{
  "abstract": "Background The health benefits of the outdoors have become an increasing area of interest within public health research. Despite the growing evidence of the physical, psychological and social benefits of outdoor activities in community and mental health settings, no known systematic reviews have explored the benefits of outdoor activities during inpatient rehabilitation for physical illness or injury.Methods Three databases were searched (MEDLINE, EMCARE and SCOPUS) in June 2025. The inclusion criteria were randomised controlled trials or quasi-experimental studies, any outdoor rehabilitation activities for any physical illness/injury, using any rehabilitation outcomes, in inpatient settings in high-income countries. Studies in children, inpatient mental health, community or passive outdoor interventions were excluded. Joanna Briggs Institute Tools were used to assess risk of bias. Findings were presented as a quantitative narrative synthesis with an effect direction plot. Public involvement informed this study, including insights from an individual with experience of inpatient rehabilitation, and a caregiver of an individual living with dementia. A student protocol was completed on PROSEPRO (CRD420251055637).Results Nine studies were included. Outdoor interventions included walking, horticultural therapy and mixed activities in hospital grounds, gardens, rooftops and greenhouses, across neurological, musculoskeletal and cardiorespiratory conditions. For physical outcomes, 4 out of 8 results showed outdoor activities were better than indoor activities alone. For psychological outcomes, 7 out of 9 studies showed outdoor activities provided additional benefits or improvements, when compared to indoor activities alone or pre-intervention measures. However, the studies were at moderate or high risk of bias, limiting the certainty of evidence.Conclusion There is limited but emerging evidence that outdoor activities could contribute to better outcomes during inpatient rehabilitation. Outdoor activities could improve environmental enrichment, functional recovery, physiological parameters, satisfaction, mood, wellbeing, motivation, self-efficacy, socialisation and quality of life. Future research should use larger samples, longer follow-up and input from patients and rehabilitation professionals.",
  "authors": [
    {
      "affiliations": [
        "Faculty of Population Health Sciences, University College London, London, UK"
      ],
      "name": "Alys Murphy"
    },
    {
      "affiliations": [
        "Faculty of Population Health Sciences, University College London, London, UK"
      ],
      "name": "Joanna Dawes"
    },
    {
      "affiliations": [
        "Faculty of Population Health Sciences, University College London, London, UK"
      ],
      "name": "Emma Dunphy"
    },
    {
      "affiliations": [
        "Faculty of Population Health Sciences, University College London, London, UK"
      ],
      "name": "Georgia Bacon"
    }
  ],
  "title": "P07-2 Do outdoor activities improve rehabilitation outcomes compared to usual indoor activities in adult inpatient care? A systematic review",
  "uid": "55358fcb-400d-5d04-ae55-3c916de152b2"
}