Nature-based therapies in the alpine terrain of Austria

Written by Julia Kersche, Julia Golser, Valentýna Mikutová, Jana Gahleitner, Antonia Köberlein, Markus Bräutigam

Introduction

Nature-based therapies are becoming increasingly important in modern health promotion. With its unique natural scenery and diverse resources, Austria’s alpine terrain in particular offers ideal conditions for testing and scientifically investigating innovative therapeutic approaches. Univ.-Doz. Dr. Arnulf Hartl, Head of the Institute of Ecomedicine at Paracelsus Medical University Salzburg, and his team are researching how nature therapies can promote health and well-being. The results of studies to date show that physical activity in alpine nature is associated with a lower level of psychological stress – even though psychological problems can also occur in active mountain sports enthusiasts (Niedermeier et al., 2017).

It is particularly noteworthy that emotional well-being improves significantly more when hiking in the mountains outdoors than when exercising indoors (Niedermeier et al., 2017). In addition, alpine natural resources such as forests, waterfalls and high altitudes have a positive effect on both physical and mental health. Such nature therapies could be particularly helpful in cases of stress or chronic illness (Hartl et al., 2023). A biopsychosocial resilience model emphasizes the importance of contact with nature for the ability to adapt to environmental stress (White et al., 2023). Overall, these research findings make it clear that nature therapies can be a useful addition to health promotion and prevention.

Altitude training

In addition to waterfall therapy, there are other nature-based methods that aim to promote health. A prominent example of this is altitude training, which is mainly used in competitive sports.

An increasing number of athletes and coaches are incorporating altitude training into their training plans. This kind of training influences the aerobic capacity of athletes. One study found that altitude training resulted in higher maximum oxygen uptake and haemoglobin levels than training at lower altitudes. Altitude training, a form of hypoxic training, involves athletes training at high altitudes or being deliberately exposed to artificial hypoxia in a controlled and targeted manner. This type of training is primarily used by endurance athletes to enhance their aerobic capacity. There are several variations, which differ in terms of training and living altitude. The most effective method, cycle or altitude has not yet been fully clarified. However, current guidelines for effective altitude training recommend an altitude of around 2,500 metres for around three weeks (Chen et al., 2023).

The way in which the human body reacts to hypoxia differs depending on gender. For instance, women exhibit different ventilation patterns, resulting in greater expiratory restrictions and a higher risk of iron deficiency. Furthermore, one study cites a potentially higher risk of acute altitude sickness. Nonetheless, several questions remain open for further investigation (Burtscher et al., 2023).

Climbing therapy

Exercise in nature is no longer only used therapeutically in traditional forms. Climbing therapy, also known as therapeutic climbing, is a modern functional therapy which uses movements of the climbing sport. Climbing therapy has its origin in bouldering sport (climbing without a rope in jumping height). In the field of physiotherapy, therapeutic climbing is most often used for patients with orthopedic or neurological symptoms.

By performing targeted movements on a wall using hand grips and kicks in an upright body position, patients must constantly adjust the tension of their body. This places high demands on intra- and intermuscular coordination, perception and mobility. Disadvantageous tension conditions in the muscles should be improved, and disturbed movement sequences reorganized. Furthermore, there is a focus on strengthening certain muscle groups (trunk, arm and leg muscles) and improving postural control (the ability to hold the body upright under the influence of gravity).

Climbing has the advantage of using natural, functional movements that the brain can learn and remember more easily. By “crawling vertically”, automated movement patterns from childhood development can be activated. Other important objectives of therapeutic climbing can be found on a psychosocial level. Climbing is not only fun for many patients, but also helps to reduce anxiety, increases concentration performance, mindfulness and self-esteem.

Climbing therapy is most often offered on indoor therapeutic climbing walls, typically found in climbing centers, bouldering gyms, or physiotherapy practices equipped with their own walls. Nevertheless, some providers also offer outdoor climbing therapy concepts. This especially improves balance, depth and surface sensitivity, spatial perception and body schema in combination with an environmental outdoor experience. (The content of this summary was inspired by information from the websites of Achrainer (n.d.), Edelweiss Klettern (n.d.), Klinik Pirawarth (n.d.), Naturfreunde Österreich (n.d.), and Wikipedia (2024).)

Gasteiner Healing Gallery

The Gastein Healing Gallery is a particularly unusual form of natural alpine therapy. In Böckstein near Bad Gastein, at 1,270 meters above sea level in Salzburg, lies the Gastein Healing Gallery – a unique form of natural therapy. Originally used as a mine, the tunnel has served as a treatment and therapy center for people with chronic illnesses since the 1950s. Today, it is considered one of the most renowned facilities of its kind worldwide.

The therapy’s effect is based on a combination of natural factors. The key element is the noble gas radon, released in low concentrations inside the tunnel. Together with temperatures of up to 41.5°C and nearly 100% humidity, a unique microclimate is created. Numerous studies have shown this environment to have anti-inflammatory, pain-relieving, and muscle-relaxing effects, while also strengthening the immune system. A reduction in medication use has also been observed.

The Healing Gallery is primarily used to treat chronic inflammatory and painful conditions such as ankylosing spondylitis, rheumatoid arthritis, osteoarthritis, fibromyalgia, as well as certain skin and respiratory diseases. Patients with chronic back pain or cervical spine syndrome also frequently benefit from this form of therapy. The therapy takes place under medical supervision. A small train transports patients deep into the mountain for about an hour each day, allowing the body to gradually adapt to the special climate—a gentle yet highly effective treatment (Gasteiner Heilstollen, o.D.).

For closer reference, our team produced a short informative video on this topic: