Interventional Study on the Effects of Forest Therapy in Fibromyalgia Patients

A Monocentric, Randomized, Controlled, No-profit, Interventional Study on the Effects of Forest Therapy in Patients With Fibromyalgia

The goal of this clinical trial is to evaluate if Forest therapy can reduce pain levels and improve the quality of life related to the level of pain perceived in fibromyalgia patients.

The main question it aims to answer is:

Does frequenting certified forest environments, according to the principles and methods of Forest Therapy, produce positive effects on chronic pain and the consumption of painkillers? The study is part of the "Forest Therapy Project as a Broad-Spectrum Tool for Patients Affected by Fibromyalgia" funded by the Tuscany Region as part of the Complementary Medicine program for the three-year period 2025-2027. The project will be carried out thanks to the collaboration with the National Research Council - Institute for BioEconomy (CNR-IBE)

Participants will be divided into two groups. One group, called the "intervention group," will participate in experimental Forest Therapy sessions at an easily accessible forest site. Another group, called the "control group," will not be required to make any changes to their usual habits or activities.

The Forest Therapy sessions consist of short, slow walks, intentionally without significant physical exertion, along safe and easy paths. Led by clinical professionals such as doctors, psychologists, or psychotherapists from the Anesthesia and Intensive Care Unit of Cecina, the sessions include frequent breaks and encourage concentration on the sensory connection with the forest environment.

The study is randomized, so assignment to one of the two treatment groups above will follow a pre-defined random criterion.

During the study, all patients will follow standard therapeutic treatments specific to their condition.

Inclusion Criteria:

• 18 years or older
• diagnosis of fibromyalgia (diagnosed by a rheumatologist according to ACR criteria)
• enrolled in the pain management program at the Intensive Care Unit of Cecina Hospital
• under treatment with painkillers
• without mobility limitations that prevent them from taking slow, easy walks lasting approximately 2.5 hours and covering approximately 2 km, willing to self-certify their ability to walk unassisted in an obstacle-free environment
• capable of understanding the purpose of the study and providing informed consent to participate.

Exclusion Criteria:

• Patients who have not been diagnosed with fibromyalgia
• Diagnosis of neoplastic disease
• Pregnant women
• Allergies to pollen and/or grasses and/or insect bites
• Active systemic disease
• Neurological disease
• Degenerative disease
• Infectious disease