Trail Running as a Therapeutic Modality: A Meta-Analytic Review of its Efficacy in Anxiety Management and Resilience Building

<span style="font-weight: 400;">The proposition that natural environments can confer significant mental health benefits is no longer a fringe concept but a subject of extensive scientific inquiry. As global populations become increasingly urbanized, the search for accessible, non-pharmacological interventions to mitigate the rising prevalence of mental health disorders has intensified.</span><span style="font-weight: 400;">1</span><span style="font-weight: 400;"> This has led to the formalization of concepts such as "green exercise," which involves physical activity in the presence of nature, and "ecotherapy," which encompasses a range of structured therapeutic interventions that utilize natural environments to promote healing.</span><span style="font-weight: 400;">4</span><span style="font-weight: 400;"> Trail running, the specific focus of this report, exists at the intersection of these domains, representing a potent form of green exercise that is increasingly being adopted not for competition, but for its perceived therapeutic value. This section synthesizes the broad evidence base for nature-based health interventions (NBHIs) to establish the scientific context from which the specific benefits of trail running emerge. It will review the documented psychological and physiological effects, examine the quantitative evidence from existing meta-analyses, and explore the theoretical frameworks that explain these phenomena. Crucially, it will also address the methodological complexities and limitations that characterize this field, providing a balanced and critical foundation for the subsequent analysis.</span>