Evidence map›Paper›PMID 40438400›Full record

Trial reportFrontiers in endocrinology2025

Psychosocial and physiological health outcomes of outdoor green exercise versus indoor exercise in knee osteoarthritis patients coexisting with type 2 diabetes mellitus: a randomized controlled trial.

Yilin Jin, Xiang Geng, Qiaojie Wang, Feng Xue, Shengdi Lu, Lihua Huang

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Frontiers in endocrinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Yilin Jin *Department of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, China.
Xiang Geng *Department of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, China.
Qiaojie WangDepartment of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Feng XueDepartment of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shengdi LuDepartment of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Lihua HuangDepartment of Rehabilitation, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Both physical activity and nature exposure are associated with several health benefits for both knee osteoarthritis (KOA) and type 2 diabetes mellitus (T2DM). However, the health outcomes when being physically active in nature, called green exercise (GE), are less clear. The purpose of this study is to evaluate the psychosocial and physiological outcomes for green exercise in KOA patients coexisting with T2DM compared to indoor exercise. Method: A prospective, randomized, open-label, parallel, multi-center clinical trial conducted at two hospitals in Shanghai that included 82 patients T2DM and KOA. Enrollment occurred between January 2020 and March 2022, and follow-up was completed October 2022. Participants were randomized to outdoor green cycling (OGC) group and indoor stationary cycling (ISC) group. Psychosocial and physiological health outcomes were evaluated through questionnaires comprising standard international measures of self-esteem (Rosenberg Self-esteem Scale [RSE]), perceived stress (Perceived Stress Scale [PSS]), mood (Profile of Mood States [POMS]) and nature relatedness (Nature Relatedness Scale - short-form version). Participants' enjoyment of exercise and intention for a future exercise behavior was measured in a questionnaire using a 100mm visual analogue scale as a continuum from 0 - 'not at all' to 100 - 'very much'. Results: Among 82 patients, 74 (90.2%) completed the trial. By 24 weeks, the OGC group showed a greater reduction in perceived stress (3.7 vs. 2.8, P = 0.007), and total mood disturbance (POMS) scores decreased more in the OGC group (-7.2 vs. -6.1, P = 0.030). Tension and depression subscales also showed greater reductions in the OGC group (P < 0.001 for both), along with higher improvements in vigor (10.2 vs. 8.1, P < 0.001). Enjoyment of exercise was slightly higher in the OGC group, though this difference did not reach statistical significance (P = 0.061), and their intention to continue exercising was also significantly stronger (P = 0.021). Participants in OGC group achieved significant decrease of HbA1c than participants in ISC group. Conclusion: Green exercise offers an accessible provision for improving short-term psychological wellbeing than indoor exercises. Clinical Trial Registration: https://www.chictr.org.cn/, identifier ChiCTR2100042872.

Indexed as

Diabetes Mellitus, Type 2ExerciseExercise TherapyOsteoarthritis, KneeAgedFemaleHumansMaleMiddle AgedProspective StudiesTreatment Outcomegreen exerciseknee osteoarthritisphysical activitypsychosocial and physiological healthtype 2 diabetes mellitus

Identifiers

PMID40438400
PMCPMC12116314

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.