Table 3.
Details of interventional studies
| Study | Country | Design | Participants | Female% | Mean age | HT site | Adviser | Measures | Intervention | Duration (Frequency/Week × Duration/Session) | Follow-up | Outcome | Intervention attendance | Adverse events |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Tse (2010) | Hong Kong (China) | Randomized parallel group | 53 elderly people who can communicate in Cantonese, have good physical cognition and no history of allergies in nursing homes. | 84.9 | 84.09, SD=6.71 | Four nursing homes | Researcher and research assistants | Life satisfaction, loneliness, ADL, social network |
Indoor gardening (Experimental): acquire information on gardening activities, gardening skills reinforced, planting diary, evaluate the gardening program,share experiences. Routine care (Control) |
8 weeks × Depends on participants | — | Gardening groups were higher in life satisfaction and social network,lower in loneliness than control group,but physical activity has no different | NA | NA |
| Suk-Young and Byung-Jin (2010) | North Gyeongsang (South Korea) | Randomized parallel group | 16 demented elderly people who were not taking medication and consented to a blood test were recruited by a geriatric hospital | 75 | 79.82, SD=5.97 | A nursing home and hospital for the elderly | Horticultural Therapists | Stress, Serum cortisol, MMSE |
Gardening activity (Experimental): plant-themed stories, talking to gardeners; visual stimulation, identifying their fragrances, gardening activities, cutting and arranging flowers, daily tasks such as changing water, cutting branches, removing green leaves, etc., free play. Routine care (Control) |
3 weeks × 2 × 40min | — | Obviously reduced the blood cortisol hormone level and stress | NA | NA |
| Hawkins et al. (2011) | Wales (UK) | Randomized parallel group | 94 elderly people in various local activity groups | 68.1 | 67.43, SD=8.56 | Participant's home and an open space of Wales(UK) | Researcher and research assistants | Stress, social support, physical activity, PCS, MCS |
Allotment gardening (Experimental): gardeners who assign gardening and home gardeners who garden on separate plots of land and in their own gardens, respectively. Indoor exercise (Control) |
30 min | — | Significantly reduced stress than control group, no differences in levels of social support and physical activity | NA | NA |
| Park et al. (2016) | Seoul (South Korea) | Randomized parallel group | 50 elderly people at senior community centers | 100 | 82.05, SD=±5.36 | A community centers | a horticultural therapist with three assistants | BMI, senior fitness test, hand function ability, cognitive ability, depression, docial engagement, physical activity level |
Gardening activity (Experimental): design garden, making garden plots and signs, planting transplants, maintaining, fertilizing, marking flower garden and vegetable beds, organic fertilizers, planting, harvesting and sowing seeds, garden party. Daily activities (Control) |
12 weeks × 2 × 50min | — | Improved the physical and psychological health | 80% | NA |
| Park et al. (2017) | Seoul (South Korea) | Randomized parallel group | 21 elderly people without cardiovascular disease from community | 100 | 80.63, SD=±5.14 | A senior community center | Researcher and a certified nurse | Blood lipid, BP, proteins that promote inflammation, oxidant proteins |
Gardening activity (Experimental): planning garden, making garden plots and signs, planting transplants, hydroponics, fertilizing, making a flower bed, making a vegetable bed, making organic fertilizers, mulching, planting plants, harvesting produce, flower arrangement, sowing seeds, cooking with harvest. Waiting control (Control) |
7.5 weeks × 2 × 50min | — | Positive effects on the blood lipid profiles, blood pressure, level of inflammatory markers in blood, and oxidative stress | NA | NA |
| Yao and Chen (2017) | Taiwan (China) | Randomized parallel group | 85 elderly people from nursing homes | 50.1 | 80.07, SD=±8.39 | Seven nursing homes | Two to four nursing assistants and one social worker from each nursing home, and one administrative | ADL, happiness, meaning of life, interpersonal intimacy |
Indoor gardening (Experimental): eight HT sessions with eight different themes was conducted: the joy of life, flower admiration and arrangement, 1000 decades of wealth and prosperity, miracles of flowers, happiness and luck, fortune cards, kingdom of herbs, the big harvest. Daily activities (Control) |
8 weeks × 1 × 60min | — | Happiness,interpersonal intimacy scores of experimental group participants were significantly better than the scores of control group | 96% | no serious adverse events |
| Bassi et al.(2018) | Milano (Italy) | Randomized crossover group | 11 elderly people from a nursing home | 81.8 | 81.18, SD=±4.17 | Private nursing home | Agronomist (horticultural activities), educator (vocational activities), two researchers | Concentration, happiness, sociability, involvement, challenges, stakes, self-satisfaction |
Gardening activity (Experimental): horticulture courses, seeding, planting, propagation, transplanting, flower arranging and plant growing. Daily activities (Control) |
6 weeks× 1 × 60min | — | The gardening group offered higher challenges and risks than the occupational activity group, and increased self-satisfaction and happiness | 93.75% | NA |
| Wendy et al.(2018) | Alabama (USA) | Randomized parallel group | 46 elderly people cancer survivors without severe orthopedic, cardiovascular,or pulmonary disease | 69.6 | 70.4, SD=±7.8 | Survivors’homes | Master gardeners | Vegetable and fruit intake, anthropometric measurements, performance, biomarkers, QOL |
Home-based vegetable gardening (Experimental): master gardeners were instructed to visit with the participant once a month and assess the home garden, participants follow the planting schedule and garden plan. Waiting control (Control) |
48 weeks × Depends on participants | — | The gardening group had a significant increase in reassurance of worth, reduced waist circumference, and increased daily consumption of vegetables and fruit compared with the control group | 91.30% | no serious adverse events |
| Ah-Reum et al. (2018) | Suwon (South Korea) | Randomized parallel group | 28 elderly people with mental health problems from two elderly mental health centers | 85.7 | 78.75, SD=±4.76 | Two elderly mental health centres | Researcher, four assistant therapists and staff member | Cortisol, senior fitness test |
Gardening activity (Experimental): making garden plot and sign, fertilizing, planting, hydroponics, weeding, watering, mulching, setting up plant stakes, harvesting, tying stakes, picking a side, covering up crops with soil, making herb tea, farm party. Routine care (Control) |
8 weeks × 1 × 90min | — | Cortisol levels significantly decreased and fitness levels significantly improved in the horticultural therapy group, while there was no significant improvement in the control group | 86% | NA |
| Claudia et al.(2018) | Hong Kong (China) | Randomized parallel group | 96 elderly people in a frail or pref-rail state from the 4 residential care homes | 65.6 | 84.60, SD=±7.24 | NA | One registered horticultural therapist, one trainee assistant | Happiness, depressive, self-efficacy, well-being, social network, social engagement |
Gardening activity (Experimental): gardening courses, fertilization, replanting plants, watering, pruning, propagation, introduction to varieties and sowing of seeds. Daily activitiesv (Control) |
8 weeks × Depends on participants | 12 weeks | The results did not show a particular positive effect of gardening activity on other factors other than "happiness" | 85% | NA |
| Chu et al. (2018) | Taiwan (China) | Randomized parallel group | 150 elderly people in three nursing homes | 62.7 | 79.2, - | Nursing homes | Researcher and four research assistants | Depression, loneliness |
Gardening activity (Experimental): warm-up activities, gardening activities (including stringing, inserting, rolling, cutting, sticking, and binding motions), interpersonal interaction and group sharing activities. Daily activities (Control) |
8 weeks × 1 × 90 to 120min | — | Reduced depression and loneliness | 100% | Two participants in the control group dropped out due to chronic illness |
| Makizako et al.(2019) | Obu (Japan) | Randomized parallel group | 89 elderly people with presence of depressive symptoms and memory problems from community | 50.6 | 73.1, SD=±5.5 | NA | Researcher and vegetable experts | Depression, memory |
Gardening activity (Experimental): cultivating, growing, harvesting, group planting. Education course or exercise intervention (Control) |
20 weeks × 1 × 60 to 90minute | 48 weeks | None showed improvement, and the same 12 months later | 84.50% | NA |
| Park et al.(2020) | Eunpyeong-gu (South Korea) | Randomized parallel group | 40 elderly people at a senior welfare center | 65 | 73.85, SD=±5.41 | A senior welfare center | Researcher and a certified nurse | Cognitive ability, hand function ability, senior fitness test |
Gardening activity (Experimental): design garden and making garden plot, planting transplants, making medicated plant garden beds, making vegetable garden beds, making organic fertilizers, maintaining garden, making flower garden beds, making herb garden beds, hydroponics, sowing seeds, cutting stems, harvesting and packing harvests, garden party. Waiting control (Control) |
7 weeks × Depends on participants | — | Cognitive ability in the gardening group were significantly increased | NA | NA |
| Chu et al. (2021) | Tainan (China) | Randomized parallel group | 88 elderly people aged 65 and over without mental illness from three nursing homes | 55.68 | 65 years and older | Nursing homes | Researcher and four research assistants | Attitudes to ageing questionnaire, health hope index, hand eye coordination |
Gardening activity (Experimental): warm-up activities, gardening activities (including stringing, inserting, rolling, cutting, sticking, and binding motions), interpersonal interaction and group sharing activities. Routine care (Control) |
8 weeks × 1 × 120min | 12 weeks | Improved attitudes to ageing questionnaire,health hope index,hand eye coordination in experimental group,the effects lasted up to two months. | 100% | Two participants in the control group dropped out due to chronic illness |
| Mochizuki Kawai et al. (2021) | Tokyo (Japan) | Randomized parallel group | 16 elderly people with dementia in a nursing home | — | 90.3, SD=±6.8 | A nursing home | One neuropsychologist, one occupational therapist and two assistants | QOL, CSDD |
Indoor gardening (Experimental): select three flowers and place them on the absorbent foam markers (circles) to create floral artwork decorations. Routine care (Control) |
5 days × Depends on participants | — | The mean health-related quality of life and total Cornell Scale for Depression in Dementia scores of experimental group significantly improved | 100% | NA |
| Wong et al.(2021) | Singapore | Single-blind randomized parallel group | 59 elderly people from a community | 49.15 | 67.1, SD=±4.31 | NA | A trained practitioner and volunteer, National Park Board (NPB) staff | BMI, Biomarkers included: BDNF,BP, DHEA, HS-CRP, IL |
Indoor gardening (Experimental): horticulture courses, indoor gardening, ornamental plants, providing knowledge of various plants and landscapes, outdoor gardening (including education on weeding, seeding, herbal plants and fertilizer making). Waiting control (Control) |
12 weeks × Depends on participants | 12 weeks | HT is associated with increased numbers of naive CD8+ T cells and fewer CTLA4-expressing terminally differentiated effector CD4+ and CD8+ memory T cells re-expressing CD45RA (TEMRA). Furthermore, IL-6 levels were reduced during HT , and the frequencies of naive and TEMRA CD8+ T cells were found to be associated with IL-6 levels | ≥90% | NA |
| Ng et al. (2018) | Singapore | Randomized parallel group | 59 elderly people from community | 49.15 | 67.1, SD=±4.31 | Several parks/gardens and a nature reserve | An experienced coach and assistant | Cognitive functions, depression, anxiety , psychological well-being, social conceitedness and satisfaction with life, biomarkers included: IL-1β, IL-6, sgp-130, CXCL12/SDF-1α, CCL-5/RANTES, BDNF, hs-CRP, DHEA, cortisol |
Gardening activity (Experimental): gardening sessions, from indoor gardening, planting, maintenance and harvesting of vegetables and herbs, to guided walks in various parks. Waiting control (Control) |
12 weeks × Depends on participants | 12 weeks | Horticultural therapy reduced plasma IL-6 and through maintaining plasma CXCL12 (SDF-1α), may maintain hematopoietic support to the brain and prevent inflammatory disorders | NA | NA |
| Barnicle and Midden (2003) | St.Louis(USA) | Randomized parallel group | 62 elderly people aged 65 and over from two long-term care facilitation | 90.32 | 65 years and older | NA | Researcher and research assistants | Balance, psychological well-being |
Indoor gardening (Experimental): seed selection, planting, pruning, watering, transplanting, plant observation, horticulture courses. Waiting control (Control) |
7 weeks × 1 × 120min | — | The horticulture group had a significant increase in psychological well-being, whereas the control group decreased | NA | NA |
| Masuya (2014) | Tokyo (Japan) | Randomized parallel group | 18 elderly people residents of nursing homes | 77.78 | 85.60, SD=±7.51 | A nursing home | A specialist (author), care worker (facility staff), and research collaborator | VI, GDS, ADL, QOL, MMSE |
Gardening activity (Experimental): taking care of plant and observation, grow vegetables, transplant flowers, pruning and harvesting of plants, sharing the workmanship of plants. Routine care (Control) |
6 weeks × 1 × 30 to 40 min | — | GDS-15 score of Intervention Group Regarding decreased,and reduced depression and increased life satisfaction than control group | NA | NA |
| Yuka (2013) | Sendai (Japan) | Randomized crossover group | 39 elderly people women with earthquake stress | 100 | 66.15, SD=±4.52 | A university lab | A horticultural therapist and clinical psychologists | CAPS, GDS, PTGI, QOL |
Indoor gardening (Experimental): interactive lectures and practical horticultural training, six horticultural lessons, including topics such as designing a garden planter, seeding, watering, weeding, and picking flowers. Pressure education (Control) |
8 weeks × 1 ×60 min | — | CAPS score, GDS score, PTGI-J score, and WHO-QOL26 score and salivary cortisol level in the intervention group was improved,the same as the follow up | NA | NA |
| Pedrinolla et al.(2019) | Verona (Italy) | Single-blind randomized parallel group | 163 elderly people with Alzheimer's disease | 74.23 | 76.4, SD=±4.3 | An indoor therapeutic garden | Researchers, geriatricians and neuropsychologists | MMSE, NPI, biomarkers included: BI, BP, salivary cortisol, quetiapine |
Indoor gardening (Experimental): walking in the therapeutic garden, touching plants and flowers, independent activities. Indoor exercise (Control) |
24 weeks × 5 × 120 min | — | NPI scores were significantly improved, quetiapine dosage, blood pressure, and salivary cortisol concentrations were significantly reduced | 66% | No major or relevant adverse events |
| Ng et al.(2021) | Singapore | Randomized parallel group | 59 elderly people from a neighbourhood | 78 | 67.10, SD=±4.31 | Several parks and a nature reserve | NA | IL-6, PRWO |
Gardening activity (Experimental): planting courses, planting journals, sowing seeds, making natural pesticides, caring for plants. Routine care (Control) |
12 weeks × 1 × 60 min | 24 weeks | PRWO and IL-6 level were significantly improved of intervention group,and the same 12 months later | NA | NA |
| Jarrott and Gigliotti (2010) | Virginia (USA) | Randomized parallel group | 129 elderly people with dementia from 8 care programs | 53.1 | 80.09, SD=±8.05 | Nursing homes | Horticultural therapist and gerontologist | Affective and behavioral responses |
Gardening activity (Experimental): gardening courses, soil filling, plugs, spikes, planting. Daily activities (Control) |
6 weeks × 2 × 50 min | — | No differences on affective domains,with the treatment group demonstrating higher levels of active | NA | NA |
| Bail et al. (2018) | Birmingham (UK) | Randomized parallel group | 82 breast cancer survivors from hospital registries | — | 60.5, SD=±9.4 | Participants ’homes | Master Gardeners and management groups,and cooperative Extension agent | Vegetable consumption, physical activity, performance function, anthropometrics, biomarkers, QOL |
Vegetable Gardening (Experimental): direct the planning, planting and maintenance of 3 (spring, summer and fall) home gardens over the course of a year, master Gardeners monthly home visits, garden photographs, and bimonthly e-mails and/or telephone calls were tracked by study staff. Wait-list control (Control) |
48 weeks × Depends on participants | — | Compared with the controls, intervention participants reported significantly greater improvements in moderate activity , improved vegetable consumption. | ≥80% | no serious adverse events |
ADL: Activities of daily living; MMES: mini-mental state examination; PCS: self-reported physical health; MCS: self-reported mental health; BMI: body mass index; QOL: quality of life; CSDD: cornell scale for depression in dementia, BDNF: brain-derived neuro factor; BP: blood pressure; DHEA: dehydroepiandrosterone; HS-CRP: high-sensitivity C-reactive protein; IL: interleukin; VI: vitality index; GDS: geriatric depression scale; CAPS: traumatic stress disorder; PTGI: post traumatic growth inventory; NPI: neuropsychiatric questionnaire; PRWO: positive relations with others