Related Experiment Video
Updated: May 8, 2026

Measuring Biophysical and Psychological Stress Levels Following Visitation to Three Locations with Differing Levels of Nature
Published on: June 19, 2019
Hiking in suicidal patients: neutral effects on markers of suicidality
Daniel Neunhäuserer1, Josef Sturm, Mira M Baumgartlinger
1Department of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Institute of Sports Medicine of the State of Salzburg, Sports Medicine of the Olympic Center Salzburg-Rif, Salzburg, Austria.
Background:
Regular physical activity promotes physical and mental health. Psychiatric patients are prone to a sedentary lifestyle, and accumulating evidence has identified physical activity as a supplemental treatment option.
Methods:
This prospective, randomized, crossover study evaluated the effects of hiking in high-risk suicidal patients (n = 20) who performed 9 weeks of hiking (2-3 hikes/week, 2-2.5 hours each) and a 9-week control period.
Results:
All patients participated in the required 2 hikes per week and thus showed a compliance of 100%. Regular hiking led to significant improvement in maximal exercise capacity (hiking period Δ: +18.82 ± 0.99 watt, P < .001; control period: P = .134) and in aerobic capability at 70% of the individual heart rate reserve (hiking period Δ: +8.47 ± 2.22 watt; P = .010; control period: P = .183). Cytokines, associated previously with suicidality (tumor necrosis factor-α, interleukin-6, S100), remained essentially unchanged.
Conclusions:
Hiking is an effective and safe form of exercise training even in high-risk suicidal patients. It leads to a significant improvement in maximal exercise capacity and aerobic capability without concomitant deterioration of markers of suicidality. Offering this popular mode of exercise to these patients might help them to adopt a physically more active lifestyle.