The Effects of Outdoor versus Indoor Exercise on Psychological Health, Physical Health, and Physical Activity Behaviour: A Systematic Review of Longitudinal Trials

Abstract

A growing body of research is exploring the potential added health benefits of exercise when performed outdoors in nature versus indoors. This systematic review aimed to compare the effects of exercise in outdoor environments versus indoor environments on psychological health, physical health, and physical activity behaviour. We searched nine databases from inception to March 2021 for English language, peer-reviewed articles: MEDLINE, Embase, PubMed, Scopus, Web of Science, CINAHL, SportsDiscus, GreenFile, and CENTRAL. We included randomized and non-randomized trials that compared multiple bouts of exercise in outdoor versus indoor environments, and that assessed at least one outcome related to physical health, psychological health, or physical activity behaviour. Due to minimal outcome overlap and a paucity of studies, we performed a narrative synthesis. We identified 10 eligible trials, including 7 randomized controlled trials, and a total of 343 participants. Participant demographics, exercise protocols, and outcomes varied widely. In the 10 eligible studies, a total of 99 comparisons were made between outdoor and indoor exercise; all 25 statistically significant comparisons favoured outdoor exercise. Interpretation of findings was hindered by an overall high risk of bias, unclear reporting, and high outcome heterogeneity. There is limited evidence for added health or behaviour benefits of outdoor exercise versus indoor exercise. Rigorous randomized controlled trials are needed with larger samples and clear reporting.

Investigating Differences in Personality Traits, Self-Esteem, Eating Attitudes, and Body Image among Participants in Indoor and Outdoor Fitness Activities

“…Combining physical activity with direct exposure to nature may enhance mood, as both regular exercise and outdoor green environments can increase happiness and reduce stress [ 20 , 23 , 27 , 67 ]. Noseworthy et al [ 5 ] found that outdoor exercise is associated with higher levels of enjoyment, vitality, positive engagement, and intention to return to exercise than indoor exercise. Lu and Hu [ 68 ] found that extraversion is significantly correlated with almost all types of leisure engagement, whereas neuroticism is unrelated to leisure engagement.…”

“…Physical activities and exercise programs during leisure time are important to promoting quality of life and overall well-being [ 1 , 2 , 3 ]. Research shows that regular leisure-time physical activity can help in the prevention or management of many chronic physical conditions [ 4 , 5 ]. It can also improve social, emotional, and mental well-being by reducing depression, stress, and social physique anxiety [ 6 , 7 , 8 , 9 ].…”

“…The environment, whether natural or built, significantly influences the benefits, attitudes, preferences, and behaviors associated with exercise [ 5 , 18 , 19 , 20 , 21 ]. Exposure to natural and outdoor environments during exercise can enhance mood, increase happiness, reduce stress, and lead to higher levels of enjoyment, vitality, and positive engagement [ 3 , 20 , 21 , 22 , 23 , 24 , 25 ].…”

“…Healthcare 2024, 12, 47 2 of 14 Different forms of physical exercise are linked to different environments. For instance, gym-based activities tend to take place indoors or in constructed environments, while activities such as jogging, running, or cycling tend to take place in outdoor urban or natural environments [5]. Time spent exercising indoors has been shown to have a stronger connection with specific psychosocial factors, such as negative body image and eating disorders, than outdoor exercise [31].…”

Effects of Physical Activity on Cognitive Functioning: The Role of Cognitive Reserve and Active Aging

“…In general, hiking with regularity favors an improvement in general physical fitness [44,45]. In addition, hiking contributes towards the previously described benefits to cognitive abilities, and it is reasonable to assume that the individual who practices sport in a natural setting can benefit from further advantages [46]. Atchley and Strayer (2012) [47] hypothesized that the natural environment itself can have a positive impact on cognitive functions such as selective attention, problem-solving, and inhibition.…”