Psychological Well BeingNCT07056634
The Effects of Nature-Based Activity vs. Indoor Exercise on Cognition, Psychological, and Physiological Health
A study testing Active Nature Engagement, Passive Nature Engagement and Indoor Exercise in people with Psychological Well Being and Cognitive Performance, run by University of Reading at 1 site in Malaysia.
Trial summary
This randomized controlled trial aims to investigate the comparative effects of nature-based versus indoor exercise interventions on cognitive performance, psychological well-being, and physiological stress in Malaysian adults. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Psychological Well Being, Cognitive Performance
- What is being tested?
- Active Nature Engagement, Passive Nature Engagement and Indoor Exercise
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 69 participants
- Where
- 1 siteMalaysia
- Study dates
- 7 Jul 2025to 31 Dec 2025
- 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 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Adults (≥18 years old)
- Normal or corrected-to-normal vision
- Normal or corrected-to-normal hearing
- Physically fit - able to walk unassisted for at least 30 minutes
Who cannot join
- Participants with limited mobility that prevents outdoor activities
- Participants who do not have adequate comprehension in English necessary to participate in measurement of outcomes
Trial locations and contacts
1 site in 1 country.
About this study
Official title: The Effects of Nature-Based Activity vs. Indoor Exercise on Cognitive, Psychological, and Physiological Health: A Randomized Controlled Trial
This randomized controlled trial aims to investigate the comparative effects of nature-based versus indoor exercise interventions on cognitive performance, psychological well-being, and physiological stress in Malaysian adults. Participants will be randomly assigned to one of four groups: (1) active nature engagement (walking outdoors), (2) passive nature engagement (seated outdoor observation), (3) indoor treadmill walking, or (4) a no-intervention control group. The study will examine changes in attention, working memory, affect, blood pressure, body composition, and salivary cortisol across baseline, mid-point, and post-intervention assessments.
- Conditions
- Psychological Well Being, Cognitive Performance
- Being tested
- Active Nature Engagement, Passive Nature Engagement, Indoor Exercise
- Medical subject headings
- Psychological Well-Being
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Active Nature EngagementBehavioural
Participants in this group will walk at a comfortable pace for 30 minutes in an urban park, three times per week for four weeks. They will be guided to focus on their surroundings using a grounding exercise (e.g., noticing sights, sounds, and smells) and instructed not to use mobile phones or listen to music during the walk.
Passive Nature EngagementBehavioural
Participants in this group will sit quietly for 30 minutes in a designated spot within an urban park, three times per week for four weeks. They will engage in grounding exercises and draw aspects of the natural environment. Participants will be instructed not to use mobile phones or listen to music during the walk.
Indoor ExerciseBehavioural
Participants will be asked to walk on a treadmill in an indoor room without windows for 30 minutes. The treadmill will be set to the speed that match the average pace in nature walk group (approximately 3 km/hr). The speed could be adjusted by the participant if needed, but kept within the range of 2.6 km/hr to 4.6 km/hr. Participants will be asked to not use their phones or listen to music.
| Study group | Role | What they receive |
|---|---|---|
| Active Nature Engagement | Experimental | Outdoor walking in a designated urban park, 3 times/week for 4 weeks, 30 minutes/session Receives: Behavioral: Active Nature Engagement |
| Passive Nature Engagement | Experimental | Sitting quietly and observing nature, with grounding exercise, 3 times/week for 4 weeks, 30 minutes/session Receives: Behavioral: Passive Nature Engagement |
| Indoor Exercise | Active comparator | Treadmill walking indoors under controlled conditions, 3 times/week for 4 weeks, 30 minutes/session Receives: Behavioral: Indoor Exercise |
| Control | No intervention | No exposure to intervention between baseline and post-test |
What is being measured
The primary outcome is the main question the study is designed to answer.
Sustained attention
Sustained attention to response task (SART) will be used to measure sustained attention. Participants will be presented with a series of single digits (1-9) displayed one at a time on a computer screen. The digit appears in a random order at a fixed interval. They will be instructed to press the spacebar as quickly as possible every time they see any digit except the target digit (i.e., the digit 3). Participants are instructed to withhold their response when the target digit appears.
Measured: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Salivary cortisol
Participants' salivary cortisol will be collected using the passive drool method in sampling tubes. The samples were then be sent to the laboratory for measurement of cortisol in saliva, as an indicator for participants' stress level.
Measured: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Working memory
Digit span backward (DSB) will be used to measure working memory. A series of digits will be presented sequentially, and the participants will be asked to repeat them in backward order. Sequences were 2 to 8 digits, and there will be a total of 14 trials (with 2 trials for each length).
Measured: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Secondary outcomes (13)
Executive functioning
Heart and Flower Task will be used to measure executive functions. The test is comprised of three phases: (1) the congruent trials phase, where participants will be instructed to press the response button corresponding to the side where the heart appeared; (2) the incongruent trial phase, where the participants will be asked to press the opposite response button corresponding to the side where the flower appeared and; (3) the mixed phase, comprising a mix of congruent and incongruent trials. During all phases, stimuli were displayed for 750ms, and participants will have 1 second to respond accurately while holding instructions in mind, which requires a working memory function. Additionally, cognitive flexibility will be necessary during phase three, where participants will have to switch rules flexibly and inhibit responding on the same side when the flower appeared in phases two and three.
Measured: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Creativity
Alternate Uses Task (AUT) will be used to evaluate divergent creative thinking and cognitive flexibility. Participants will be provided with two items (i.e., a tennis ball, a coffee cup)) and they will be required to come up with as many alternative uses for it as they can, in 2 minutes. The responses will be evaluated on four components: (1) fluency, refers to the total number of non-repeated, appropriate responses, and any responses that were infeasible, vague, or similar to the common use will be discarded; (2) flexibility, refers to the number of different topics or categories of responses; (3) elaboration, refers to the level of detail and development of each idea, measured by the average number of words per response; (4) originality, refers to the statistically uncommon response when compared to the overall data set.
Measured: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Positive and negative affect
Positive and negative affect schedule (PANAS) is a self-report tool that consists of 20 items, where 10 items measure positive affect (PA) and 10 items measure negative affect (NA). Participants will rate their affect over the past week on a 5-point Likert scale from 1 (not at all) to 5 (extremely). The scores for PA and NA are calculated by adding up the items that measure the respective constructs, with scores ranging from 10 to 50. Higher scores indicate higher levels of PA or NA.
Measured: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Stress level
Perceived stress scale (PSS-10) will serve as a subjective measure of participants' stress levels where it measures the degree to which an individual has perceived life as unpredictable, uncontrollable and overloading over the past week. Participants will report how they felt on a 5-point Likert scale from 0 (never) to 4 (very often). The score is obtained by summing across all items (with reverse items being reversed-score), higher scores indicate higher levels of perceived stress.
Measured: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Blood pressure
The blood pressure (BP) of participants (both diastolic and systolic BP) will be measured using a standard sphygmomanometer. A sphygmomanometer is a non-invasive measurement of bodily arousal.
Measured: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Body weight
Weight measured using TANITA body composition scale. Reported in kg.
Measured: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Muscle mass
Measured via TANITA body composition scale, and reported in kg.
Measured: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Body fat percentage
Estimated body fat proportion measured using TANITA body composition scale, reported in %.
Measured: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Visceral fat level
Rating provided by TANITA body composition scale indicating estimated visceral fat level. This will be reported in unitless scale rating from 1-59.
Measured: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Total body water percentage
Percentage of body weight that is water, measured by TANITA body composition scale, reported in %.
Measured: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Daily calorie intake
Estimated daily caloric requirement provided by TANITA body composition scale based on resting metabolic rate. Reported in kcal/day.
Measured: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Metabolic age
Age estimation based on metabolic profile, as calculated by TANITA body composition scale. Metabolic age will be reported in the unit of 'years'.
Measured: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Nature relatedness
Nature-relatedness scale (NR-6) will be used to measure one's subjective relatedness to the natural environment. Participants complete 6 items, on a 5-point Likert Scale (with 1 = strongly disagree, 5 = strongly agree). Nature-relatedness will serve as a covariate (will only be measured once).
Measured: Baseline (Week 0)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Jul 2025
- Study start7 Jul 2025
- Primary completion15 Dec 2025
- Study completion31 Dec 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Psychological Well BeingStudies 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
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 69 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Reading
- Sponsor type
- University, hospital or other
- Collaborators
- Ministry of Higher Education, Malaysia
- Responsible party
- Principal investigator, Tan Kok Wei, University of Reading
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07056634
- Sponsor's protocol ID
- UoRM REC 2025/05
- Other IDs
- FRGS/1/2023/SS09/READING/03/1
- Status last verified
- May 2026
- First submitted
- 19 Jun 2025
- Last updated
- 6 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 6 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effects of Nature-Based Activity vs. Indoor Exercise on Cognitive, Psychological, and Physiological Health: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07056634
- Acronym / sponsor ID
- UoRM REC 2025/05
- Conditions
- Psychological Well Being, Cognitive Performance
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 69 participants (actual)
- Lead sponsor
- University of ReadingUniversity, hospital or other
- Collaborators
- Ministry of Higher Education, Malaysia
- Study start
- 7 Jul 2025 (actual)
- Primary completion
- 15 Dec 2025 (actual)
- Study completion
- 31 Dec 2025 (actual)
- First posted
- 9 Jul 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.
This randomized controlled trial aims to investigate the comparative effects of nature-based versus indoor exercise interventions on cognitive performance, psychological well-being, and physiological stress in Malaysian adults. Participants will be randomly assigned to one of four groups: (1) active nature engagement (walking outdoors), (2) passive nature engagement (seated outdoor observation), (3) indoor treadmill walking, or (4) a no-intervention control group. The study will examine changes in attention, working memory, affect, blood pressure, body composition, and salivary cortisol across baseline, mid-point, and post-intervention assessments.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Active Nature Engagement | Experimental | Behavioral: Active Nature EngagementOutdoor walking in a designated urban park, 3 times/week for 4 weeks, 30 minutes/session |
| Passive Nature Engagement | Experimental | Behavioral: Passive Nature EngagementSitting quietly and observing nature, with grounding exercise, 3 times/week for 4 weeks, 30 minutes/session |
| Indoor Exercise | Active comparator | Behavioral: Indoor ExerciseTreadmill walking indoors under controlled conditions, 3 times/week for 4 weeks, 30 minutes/session |
| Control | No intervention | –No exposure to intervention between baseline and post-test |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Adults (≥18 years old)
- Normal or corrected-to-normal vision
- Normal or corrected-to-normal hearing
- Physically fit - able to walk unassisted for at least 30 minutes
Key exclusion criteria (2 listed)
- Participants with limited mobility that prevents outdoor activities
- Participants who do not have adequate comprehension in English necessary to participate in measurement of outcomes
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 |
|---|---|---|
| Active Nature EngagementParticipants in this group will walk at a comfortable pace for 30 minutes in an urban park, three times per week for four weeks. They will be guided to focus on their surroundings using a grounding exercise (e.g., noticing sights, sounds, and smells) and instructed not to use mobile phones or listen to music during the walk. | Behavioural | Active Nature Engagement |
| Passive Nature EngagementParticipants in this group will sit quietly for 30 minutes in a designated spot within an urban park, three times per week for four weeks. They will engage in grounding exercises and draw aspects of the natural environment. Participants will be instructed not to use mobile phones or listen to music during the walk. | Behavioural | Passive Nature Engagement |
| Indoor ExerciseParticipants will be asked to walk on a treadmill in an indoor room without windows for 30 minutes. The treadmill will be set to the speed that match the average pace in nature walk group (approximately 3 km/hr). The speed could be adjusted by the participant if needed, but kept within the range of 2.6 km/hr to 4.6 km/hr. Participants will be asked to not use their phones or listen to music. | Behavioural | Indoor Exercise |
Primary outcome
Sustained attention
Time frame: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Sustained attention to response task (SART) will be used to measure sustained attention. Participants will be presented with a series of single digits (1-9) displayed one at a time on a computer screen. The digit appears in a random order at a fixed interval. They will be instructed to press the spacebar as quickly as possible every time they see any digit except the target digit (i.e., the digit 3). Participants are instructed to withhold their response when the target digit appears.
Salivary cortisol
Time frame: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Participants' salivary cortisol will be collected using the passive drool method in sampling tubes. The samples were then be sent to the laboratory for measurement of cortisol in saliva, as an indicator for participants' stress level.
Working memory
Time frame: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Digit span backward (DSB) will be used to measure working memory. A series of digits will be presented sequentially, and the participants will be asked to repeat them in backward order. Sequences were 2 to 8 digits, and there will be a total of 14 trials (with 2 trials for each length).
13 secondary outcomes
Executive functioning
Time frame: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Creativity
Time frame: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Positive and negative affect
Time frame: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Stress level
Time frame: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Blood pressure
Time frame: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Body weight
Time frame: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Muscle mass
Time frame: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Body fat percentage
Time frame: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Visceral fat level
Time frame: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Total body water percentage
Time frame: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Daily calorie intake
Time frame: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Metabolic age
Time frame: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)
Nature relatedness
Time frame: Baseline (Week 0)
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 6 May 2026.
- 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.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Active Nature Engagement, Passive Nature Engagement and Indoor Exercise in people with Psychological Well Being and Cognitive Performance, run by University of Reading at 1 site in Malaysia.
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 4 inclusion and 2 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 6 May 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 Malaysia. 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?
Sustained attention (time frame: 1) Baseline (Week 0) 2) Midpoint (Week 2) 3) Post-intervention (Week 4)). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 6 May 2026.