The Effects of Nature-Based Activity vs. Indoor Exercise on Cognition, Psychological, and Physiological Health

NCT07056634 | Completed

• 2 other identifiers: UoRM REC 2025/05FRGS/1/2023/SS09/READING/03/1
• Study Type: interventional
• Target: 69
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial aims to investigate the comparative effects of nature-based versus indoor exercise interventions on cognitive performance, psychological well-being, and physiological stress in Malaysian adults. Participants will be randomly assigned to one of four groups: (1) active nature engagement (walking outdoors), (2) passive nature engagement (seated outdoor observation), (3) indoor treadmill walking, or (4) a no-intervention control group. The study will examine changes in attention, working memory, affect, blood pressure, body composition, and salivary cortisol across baseline, mid-point, and post-intervention assessments.

Conditions

Psychological Well Being; Cognitive Performance

Outcome Measures

Primary Outcomes (3)

• Sustained attention

  Sustained attention to response task (SART) will be used to measure sustained attention. Participants will be presented with a series of single digits (1-9) displayed one at a time on a computer screen. The digit appears in a random order at a fixed interval. They will be instructed to press the spacebar as quickly as possible every time they see any digit except the target digit (i.e., the digit 3). Participants are instructed to withhold their response when the target digit appears.

  1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)

• Salivary cortisol

  Participants' salivary cortisol will be collected using the passive drool method in sampling tubes. The samples were then be sent to the laboratory for measurement of cortisol in saliva, as an indicator for participants' stress level.

  1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)

• Working memory

  Digit span backward (DSB) will be used to measure working memory. A series of digits will be presented sequentially, and the participants will be asked to repeat them in backward order. Sequences were 2 to 8 digits, and there will be a total of 14 trials (with 2 trials for each length).

  1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)

Secondary Outcomes (13)

• Executive functioning

  1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)

• Creativity

  1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)

• Positive and negative affect

  1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)

• Stress level

  1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)

• Blood pressure

  1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)

Study Arms (4)

Active Nature Engagement

EXPERIMENTAL

Outdoor walking in a designated urban park, 3 times/week for 4 weeks, 30 minutes/session

Behavioral: Active Nature Engagement

Passive Nature Engagement

EXPERIMENTAL

Sitting quietly and observing nature, with grounding exercise, 3 times/week for 4 weeks, 30 minutes/session

Behavioral: Passive Nature Engagement

Indoor Exercise

ACTIVE COMPARATOR

Treadmill walking indoors under controlled conditions, 3 times/week for 4 weeks, 30 minutes/session

Behavioral: Indoor Exercise

Control

NO INTERVENTION

No exposure to intervention between baseline and post-test

Interventions

Active Nature Engagement BEHAVIORAL

Participants in this group will walk at a comfortable pace for 30 minutes in an urban park, three times per week for four weeks. They will be guided to focus on their surroundings using a grounding exercise (e.g., noticing sights, sounds, and smells) and instructed not to use mobile phones or listen to music during the walk.

Active Nature Engagement

Passive Nature Engagement BEHAVIORAL

Participants in this group will sit quietly for 30 minutes in a designated spot within an urban park, three times per week for four weeks. They will engage in grounding exercises and draw aspects of the natural environment. Participants will be instructed not to use mobile phones or listen to music during the walk.

Passive Nature Engagement

Indoor Exercise BEHAVIORAL

Participants will be asked to walk on a treadmill in an indoor room without windows for 30 minutes. The treadmill will be set to the speed that match the average pace in nature walk group (approximately 3 km/hr). The speed could be adjusted by the participant if needed, but kept within the range of 2.6 km/hr to 4.6 km/hr. Participants will be asked to not use their phones or listen to music.

Indoor Exercise

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults (≥18 years old)
• Normal or corrected-to-normal vision
• Normal or corrected-to-normal hearing
• Physically fit - able to walk unassisted for at least 30 minutes

You may not qualify if:

• Participants with limited mobility that prevents outdoor activities
• Participants who do not have adequate comprehension in English necessary to participate in measurement of outcomes

Sponsors & Collaborators

• University of Reading: lead
• Ministry of Higher Education, Malaysia: collaborator

Study Sites (1)

University of Reading Malaysia

Johor Bahru, Johor, 79200, Malaysia

Location

MeSH Terms

Conditions

Psychological Well-Being

Condition Hierarchy (Ancestors)

Personal Satisfaction; Behavior

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Dr.

Study Record Dates

• First Submitted: June 19, 2025
• First Posted: July 9, 2025
• Study Start: July 7, 2025
• Primary Completion: December 15, 2025
• Study Completion: December 31, 2025
• Last Updated: May 6, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

MY (1)