Stroke is a leading cause of disability worldwide, with a growing need for effective rehabilitation strategies. Forest therapy, involving structured activities in natural environments, has shown significant beneficial effects in various health-related outcomes but no studies have assessed its direct effect on functional recovery after acute ischemic stroke. We assessed whether forest therapy is effective in recovering functional outcome of acute ischemic stroke compared to conventional rehabilitation therapy. This prospective cohort study included patients with acute ischemic stroke admitted within 24 hours of symptom onset. Participants were randomized into forest therapy (n=15) and control (n=27) groups. The forest therapy group underwent five sessions of guided activities in a national forest center, while the control group received standard outpatient rehabilitation. Primary outcome was changes in the modified Rankin Scale (mRS) scores, with secondary outcomes including grip strength, body composition, and psychological well-being assessed using the Worker's Stress Response Inventory and the Positive and Negative Affect Schedule from the time of hospital discharge to 3 months after stroke onset. Change of mRS were analyzed using the generalized estimating equation to compare changes over time between the two groups. At three-month follow-up, the forest therapy group demonstrated a significant improvement in mRS scores compared to the control group (p=0.034). Although no significant differences were found in grip strength or body composition, reductions in somatization and job-related stress were observed in the forest therapy group. No significant changes in positive or negative affect were detected. Forest therapy can contribute to functional recovery and reduce stress-related indicators in acute ischemic stroke patients. These findings support that the integration of forest therapy into stroke rehabilitation protocols to address both physical and psychological aspects of recovery, highlighting the potential for multidisciplinary approaches in post-stroke care.

中文翻译：

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森林疗法对急性缺血性脑卒中后功能恢复的影响


中风是全球残疾的主要原因，对有效康复策略的需求日益增长。森林疗法涉及自然环境中的结构化活动，在各种与健康相关的结果中显示出显着的有益影响，但没有研究评估其对急性缺血性中风后功能恢复的直接影响。我们评估了与传统康复疗法相比，森林疗法是否能有效恢复急性缺血性卒中的功能结局。这项前瞻性队列研究包括症状出现后 24 小时内入院的急性缺血性卒中患者。参与者被随机分为森林疗法 （n=15） 和对照组 （n=27）。森林治疗组在国家森林中心接受了五次指导活动，而对照组接受了标准的门诊康复治疗。主要结局是改良 Rankin 量表 （mRS） 评分的变化，次要结局包括使用工人压力反应量表和从出院时间到中风发作后 3 个月的积极和消极影响表评估握力、身体成分和心理健康。使用广义估计方程分析 mRS 的变化，以比较两组之间随时间的变化。在三个月的随访中，与对照组相比，森林疗法组的 mRS 评分显着改善 （p=0.034）。虽然在握力或身体成分方面没有发现显着差异，但在森林疗法组中观察到躯体化和与工作相关的压力减少。未检测到积极或消极影响的显着变化。 森林疗法有助于急性缺血性中风患者的功能恢复并减少与压力相关的指标。这些发现支持将森林疗法纳入中风康复方案，以解决康复的生理和心理方面问题，突出了中风后护理中多学科方法的潜力。