Abstract
Background
Green exercise, defined as exercising in nature, demonstrates mental and physical health benefits. There is limited literature on green exercise as part of the treatment for chronic pain. Our objective was to investigate chronic pain patients’ perceptions of green exercise and the possible barriers that may arise in employing it as part of their treatment regimes.
Methods
After institutional ethics committee approval, a convenience sample of 113 adult patients, who attended a chronic pain clinic, were included. Participants completed a questionnaire that included a variety of questions with responses reported using a Likert scale.
Results
The most frequent patient age was 50–70 years in 49% of respondents and the most frequent pain complaint was back pain (62%). Ninety-four percent of participants reported that nature improves their mood. Seventy percent of participants reported that green spaces were easily accessible to them on a regular basis. However, up to 38% reported that they would not be able to commit to three times a week of a green exercise regime. The majority (62% of participants) reported that they would like healthcare practitioners to discuss green exercise with them.
Conclusion
Patients who suffer from chronic pain may be interested in green exercise as part of their treatment regime. Barriers that were identified included proximity to outdoor locations, time availability, and personal appraisal of the benefits of exercise for their condition. Green exercise should be considered as a part of a chronic pain treatment plan, and future studies should be directed to evaluating its efficacy in chronic pain.
Similar content being viewed by others
References
Rainville J, Hartigan C, Martinez E, Limke J, Jouve C, Finno M (2004) Exercise as a treatment for chronic low back pain. Spine J 4(1):106–115
Hayden JA, van Tulder MW, Tomlinson G (2005) Systematic review: strategies for using exercise therapy to improve outcomes in chronic low back pain. Ann Intern Med 142(9):776–785
Bennell KL, Nelligan R, Dobson F, Rini C, Keefe F, Kasza J, French S, Bryant C, Dalwood A, Abbott JH, Hinman RS (2017) Effectiveness of an internet-delivered exercise and pain-coping skills training intervention for persons with chronic knee pain. Ann Intern Med 166(7):453–462
Smith PJ, Potter GG, Mclaren ME, Blumenthal JA (2013) Impact of aerobic exercise on neurobehavioral outcomes. Ment Health Phys Act 6(3):139–153
Brown K, Stanforth D (2017) Go green with outdoor activity. ACSMs Health Fit J 21(1):10–15
Pretty J, Peacock J, Sellens M, Griffin M (2005) The mental and physical health outcomes of green exercise. Int J Environ Health Res 15(5):319–337
Latham J (1994) Davis B (1994) The socioeconomic impact of chronic pain. Disabil Rehabil 16(1):39–44
Raftery MN, Sarma K, Murphy AW, de la Harpe D, Normand C, McGuire BE (2011) Chronic pain in the Republic of Ireland--community prevalence, psychosocial profile and predictors of pain-related disability: results from the prevalence, impact and cost of chronic pain (PRIME) study. part 1 Pain 152(5):1096–1103
Robinson K, Kennedy N, Harmon D (2011) Is occupational therapy adequately meeting the needs of people with chronic pain? Am J Occup Ther 65(1):106–113
Michalos AC (2014) Encyclopedia of quality of life and well-being research. Springer, Dordrecht
Nguyen AL, Lake JE, Reid MC, Glasner S, Jenkins J, Candelario J, Soliman S, del Pino HE, Moore AA (2017) Attitudes towards exercise among substance using older adults living with HIV and chronic pain. AIDS Care 29(9):1149–1152
Twiddy H, Bradshaw A, Chawla R, Johnson S, Lane N (2017) Female chronic pelvic pain: the journey to diagnosis and beyond. Pain Management 7(3):155–159
Stamp E, Crust L, Swann C, Perry J, Clough P, Marchant D (2015) Relationships between mental toughness and psychological wellbeing in undergraduate students. Personal Individ Differ 75:170–174
Bovier PA, Chamot E, Gallacchi MB et al (2001) Importance of patients’ perceptions and general practitioners’ recommendations in understanding missed opportunities for immunisations in Swiss adults. Vaccine 19(32):4760–4767
Royal College of Nursing Institute (RCNI) (2009) Relation between green space and morbidity reinforced. Nurs Stand 24(12):16–16
Breivik H, Collett B, Ventafridda V et al (2006) Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain 10(4):287–287
Torrance N, Smith BH, Bennett MI, Lee AJ (2006) The epidemiology of chronic pain of predominantly neuropathic origin. Results from a general population survey. J Pain 7(4):281–289
Rodrigues IB, Armstrong JJ, Adachi JD, MacDermid J (2016) Facilitators and barriers to exercise adherence in patients with osteopenia and osteoporosis: a systematic review. Osteoporos Int 28(3):735–745
Brown D, Heath G, Martin S (1999). Promoting physical activity 2nd edition: a guide for community action. United States: Center For Disease Control and Prevention; 1999
Allcock N, Elkan R, Williams J (2007) Patients referred to a pain management clinic: beliefs, expectations and priorities. J Adv Nurs 60:248–256
Swinburn BA, Walter LG, Arroll B, Tilyard MW, Russell DG (1997) Green prescriptions: attitudes and perceptions of general practitioners towards prescribing exercise. Br J Gen Pract 47(422):567–569
Alharbi M, Gallagher R, Neubeck L, Bauman A, Prebill G, Kirkness A, Randall S (2017) Exercise barriers and the relationship to self-efficacy for exercise over 12 months of a lifestyle-change program for people with heart disease and/or diabetes. Eur J Cardiovas Nurs 16(4):309–317
Pedersen BK, Saltin B (2015) Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports 25(Suppl 3):1–72
Okifuji A, Turk DC (2017) Practical strategies and tools to promote treatment engagement. Springer, Dordrecht, pp 229–251
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Selby, S., Hayes, C., O’Sullivan, N. et al. Facilitators and barriers to green exercise in chronic pain. Ir J Med Sci 188, 973–978 (2019). https://doi.org/10.1007/s11845-018-1923-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11845-018-1923-x