Many have published here their thoughts and experiences about bringing physiotherapy outdoors, in natural spaces or urban green spaces. But what is it about these spaces that can improve the effectiveness of therapeutic interventions? Is it as obvious as we might think? Since we don’t yet come across nature-based interventions (NBI) so much in our profession, I made it my mission to review the latest science we have on the benefits that can arise from nurturing human and nature connectedness (HNC) and how it has the potential of becoming an integrated tool for physiotherapy consultations. That mission took the form of my bachelor’s thesis, “Nature Connection as a Physiotherapy Tool (Senay, 2023)”.

HNC is simply the extent to which humans see themselves as part of nature, instead of governing over and exploiting it as something they are not part of. It is believed that one of the main factors of the climate crisis we are facing now lies in the latter worldview, which has also driven rampant economic growth and related environmental degradation for the past centuries (Barragan-Jason et al., 2022). In the context of health, however, we might ask whether if we try to promote human health without considering the health of their environment, we are only treating the symptoms. We are part of this body called Nature. To promote our health, we must promote the health of the whole body.

There is growing evidence that contact with natural spaces has a direct effect on our physiological and psychological health. Here are the most reported outcomes from systematic reviews that I have come across in my literature review.

Charles Senay (PT, BSc)

Charles Senay (PT, BSc)


Charles has recently completed his physiotherapy degree in Finland, where he has moved from Canada. His passion for nature and health promotion has inspired him to focus his bachelor’s thesis on these subjects, with the hopes of furthering his studies in public and global health.

Table 2: Reported Outcomes per Age Group. In parenthesis: number of systematic reviews.

*Human and nature connectedness (HNC).

**Overall mental health refers to a range of reported outcomes that include; positive mood, better emotional well-being, improved mental health and behavior, decreased psychological distress, mood and affect, perceived restoration, energy, self-concept, and pro-social behaviour.

In addition to this, certain activities and lifestyles have been shown to have a direct effect on people’s feeling of HNC. For instance, people who value their health and wellbeing are in general more concerned with the state of the environment and would be more prone to take nature conservation more seriously. Similarly, mindfulness practices, either while in contact with nature or not, have shown to increase this feeling of connectedness (Barragan-Jason et al., 2022). Interestingly, the vice versa appears to be also true; HNC seem to foster healthier and more mindful individuals (Barragan-Jason et al., 2023).

And the opposite is also true; people who support either materialistic values or conservative political worldviews tend to demonstrate much more disconnection from the rest of nature (Barragan-Jason et al., 2022).

As physiotherapists, there are many ways we can help develop nature-connectedness and it does not necessarily mean bringing our patients to the most remote and pristine places. Having photos or prints of nature in our treatment rooms, adding background nature sounds or essential oil diffusers can already provide desired benefits (Song et al., 2018). Teaching mindfulness methods and the importance of nature conservation are, after all, part of our scope in some countries (Anttila et al., 2016). Nevertheless, providing our patients and clients with a calming environment is already a great plus that can only facilitate our work.

We have a responsibility to promote healthy lifestyles and habits that prevent the spread of non-communicable diseases, and that extends not only to the patients or clients we see, but also to the society at large. Promoting health goes further than treating the sick and injured, much less treating only their sick and injured parts. Evidence is growing strong that clean, unpolluted, and biodiverse environments are essential for sustaining healthy human lives. And because we tend to care for those we share a connection with, nourishing our connection with nature will help us attain goals towards a sustainable future.


Header image by Federico Beccari on Unsplash

Anttila, H., Tuija, T., City, A., Heinonen, H. A., & Häkkinen, H. (2016). The core competencies of a physiotherapist Background to the project Good Physiotherapy Policy steering group. 

Barragan-Jason, G., de Mazancourt, C., Parmesan, C., Singer, M. C., & Loreau, M. (2022). Human–nature connectedness as a pathway to sustainability: A global meta-analysis. Conservation Letters, 15(1), e12852. 

Barragan-Jason, G., Loreau, M., de Mazancourt, C., Singer, M. C., & Parmesan, C. (2023). Psychological and physical connections with nature improve both human well-being and nature conservation: A systematic review of meta-analyses. Biological Conservation, 277, 109842. 

Senay, C. (2023). Nature Connection as a Physiotherapy Tool : Background Research on Natural Environments Interaction with Human Health for Informative Articles Destined to Physiotherapists. 

Song, C., Ikei, H., & Miyazaki, Y. (2018). Physiological Effects of Visual Stimulation with Forest Imagery. International Journal of Environmental Research and Public Health, 15(2).