Chronic DiseasePARC-2NCT07002853

Nature-based Intervention for Chronic Pain in Older People

A study testing Nature-based Intervention in people with Chronic Disease and Chronic Pain (Back / Neck), run by Université du Québec à Chicoutimi at 1 site in Canada.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record

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Trial summary

The goal of this clinical trial is to learn if a nature-based intervention program has positive effects on the physical and psychosocial health in a group of older participants with chronic non-specific lower back pain. Read more about this study

Who is it for?: Ages 65 years and older
Conditions the study is for: Chronic Disease, Chronic Pain (Back / Neck), Older Adults (65 Years and Older)
What is being tested?: Nature-based Intervention
Could I receive a placebo?: No, everyone receives an active treatment
How many people: 9 participants
Where: 1 siteCanada
Study dates: 22 May 2025to 1 Sep 2026
Phase: Interventional
Are there results?: None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

Ages 65 years and older
All sexes
No healthy volunteers
Older adult

Who may be able to join

Aged 65 years +
Having low back pain for 3 months or more
Being able to walk independently
Mental state >25/30 in the MMSE questionnaire
Frailty score <3/5 (Fried criterias)

Who cannot join

Presenting other severe musculoskeletal, cardiovascular, or neurological conditions, or systemic diseases (e.g., cancer).

Trial locations and contacts

1 site in 1 country.

Canada1 site

Université du Québec à Chicoutimi
Saguenay, Quebec, G7H 2B1

Other trials in Canada

About this study

Official title: Nature-based Intervention Program for Sustainable Health in Older People Living With Chronic Non-specific Lower Back Pain (PARC Project 2) - A Feasibility Trial

Will the program improve:

The physical outcomes such as mobility, strength and balance?
The psychosocial health outcomes?

Participants will:

Be assessed before and after the program;
Participate in one session per week of the intervention.

Read the detailed description

Nonspecific chronic low back pain is defined as persistent pain located between the lower ribs and the gluteal fold, with no identifiable pathoanatomical cause. It is associated with decreased quality of life, mental well-being, increased work absenteeism, and represents a significant economic burden for both individuals and the healthcare system. In the scientific literature, physical activity remains the primary recommended intervention. Recently, nature-based interventions have also been explored as a potential multidisciplinary ally for the management of chronic pain.

The objective of this study is to examine the effects of outdoor physical activity (i.e. walking, general back mobility and strengthening) combined with other nature interventions (i.e. shinrin-yoku, meditation, gardening and pain education) in a group of older adults living with chronic non-specific lower back pain. The intervention will consist of an 8-week group program, conducted once a week for 2 hours. A total of 15 participants will take part in the program to evaluate its impact on both physical and mental health.

Data collection will include both quantitative and qualitative measures. Quantitative outcomes will assess pain disability, quality of life, kinesiophobia (fear of movement), fear of falling, pain catastrophisation, pain beliefs, well-being, depression, nature connectedness, and physical function through standardized tests (e.g., 5 Times Sit to Stand Test), postural control, and gait patterns. Statistical analyses will be performed to compare pre- and post-intervention outcomes, as well as to explore associations between clinical variables, using SPSS software.

Qualitative data will be collected through individual interviews conducted before and at the end of the program to provide a richer understanding of participants' experiences of pain and perceived effects of the program. Interview transcripts will be analyzed using NVivo software.

It is anticipated that this type of intervention will have positive effects for this population and may be considered a promising rehabilitation approach for the management of chronic low back pain in older adults.

Conditions: Chronic Disease, Chronic Pain (Back / Neck), Older Adults (65 Years and Older)
Being tested: Nature-based Intervention
Keywords: Aging, Chronic pain, Non-specific low back pain, Nature-based interventions, Falls, Forest bathing, Shinrin-yoku, Social, Nature connectedness, Functionning, Physical activity, Mindfulness, Meditation, Rehabilitation, Postural control, Strength, Quality of life, Balance
Medical subject headings: Chronic Disease, Chronic Pain, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Nature-based InterventionOther
Combination of activities in nature such as walking, exercises (strengthening, mobility, balance), mindfulness, guided meditation, forest bathing or Shinrin-Yoku, interpretation of nature, gardening and pain education.

Study groups in NCT07002853
Study group	Role	What they receive
Nature-based intervention	Experimental	Nature-based intervention group of once a week (2 hours) for 8 weeks Receives: Other: Nature-based Intervention

What is being measured

The primary outcome is the main question the study is designed to answer.

Retention rate
Proportion of participants completing the full protocol, including pre and post intervention assessments.
Measured: 8 weeks
Adherence to supervised outdoor sessions
Proportion of scheduled supervised outdoor sessions completed by each participant. Calculated as number of sessions completed ÷ number of sessions planned.
Measured: 8 weeks
Dropout rate
Proportion of participants who discontinue participation before completing the intervention.
Measured: 8 weeks
Participant satisfaction
Participant Satisfaction was measured using the "Participant Satisfaction Likert Scale", a 4-point scale ranging from 0 (strongly disagree) to 3 (strongly agree). Higher scores indicate greater satisfaction with the intervention, including clarity of instructions, perceived usefulness, exercise difficulty, and overall acceptability.
Measured: through study completion, an average of 8 weeks.
Adverse effects
Number and type of adverse events reported during the intervention, documented after each session.
Measured: 8 weeks
Qualitative feedback on perceived benefits
Qualitative feedback collected after each session through brief open ended questions documenting perceived benefits such as increased hope, enhanced social interaction, and other emergent themes.
Measured: 8 weeks
Well-being state (WHO-5)
The World Health Organization Well-Being Index (WHO-5) is a widely used self-reported questionnaire designed to measure subjective well-being. It assesses the individual's overall psychological well-being and quality of life. The WHO-5 consists of five simple questions that ask respondents to rate their well-being over the past two weeks. The questions cover aspects such as positive mood, vitality, and general interest in life.The questionnaire is scored on a scale from 0 to 100, with higher scores indicating better well-being.
Measured: change from baseline at 0 to 8 weeks
Depression state (PHQ-9)
The Patient Health Questionnaire-9 (PHQ-9) is a self-administered tool used to screen, diagnose, monitor, and measure the severity of depression. It consists of nine questions based on the diagnostic criteria for major depressive disorder in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition).Respondents rate how often they have experienced each symptom over the past two weeks on a scale ranging from 0 (not at all) to 3 (nearly every day). The scores are then added together to produce a total score ranging from 0 to 27, with higher scores indicating greater severity of depressive symptoms
Measured: change from baseline at 0 to 8 weeks
Connection to nature (CNS)
The Connectedness to Nature Scale (CNS) is a psychological assessment tool designed to measure an individual's subjective connection to nature. It evaluates the degree to which people perceive themselves as a part of the natural world and the extent to which they appreciate and value nature in their lives. Respondents are asked to rate their agreement with each statement on a Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). The scores are then totaled to provide an overall measure of an individual's connection to nature.
Measured: change from baseline at 0 to 8 weeks
Social Loneliness and Isolation (ÉSUL)
The Échelle de Solitude de l'Université Laval (ÉSUL) is a French-language adaptation of the UCLA Loneliness Scale, developed and validated in Quebec. It is a 20-item self-report questionnaire designed to assess perceived loneliness and social isolation. Each item is rated on a 4-point Likert scale ranging from "Never" to "Often," with higher scores indicating greater feelings of loneliness. The ESUL is commonly used in research and clinical settings involving French-speaking populations.
Measured: change from baseline at 0 to 8 weeks
Interoceptive Awareness (MAIA-Fr)
The Multidimensional Assessment of Interoceptive Awareness - French version (MAIA-Fr) is a validated French-language adaptation of the original MAIA questionnaire. It consists of 32 self-report items grouped into eight subscales that assess different dimensions of interoceptive body awareness, such as Noticing, Emotional Awareness, Self-Regulation, and Body Listening. Items are rated on a 6-point Likert scale ranging from "never" to "always," with higher scores indicating greater interoceptive awareness.
Measured: change from baseline at 0 to 8 weeks
Pain measures
Pain measurement will be done using the Brain pain inventory (BPI) questionnaire. The interference items will be presented with 0-10 scales, with 0=no interference and 10=interferes completely.
Measured: change from baseline at 0 to 8 weeks
Social Provisions (SPS-10)
The Social Provisions Scale-10 (SPS-10) is a shorter version of the original Social Provisions Scale (SPS). It is a brief self-report questionnaire designed to measure perceived social support across five dimensions. The SPS-10 is derived from the longer SPS but consists of a subset of items that capture key aspects of social support.
Similar to the original SPS, respondents rate their agreement with each item on a Likert scale, ranging from 1 (strongly disagree) to 4 (strongly agree). The SPS-10 provides a quick and efficient way to assess an individual's perceived social support network and their satisfaction with various aspects of their social relationships.
Measured: change from baseline at 8 to 12 weeks
Disability related to low back pain (RMDQ)
The Roland-Morris Disability Questionnaire (RMDQ) is a widely used self-report measure designed to assess physical disability due to low back pain. It consists of 24 yes/no items related to daily physical activities and functional limitations caused by back pain. Each affirmative response scores one point, for a total score ranging from 0 (no disability) to 24 (maximum disability). Higher scores indicate greater functional impairment.
Measured: change from baseline at 0 to 8 weeks
Mood states (POMS-SF)
The Profile of Mood States - Short Form (POMS-SF), French Version is a validated self-report questionnaire used to assess short-term changes in mood states. This version consists of 20 items rated on a 5-point Likert scale from 0 ("not at all") to 4 ("extremely"), and measures six mood dimensions: Anxiety (ANX), Depression (DEP), Anger (COL), Vigor (VIG), Fatigue (FAT), and Confusion (CON). Subscale scores are summed separately, with higher scores indicating greater intensity of the respective mood state, except for Vigor, where higher scores reflect better mood. This version, adapted and validated in French by Fillion \& Gagnon (1999), is administered before and after each intervention session to assess immediate psychological effects.
Measured: 8 weeks
Pain catastrophisation (PCS)
The Pain Catastrophizing Scale (PCS) is a validated self-report questionnaire designed to assess catastrophic thinking related to pain. It consists of 13 items that measure three dimensions: rumination, magnification, and helplessness. Participants rate each item on a 5-point Likert scale ranging from 0 ("not at all") to 4 ("all the time"). The total score ranges from 0 to 52, with higher scores indicating greater levels of pain catastrophizing. The PCS is widely used in both clinical and research settings to evaluate psychological responses to pain.
Measured: change from baseline at 0 to 8 weeks
Fear and beliefs regarded pain (FABQ)
The Fear and Beliefs Questionnaire (FBQ) is a self-administered questionnaire designed to assess fear-avoidance beliefs and perceptions related to low back pain. It evaluates how individuals perceive the harmfulness of movement and physical activity, and how these beliefs may influence their behavior and functional limitations. The FBQ includes items rated on a Likert scale, with higher scores reflecting stronger fear-avoidance beliefs. It is commonly used in clinical and research settings to better understand the psychosocial factors contributing to chronic pain and disability.
Measured: change from baseline at 0 to 8 weeks

Secondary outcomes (6)

Functional mobility test (TUG)
To assess mobility. Equipment: A stopwatch. Directions: Patients wear their regular footwear and can use a walking aid, if needed. Begin by having the patient sit back in a standard arm chair and identify a line 3 meters, or 10 feet away, on the floor.
Measured: change from baseline at 0 to 8 weeks
5 times Sit-To-Stand (FTSTS)
The Five Times Sit to Stand Test (5xSTS) is a standardized functional assessment used to evaluate lower limb strength, balance, and functional mobility. Participants are instructed to rise from a standard chair and sit back down five times as quickly as possible without using their arms. The total time to complete the five repetitions is recorded in seconds. This measure is commonly used to assess physical function and fall risk in older adults.
Measured: change from baseline at 0 to 8 weeks
Grip strength
Jamar dynamometer to assess maximal isometric hand grip strength and frailty criteria. 3 trials of maximal contraction up 5 seconds. The best value is retained and corrected by body mass index from Fried classification.
Measured: change from baseline at 0 to 8 weeks
Walking speed on 10 metres
Walking speed executed in 10 meter walking test. 2 trials and the best value in time seconds is retained for analysis.
Measured: change from baseline at 0 to 8 weeks
Postural control
Measures of center of pressure (COP) using a force platform during different balance tasks
Measured: change from baseline at 0 to 8 weeks
Gait
Gait parameters from GaitRite measurement: The participants will be asked to walk at normal and fast speeds on a GaitRite treadmill (GAI-TRite® Platinum Plus System 16' - 4.876 m, SN: Q209, CIR Systems Inc., Franklin, NJ, USA).
Participants will perform each task twice. Main gait parameters will be used as main outcomes such as velocity in m/s.
Measured: change from baseline at 0 to 8 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

22 May 20251 Sep 2026

First posted4 Jun 2025
Study start22 May 2025
Primary completion1 Sep 2026
Study completion1 Sep 2026

Resources

Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
Publications (31)Papers the sponsor has linked to this study.
Other trials for Chronic DiseaseStudies of the same condition, open and under way.
What the trial phases meanHow a treatment moves from first tests in people to approval.

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design

Study type: Interventional
Phase: Phase N/A
Primary purpose: Treatment
Allocation: Not applicable
Intervention model: Single group
Masking: None (open label)
Enrolment: 9 participants (actual)

IDs, dates and publications

ClinicalTrials.gov ID: NCT07002853
Sponsor's protocol ID: 2025-1991
Acronym: PARC-2
Status last verified: Nov 2026
First submitted: 24 May 2025
Last updated: 5 Nov 2026
Results posted: No
Data monitoring committee: No
FDA-regulated drug: No
FDA-regulated device: No
Individual data sharing: No

Publications

Suh JH, Kim H, Jung GP, Ko JY, Ryu JS. The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine (Baltimore). 2019 Jun;98(26):e16173. doi: 10.1097/MD.0000000000016173.
PubMed 31261549
Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev. 2021 Sep 28;9(9):CD009790. doi: 10.1002/14651858.CD009790.pub2.
PubMed 34580864
Fernandez-Rodriguez R, Alvarez-Bueno C, Cavero-Redondo I, Torres-Costoso A, Pozuelo-Carrascosa DP, Reina-Gutierrez S, Pascual-Morena C, Martinez-Vizcaino V. Best Exercise Options for Reducing Pain and Disability in Adults With Chronic Low Back Pain: Pilates, Strength, Core-Based, and Mind-Body. A Network Meta-analysis. J Orthop Sports Phys Ther. 2022 Aug;52(8):505-521. doi: 10.2519/jospt.2022.10671. Epub 2022 Jun 19.
PubMed 35722759
Dagenais S, Tricco AC, Haldeman S. Synthesis of recommendations for the assessment and management of low back pain from recent clinical practice guidelines. Spine J. 2010 Jun;10(6):514-29. doi: 10.1016/j.spinee.2010.03.032.
PubMed 20494814
Brumitt J, Matheson JW, Meira EP. Core stabilization exercise prescription, part I: current concepts in assessment and intervention. Sports Health. 2013 Nov;5(6):504-9. doi: 10.1177/1941738113502451.
PubMed 24427424
Han JW, Choi H, Jeon YH, Yoon CH, Woo JM, Kim W. The Effects of Forest Therapy on Coping with Chronic Widespread Pain: Physiological and Psychological Differences between Participants in a Forest Therapy Program and a Control Group. Int J Environ Res Public Health. 2016 Feb 24;13(3):255. doi: 10.3390/ijerph13030255.
PubMed 26927141
Li Q, Morimoto K, Kobayashi M, Inagaki H, Katsumata M, Hirata Y, Hirata K, Shimizu T, Li YJ, Wakayama Y, Kawada T, Ohira T, Takayama N, Kagawa T, Miyazaki Y. A forest bathing trip increases human natural killer activity and expression of anti-cancer proteins in female subjects. J Biol Regul Homeost Agents. 2008 Jan-Mar;22(1):45-55.
PubMed 18394317
Li Q. Effects of forest environment (Shinrin-yoku/Forest bathing) on health promotion and disease prevention -the Establishment of "Forest Medicine". Environ Health Prev Med. 2022;27:43. doi: 10.1265/ehpm.22-00160.
PubMed 36328581
Irvine KN, Fisher D, Currie M, Colley K, Warber SL. A Nature-Based Intervention for Promoting Physical Activity in Older Adults: A Qualitative Study Using the COM-B Model. Int J Environ Res Public Health. 2024 Jun 27;21(7):843. doi: 10.3390/ijerph21070843.
PubMed 39063420
Frumkin H, Bratman GN, Breslow SJ, Cochran B, Kahn PH Jr, Lawler JJ, Levin PS, Tandon PS, Varanasi U, Wolf KL, Wood SA. Nature Contact and Human Health: A Research Agenda. Environ Health Perspect. 2017 Jul 31;125(7):075001. doi: 10.1289/EHP1663.
PubMed 28796634
Zhang SK, Gu ML, Zhang T, Xu H, Mao SJ, Zhou WS. Effects of exercise therapy on disability, mobility, and quality of life in the elderly with chronic low back pain: a systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res. 2023 Jul 19;18(1):513. doi: 10.1186/s13018-023-03988-y.
PubMed 37468931
Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010 Dec;24(6):769-81. doi: 10.1016/j.berh.2010.10.002.
PubMed 21665125
Vlaeyen JWS, Maher CG, Wiech K, Van Zundert J, Meloto CB, Diatchenko L, Battie MC, Goossens M, Koes B, Linton SJ. Low back pain. Nat Rev Dis Primers. 2018 Dec 13;4(1):52. doi: 10.1038/s41572-018-0052-1.
PubMed 30546064
Dionne CE, Dunn KM, Croft PR. Does back pain prevalence really decrease with increasing age? A systematic review. Age Ageing. 2006 May;35(3):229-34. doi: 10.1093/ageing/afj055. Epub 2006 Mar 17.
PubMed 16547119
da Silva RA, Vieira ER, Carvalho CE, Oliveira MR, Amorim CF, Neto EN. Age-related differences on low back pain and postural control during one-leg stance: a case-control study. Eur Spine J. 2016 Apr;25(4):1251-7. doi: 10.1007/s00586-015-4255-9. Epub 2015 Oct 1.
PubMed 26428907

Want to know more?

The sponsor has not listed a contact. The official record may have more details.

Talk to your doctor first and take this page with you. Only the study team can confirm whether you can join.

Questions to ask the study team

What is the study trying to find out?
What would I need to do, and how often would I visit?
Could I receive a placebo instead of the treatment?
What are the possible risks and benefits for me?
Will it cost me anything? Are travel or time paid for?
Can I keep seeing my own doctor during the study?
What happens when the study ends?

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Study at a glance

From the registry record, last updated by the sponsor on 5 Nov 2026. Recruitment status is as the sponsor reported it: confirm with the study team.

Official title: Nature-based Intervention Program for Sustainable Health in Older People Living With Chronic Non-specific Lower Back Pain (PARC Project 2) - A Feasibility Trial
ClinicalTrials.gov ID: NCT07002853
Acronym / sponsor ID: PARC-2 / 2025-1991
Conditions: Chronic Disease, Chronic Pain (Back / Neck), Older Adults (65 Years and Older)
Keywords: Aging, Chronic pain, Non-specific low back pain, Nature-based interventions, Falls, Forest bathing, Shinrin-yoku, Social
Study type: Interventional
Recruitment status: Completed
Enrolment: 9 participants (actual)
Lead sponsor: Université du Québec à ChicoutimiUniversity, hospital or other
Collaborators: Fonds de la Recherche en Santé du Québec, FUQAC
Study start: 22 May 2025 (actual)
Primary completion: 1 Sep 2026 (actual)
Study completion: 1 Sep 2026 (actual)
First posted: 4 Jun 2025 (actual)
Results: Not posted in the source record

Clinical summary

The research question as the sponsor registered it. This describes what the study plans to test, not what it found.

Will the program improve:

The physical outcomes such as mobility, strength and balance?
The psychosocial health outcomes?

Participants will:

Be assessed before and after the program;
Participate in one session per week of the intervention.

Detailed description

Study design

Primary purpose: Treatment
Allocation: Not applicable
Intervention model: Single group
Masking: None (open label)
Number of arms: 1

Arm	Type	Receives
Nature-based intervention	Experimental	Other: Nature-based InterventionNature-based intervention group of once a week (2 hours) for 8 weeks

Who may qualify

Ages: 65 years and older
Sex: All
Healthy volunteers: Not accepted
Age groups: Older adult

Key inclusion criteria (5 listed)

Aged 65 years +
Having low back pain for 3 months or more
Being able to walk independently
Mental state >25/30 in the MMSE questionnaire
Frailty score <3/5 (Fried criterias)

Key exclusion criteria (1 listed)

Presenting other severe musculoskeletal, cardiovascular, or neurological conditions, or systemic diseases (e.g., cancer).

Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.

Interventions

Intervention	Type	Arms
Nature-based InterventionCombination of activities in nature such as walking, exercises (strengthening, mobility, balance), mindfulness, guided meditation, forest bathing or Shinrin-Yoku, interpretation of nature, gardening and pain education.	Other	Nature-based intervention

Primary outcome

Retention rate
Time frame: 8 weeks
Proportion of participants completing the full protocol, including pre and post intervention assessments.
Adherence to supervised outdoor sessions
Time frame: 8 weeks
Proportion of scheduled supervised outdoor sessions completed by each participant. Calculated as number of sessions completed ÷ number of sessions planned.
Dropout rate
Time frame: 8 weeks
Proportion of participants who discontinue participation before completing the intervention.
Participant satisfaction
Time frame: through study completion, an average of 8 weeks.
Participant Satisfaction was measured using the "Participant Satisfaction Likert Scale", a 4-point scale ranging from 0 (strongly disagree) to 3 (strongly agree). Higher scores indicate greater satisfaction with the intervention, including clarity of instructions, perceived usefulness, exercise difficulty, and overall acceptability.
Adverse effects
Time frame: 8 weeks
Number and type of adverse events reported during the intervention, documented after each session.
Qualitative feedback on perceived benefits
Time frame: 8 weeks
Qualitative feedback collected after each session through brief open ended questions documenting perceived benefits such as increased hope, enhanced social interaction, and other emergent themes.
Well-being state (WHO-5)
Time frame: change from baseline at 0 to 8 weeks
The World Health Organization Well-Being Index (WHO-5) is a widely used self-reported questionnaire designed to measure subjective well-being. It assesses the individual's overall psychological well-being and quality of life. The WHO-5 consists of five simple questions that ask respondents to rate their well-being over the past two weeks. The questions cover aspects such as positive mood, vitality, and general interest in life.The questionnaire is scored on a scale from 0 to 100, with higher scores indicating better well-being.
Depression state (PHQ-9)
Time frame: change from baseline at 0 to 8 weeks
The Patient Health Questionnaire-9 (PHQ-9) is a self-administered tool used to screen, diagnose, monitor, and measure the severity of depression. It consists of nine questions based on the diagnostic criteria for major depressive disorder in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition).Respondents rate how often they have experienced each symptom over the past two weeks on a scale ranging from 0 (not at all) to 3 (nearly every day). The scores are then added together to produce a total score ranging from 0 to 27, with higher scores indicating greater severity of depressive symptoms
Connection to nature (CNS)
Time frame: change from baseline at 0 to 8 weeks
The Connectedness to Nature Scale (CNS) is a psychological assessment tool designed to measure an individual's subjective connection to nature. It evaluates the degree to which people perceive themselves as a part of the natural world and the extent to which they appreciate and value nature in their lives. Respondents are asked to rate their agreement with each statement on a Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). The scores are then totaled to provide an overall measure of an individual's connection to nature.
Social Loneliness and Isolation (ÉSUL)
Time frame: change from baseline at 0 to 8 weeks
The Échelle de Solitude de l'Université Laval (ÉSUL) is a French-language adaptation of the UCLA Loneliness Scale, developed and validated in Quebec. It is a 20-item self-report questionnaire designed to assess perceived loneliness and social isolation. Each item is rated on a 4-point Likert scale ranging from "Never" to "Often," with higher scores indicating greater feelings of loneliness. The ESUL is commonly used in research and clinical settings involving French-speaking populations.
Interoceptive Awareness (MAIA-Fr)
Time frame: change from baseline at 0 to 8 weeks
The Multidimensional Assessment of Interoceptive Awareness - French version (MAIA-Fr) is a validated French-language adaptation of the original MAIA questionnaire. It consists of 32 self-report items grouped into eight subscales that assess different dimensions of interoceptive body awareness, such as Noticing, Emotional Awareness, Self-Regulation, and Body Listening. Items are rated on a 6-point Likert scale ranging from "never" to "always," with higher scores indicating greater interoceptive awareness.
Pain measures
Time frame: change from baseline at 0 to 8 weeks
Pain measurement will be done using the Brain pain inventory (BPI) questionnaire. The interference items will be presented with 0-10 scales, with 0=no interference and 10=interferes completely.
Social Provisions (SPS-10)
Time frame: change from baseline at 8 to 12 weeks
The Social Provisions Scale-10 (SPS-10) is a shorter version of the original Social Provisions Scale (SPS). It is a brief self-report questionnaire designed to measure perceived social support across five dimensions. The SPS-10 is derived from the longer SPS but consists of a subset of items that capture key aspects of social support. Similar to the original SPS, respondents rate their agreement with each item on a Likert scale, ranging from 1 (strongly disagree) to 4 (strongly agree). The SPS-10 provides a quick and efficient way to assess an individual's perceived social support network and their satisfaction with various aspects of their social relationships.
Disability related to low back pain (RMDQ)
Time frame: change from baseline at 0 to 8 weeks
The Roland-Morris Disability Questionnaire (RMDQ) is a widely used self-report measure designed to assess physical disability due to low back pain. It consists of 24 yes/no items related to daily physical activities and functional limitations caused by back pain. Each affirmative response scores one point, for a total score ranging from 0 (no disability) to 24 (maximum disability). Higher scores indicate greater functional impairment.
Mood states (POMS-SF)
Time frame: 8 weeks
The Profile of Mood States - Short Form (POMS-SF), French Version is a validated self-report questionnaire used to assess short-term changes in mood states. This version consists of 20 items rated on a 5-point Likert scale from 0 ("not at all") to 4 ("extremely"), and measures six mood dimensions: Anxiety (ANX), Depression (DEP), Anger (COL), Vigor (VIG), Fatigue (FAT), and Confusion (CON). Subscale scores are summed separately, with higher scores indicating greater intensity of the respective mood state, except for Vigor, where higher scores reflect better mood. This version, adapted and validated in French by Fillion \& Gagnon (1999), is administered before and after each intervention session to assess immediate psychological effects.
Pain catastrophisation (PCS)
Time frame: change from baseline at 0 to 8 weeks
The Pain Catastrophizing Scale (PCS) is a validated self-report questionnaire designed to assess catastrophic thinking related to pain. It consists of 13 items that measure three dimensions: rumination, magnification, and helplessness. Participants rate each item on a 5-point Likert scale ranging from 0 ("not at all") to 4 ("all the time"). The total score ranges from 0 to 52, with higher scores indicating greater levels of pain catastrophizing. The PCS is widely used in both clinical and research settings to evaluate psychological responses to pain.
Fear and beliefs regarded pain (FABQ)
Time frame: change from baseline at 0 to 8 weeks
The Fear and Beliefs Questionnaire (FBQ) is a self-administered questionnaire designed to assess fear-avoidance beliefs and perceptions related to low back pain. It evaluates how individuals perceive the harmfulness of movement and physical activity, and how these beliefs may influence their behavior and functional limitations. The FBQ includes items rated on a Likert scale, with higher scores reflecting stronger fear-avoidance beliefs. It is commonly used in clinical and research settings to better understand the psychosocial factors contributing to chronic pain and disability.

6 secondary outcomes

Functional mobility test (TUG)
Time frame: change from baseline at 0 to 8 weeks
5 times Sit-To-Stand (FTSTS)
Time frame: change from baseline at 0 to 8 weeks
Grip strength
Time frame: change from baseline at 0 to 8 weeks
Walking speed on 10 metres
Time frame: change from baseline at 0 to 8 weeks
Postural control
Time frame: change from baseline at 0 to 8 weeks
Gait
Time frame: change from baseline at 0 to 8 weeks

Results and safety

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

Research links

Official record on ClinicalTrials.govLast updated by the sponsor 5 Nov 2026.
Background: PubMed 31261549Suh JH, Kim H, Jung GP, Ko JY, Ryu JS. The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine (Baltimore). 2019 Jun;98(26):e16173. doi: 10.1097/MD.0000000000016173.
Background: PubMed 34580864Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev. 2021 Sep 28;9(9):CD009790. doi: 10.1002/14651858.CD009790.pub2.
Background: PubMed 35722759Fernandez-Rodriguez R, Alvarez-Bueno C, Cavero-Redondo I, Torres-Costoso A, Pozuelo-Carrascosa DP, Reina-Gutierrez S, Pascual-Morena C, Martinez-Vizcaino V. Best Exercise Options for Reducing Pain and Disability in Adults With Chronic Low Back Pain: Pilates, Strength, Core-Based, and Mind-Body. A Network Meta-analysis. J Orthop Sports Phys Ther. 2022 Aug;52(8):505-521. doi: 10.2519/jospt.2022.10671. Epub 2022 Jun 19.
Background: PubMed 20494814Dagenais S, Tricco AC, Haldeman S. Synthesis of recommendations for the assessment and management of low back pain from recent clinical practice guidelines. Spine J. 2010 Jun;10(6):514-29. doi: 10.1016/j.spinee.2010.03.032.
Background: PubMed 24427424Brumitt J, Matheson JW, Meira EP. Core stabilization exercise prescription, part I: current concepts in assessment and intervention. Sports Health. 2013 Nov;5(6):504-9. doi: 10.1177/1941738113502451.
Background: PubMed 26927141Han JW, Choi H, Jeon YH, Yoon CH, Woo JM, Kim W. The Effects of Forest Therapy on Coping with Chronic Widespread Pain: Physiological and Psychological Differences between Participants in a Forest Therapy Program and a Control Group. Int J Environ Res Public Health. 2016 Feb 24;13(3):255. doi: 10.3390/ijerph13030255.
Background: PubMed 18394317Li Q, Morimoto K, Kobayashi M, Inagaki H, Katsumata M, Hirata Y, Hirata K, Shimizu T, Li YJ, Wakayama Y, Kawada T, Ohira T, Takayama N, Kagawa T, Miyazaki Y. A forest bathing trip increases human natural killer activity and expression of anti-cancer proteins in female subjects. J Biol Regul Homeost Agents. 2008 Jan-Mar;22(1):45-55.
Background: PubMed 36328581Li Q. Effects of forest environment (Shinrin-yoku/Forest bathing) on health promotion and disease prevention -the Establishment of "Forest Medicine". Environ Health Prev Med. 2022;27:43. doi: 10.1265/ehpm.22-00160.
Background: PubMed 39063420Irvine KN, Fisher D, Currie M, Colley K, Warber SL. A Nature-Based Intervention for Promoting Physical Activity in Older Adults: A Qualitative Study Using the COM-B Model. Int J Environ Res Public Health. 2024 Jun 27;21(7):843. doi: 10.3390/ijerph21070843.
Background: PubMed 28796634Frumkin H, Bratman GN, Breslow SJ, Cochran B, Kahn PH Jr, Lawler JJ, Levin PS, Tandon PS, Varanasi U, Wolf KL, Wood SA. Nature Contact and Human Health: A Research Agenda. Environ Health Perspect. 2017 Jul 31;125(7):075001. doi: 10.1289/EHP1663.
Background: PubMed 37468931Zhang SK, Gu ML, Zhang T, Xu H, Mao SJ, Zhou WS. Effects of exercise therapy on disability, mobility, and quality of life in the elderly with chronic low back pain: a systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res. 2023 Jul 19;18(1):513. doi: 10.1186/s13018-023-03988-y.
Background: PubMed 21665125Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010 Dec;24(6):769-81. doi: 10.1016/j.berh.2010.10.002.
PARC project 1 for Parkinson DiseaseLink provided by the sponsor.
Individual participant dataSharing planned: No

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Referral and contact

AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.

Rubens A. da Silva, Ph.D. study director

Université du Québec à Chicoutimi

Marie-Ève Langelier, MD study chair

Université du Québec à Chicoutimi

Émilie Fortin, M.Sc principal investigator

Université du Québec à Chicoutimi

1 site in 1 country: see every site and its status.

Questions about this trial

What is this clinical trial studying?

A study testing Nature-based Intervention in people with Chronic Disease and Chronic Pain (Back / Neck), run by Université du Québec à Chicoutimi at 1 site in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 5 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Retention rate (time frame: 8 weeks). The study lists 17 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07002853, which also lists 31 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Nov 2026.