Effects on Heart Rate Variability and EEG of Type of Participation in Health Tourism Programs Involving Stays in Hot Springs and Forests in Asan

Background and objective: Health tourism, which involves activities for health promotion and therapeutic travel, is gaining attention as a means of stress and fatigue relief. While therapeutic programs involving forests and hot springs have been reported to have positive effects, there is a lack of research on the combined benefits of these environments, as well as comparative studies of static and dynamic health tourism. Therefore, this study aimed to examine changes in stress levels by analyzing heart rate variability (HRV) and electroencephalograms (EEG) taken from participants in different types of health tourism programs involving stays in hot springs and forests.Methods: A total of 20 adults (9 males and 11 females) were randomly assigned to either the Relax Tour program (N=10) or the Activity Tour program (N=10). Both health tour programs, which included forest walking and aquatic exercise in hot springs, were implemented. To ensure homogeneity between the groups, physical characteristics, EEG, and HRV were assessed using independent samples t-tests. The effects of the health tourism participation type on EEG and HRV were analyzed using a two-way mixed-design ANOVA. When significant differences were found, post-hoc analyses were conducted using the Bonferroni method.Results: An HRV analysis showed no significant differences between the groups; however, significant changes were observed based on the time points measured. An EEG analysis showed a significant increase in alpha waves in the Activity Tour group, while the Relax Tour group also showed a trend toward improvement in alpha waves.Conclusion: The effects of a health tourism program combining forest and hot spring activities on the autonomic nervous system and EEG were analyzed. The Activity Tour group showed an increase in alpha and beta waves, while both the Activity and Relax Tour groups showed a decrease in RMSSD and SDNN in HRV. This suggests that physical fatigue and mental activation may occur simultaneously. Therefore, it seems necessary to consider long-term effects and optimization in program design to reduce physical fatigue and maximize psychological stability and cognitive recovery to increase effectiveness.