The academic literature provides ample evidence of strong associations between physical activities or exercise and a variety of health-related benefits. The literature also documents benefits associated with various forms of nature engagement. Some research focuses on the combination of exercise and nature engagement. This combination is referred to as “green exercise” (GE). Most of the research on GE has been conducted with adults. This review addressed this gap in the literature by investigating the psychosocial and physiological health outcomes of GE in children and adolescents. The search for related literature was limited to articles published in English in peer-reviewed journals from 2000-2019.
Fourteen articles representing eleven studies met the inclusion criteria. While most of the studies were conducted in either the United States or the United Kingdom, two were conducted in Australia and one in Japan. The number of participants for individual studies varied from 14 to over 1500. The total number of participants across studies was 9402. From the eleven studies, there were 15 different psychosocial and six different physiological outcomes reported. Of the psychosocial outcomes, self-esteem was assessed the most often; of the physiological outcomes, blood pressure was assessed the most often. Except for self-esteem, all psychosocial outcomes were assessed by only one or two studies using a variety of measurement instruments. One study was rated as being of moderate quality; the other studies were rated as low quality.
An analysis of the effectiveness of GE showed that physical activity (PA) in nature was more effective than non-green exercise for six outcomes (attention, health-related quality of life, self-reported health, social support, antisocial interactions, and diastolic blood pressure). Results also showed that while physical activity was effective, there was no difference between the green and no-green conditions for five outcomes (self-esteem, vigor, tension, fatigue, and heart rate). Ten studies reported no effect of PA or no difference between the green and no-green condition in terms of 15 outcomes. For three outcomes, physical activity in the no-green condition was more effective than in the green condition.
Overall results showed that GE does not have harmful effects for children and adolescents compared to PA in built or indoor environments. Some evidence suggests that GE might be beneficial; however, this review does not provide definite conclusions. Recommendations for future research include (1) using more rigorous research designs and (2) investigating the underlying effects and mechanisms of GE. Future studies should also consider the theoretical background regarding GE and youth development and report the validity and reliability of the measurement instruments. Additionally, both short- and long-term outcomes should be investigated across different cultures and age groups. It's also important to explore specific outcomes across frequencies, intensities, time, and type of GE.
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