Psychological recovery function of simulation green exercise: A meta-analysis and systematic review

Green exercise has emerged as a pivotal means to enhance physical and mental health. However, its efficacy can be compromised by uncontrollable external factors, such as weather and environmental conditions. This study was a preregistered review and meta-analysis (PROSPERO: CRD42024518197) that explored the feasibility of simulation green exercise as an alternative in indoor exercise and assessed its moderating variables with the aim of developing optimal intervention strategies. A comprehensive search of five English-language databases was conducted, and a meta-analysis of outcome indicators was performed on 560 subjects in 12 selected studies. Subgroup, regression, and sensitivity analysis were used to explore the sources and moderating factors of heterogeneity. The findings reveal significant benefits of simulation green exercise on Psychological recovery function. (1) The simulation green exercise significantly improved participants' mood compared with the control group (SMD [95% CI] = 0.233 [0.098; 0.367], p = 0.001, PI = [−0.373; 0.838]). (2) The simulation green exercise significantly improved participants’ attention compared with the control group (SMD [95% CI] = 0.350 [0.191; 0.509], p < 0.001, PI = [−0.167; 0.533]). (3) Subgroup analysis showed a significant difference between exercise intensity subgroup and duration subgroup in mood index (p = 0.05). Low-intensity exercise for 5–10 min during a simulation green exercise had the best effect on improving mood. In addition, the type of display subgroup showed almost significant (p = 0.06), indicating that 2D media promoted the emotional recovery effect when simulation green exercise. (4) Subgroup analysis showed a significant difference in the audio subgroup in the attention index (p = 0.02). The combination of audio and video significantly improved attention. (5) Regression analysis showed almost significant between the exercise intensity group and the exercise duration group (p = 0.09; p = 0.07). Low-intensity, short-duration of simulation green exercise can improve mood. Therefore, it is recommended to perform low-intensity, short-duration of simulation green exercise, and use 2D media combined with audio-visual stimulation. However, the number of relevant studies is relatively small, and expanding the findings is difficult. As such, future studies should aim to increase empirical studies focused on diverse age groups and genders, enhance VR quality to mitigate cybersickness, and further investigate the role of audiovisual multisensory stimulation in simulation green exercise programs.