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Abstract
ObjectivePhysical activity (PA) in an outdoor environment has been shown to exert positive effects on mental well-being beyond those found for PA indoors. The specific effect of an alpine environment has not been investigated so far. Here we evaluate the association of PA in an alpine environment with resilience and quality of life (QOL) in patients with psychosomatic disorders and controls.Methods194 patients with psychosomatic disorders (mostly somatoform disorder and major depressive syndrome) and 326 healthy controls were included in this web-based cross-sectional study. PA was scored using an adapted version of the Global Physical Activity Questionnaire including the environmental aspect (indoor, outdoor, alpine environment). Resilience was assessed using the Resilience Scale-13, QOL using the WHOQOL-BREF. Group comparisons, correlation and mediation analyses were performed.ResultsPatients showed significantly lower levels of resilience (p < 0.001) and QOL (p < 0.001) compared to controls. PA in an alpine environment was associated with resilience (patients: r = 0.35, p < 0.001; controls r = 0.18, p < 0.001). There were no significant associations between PA in other environments (outdoor or indoor) and resilience. PA in all three environments correlated with subcategories of QOL. The effect of PA in an alpine environment on QOL was partly mediated by resilience in patients (68% of total effect mediated, p < 0.001) and controls (49% mediated, p = 0.006).ConclusionThere is a positive effect of PA in an alpine environment on mental health beyond that of physical activity itself. Preventive and therapeutic programs should thus include physical activity, but also take additional benefits of natural environments into account.
Highlights
Physical activity (PA) is known to improve physical and psychological well-being [1]
In the present study we evaluated the association of physical activity in an alpine environment with resilience and quality of life in patients with psychosomatic disorders
The major findings were: (1) Patients with psychosomatic disorders had lower values in resilience and quality of life (QOL) compared to HC, (2) PA alpine, but not in other environments, correlated with resilience in patients and HC, (3) PA in all three environments correlated with QOL in patients and HC and (4) Resilience was found to partially mediate the effect of PA alpine on QOL in patients and HC
Summary
Physical activity (PA) is known to improve physical and psychological well-being [1]. The World Health Organization (WHO) recommends at least 150 min of moderate-intensity physical activity (PA) throughout the week [2]. Reduced physical activity is associated with chronic disease, whereas regular exercise enhances physical and mental health [3]. While the effects of physical activity have been well established in chronic somatic diseases, studies in psychosomatic conditions, especially somatoform disorders, are much less prevalent [4]. PA is known to improve symptoms of depression, anxiety and panic disorder [5] as well as enhance measures of mental well-being like quality of life (QOL) [6] and resilience [7]. Resilience can be viewed as one’s ability to
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