME/CFS.

Most of the participants were diagnosed with both FM and CFS/ME (n = 37, 80.4%).
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Most already do some walking exercise each week.
More than half had severe or extremely severe depression and/or anxiety.

The data for after the walk show that there was a significant improvement in reported fatigue on 2 different questionnaires.

The combination of most of the people diagnosed with ME/CFS also having FM and depression/anxiety makes me wonder whether many of them were misdiagnosed with ME/CFS. How can you be less fatigued after 3 hours on your feet walking if you have ME/CFS?
 
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