101
|
Morer C, Roques CF, Françon A, Forestier R, Maraver F. The role of mineral elements and other chemical compounds used in balneology: data from double-blind randomized clinical trials. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:2159-2173. [PMID: 28849535 DOI: 10.1007/s00484-017-1421-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 07/28/2017] [Accepted: 07/31/2017] [Indexed: 05/21/2023]
Abstract
The aims of this study were to conduct a systematic literature review on balneotherapy about the specific therapeutic role of mineral elements and other chemical compounds of mineral waters and derivate peloids/muds and to discuss the study methods used to evaluate it (in musculoskeletal conditions). We searched Medline by PubMed using the following key words: "spa therapy" "balneotherapy" "mud" "peloid" "mud pack Therapy" in combination with "randomized controlled trial" "double blind trial." We also reviewed the reference list of articles retrieved by the Medline search. We selected the double-blind randomized clinical trials that assessed the effects of mineral water or mud treatments compared to tap water, attenuated peloid/mud therapy or similar treatments without the specific minerals or chemical compounds of the treatment group ("non-mineral"). We evaluated the internal validity and the quality of the statistical analysis of these trials. The final selection comprised 27 double-blind randomized clinical trials, 20 related to rheumatology. A total of 1118 patients with rheumatological and other musculoskeletal diseases were evaluated in these studies: 552 of knee osteoarthritis, 47 of hand osteoarthritis, 147 chronic low back pain, 308 of reumathoid arthritis, and 64 of osteoporosis; 293 of these participants were assigned to the experimental groups of knee osteoarthritis, 24 in hand osteoarthritis, 82 of low back pain, 152 with reumathoid arthritis, and 32 with osteoporosis. They were treated with mineral water baths and/or mud/peloid (with or without other forms of treatment, like physical therapy, exercise…). The rest were allocated to the control groups; they received mainly tap water and/or "non-mineral" mud/peloid treatments. Mineral water or mud treatments had better and longer improvements in pain, function, quality of life, clinical parameters, and others in some rheumatologic diseases (knee and hand osteoarthritis, chronic low back pain, rheumatoid arthritis, and osteoporosis) compared to baseline and non-mineral similar treatments. Internal validity and other limitations of the study's methodology impede causal relation of spa therapy on these improvements. Randomized clinical trials are very heterogeneous. Double-blind randomized clinical trials seem to be the key for studying the role of mineral elements and other chemical compounds, observing enough consistency to demonstrate better and longer improvements for mineral waters or derivate compared to tap water; but due to heterogeneity and gaps on study protocol and methodology, existing research is not sufficiently strong to draw firm conclusions. Well-designed studies in larger patients' population are needed to establish the role of minerals and other chemical compounds in spa therapy.
Collapse
Affiliation(s)
- Carla Morer
- Department of Physical Medicine and Rehabilitation. Medical Hydrology, Faculty of Medicine, Universidad Complutense de Madrid, Plaza Ramon y Cajal, s/n, 28040, Madrid, Spain
- Institut Català de la Salut, EAP 8B Porta, Centro Atención Primaria Rio de Janeiro, UTAC Muntanya, Barcelona, Spain
| | | | - Alain Françon
- Aix-les-Bains Rheumatologic and Thermal Research Center, 15 Avenue Charles de Gaulle, 73100, Aix-les-Bains, France
| | - Romain Forestier
- Aix-les-Bains Rheumatologic and Thermal Research Center, 15 Avenue Charles de Gaulle, 73100, Aix-les-Bains, France
| | - Francisco Maraver
- Department of Physical Medicine and Rehabilitation. Medical Hydrology, Faculty of Medicine, Universidad Complutense de Madrid, Plaza Ramon y Cajal, s/n, 28040, Madrid, Spain.
- Professional School of Medical Hydrology, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain.
| |
Collapse
|
102
|
Stier-Jarmer M, Frisch D, Oberhauser C, Immich G, Kirschneck M, Schuh A. Effects of single moor baths on physiological stress response and psychological state: a pilot study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:1957-1964. [PMID: 28634659 DOI: 10.1007/s00484-017-1385-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 04/03/2017] [Accepted: 05/27/2017] [Indexed: 05/24/2023]
Abstract
Moor mud applications in the form of packs and baths are widely used therapeutically as part of balneotherapy. They are commonly given as therapy for musculoskeletal disorders, with their thermo-physical effects being furthest studied. Moor baths are one of the key therapeutic elements in our recently developed and evaluated 3-week prevention program for subjects with high stress level and increased risk of developing a burnout syndrome. An embedded pilot study add-on to this core project was carried out to assess the relaxing effect of a single moor bath. During the prevention program, 78 participants received a total of seven moor applications, each consisting of a moor bath (42 °C, 20 min, given between 02:30 and 05:20 p.m.) followed by resting period (20 min). Before and after the first moor application in week 1, and the penultimate moor application in week 3, salivary cortisol was collected, blood pressure and heart rate were measured, and mood state (Multidimensional Mood State Questionnaire) was assessed. A Friedman test of differences among repeated measures was conducted. Post hoc analyses were performed using the Wilcoxon signed-rank test. A significant decrease in salivary cortisol concentration was seen between pre- and post-moor bath in week 1 (Z = -3.355, p = 0.0008). A non-significant decrease was seen between pre- and post-moor bath in week 3. Mood state improved significantly after both moor baths. This pilot study has provided initial evidence on the stress-relieving effects of single moor baths, which can be a sensible and recommendable therapeutic element of multimodal stress-reducing prevention programs. The full potential of moor baths still needs to be validated. A randomized controlled trial should be conducted comparing this balneo-therapeutic approach against other types of stress reduction interventions.
Collapse
Affiliation(s)
- M Stier-Jarmer
- Chair for Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology - IBE, Ludwig-Maximilians-Universität (LMU), Marchioninistr. 17, 81377, Munich, Germany.
| | - D Frisch
- Chair for Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology - IBE, Ludwig-Maximilians-Universität (LMU), Marchioninistr. 17, 81377, Munich, Germany
| | - C Oberhauser
- Chair for Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology - IBE, Ludwig-Maximilians-Universität (LMU), Marchioninistr. 17, 81377, Munich, Germany
| | - G Immich
- Chair for Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology - IBE, Ludwig-Maximilians-Universität (LMU), Marchioninistr. 17, 81377, Munich, Germany
| | - M Kirschneck
- Chair for Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology - IBE, Ludwig-Maximilians-Universität (LMU), Marchioninistr. 17, 81377, Munich, Germany
| | - A Schuh
- Chair for Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology - IBE, Ludwig-Maximilians-Universität (LMU), Marchioninistr. 17, 81377, Munich, Germany
| |
Collapse
|
103
|
Karagülle M, Kardeş S, Karagülle MZ. Real-life effectiveness of spa therapy in rheumatic and musculoskeletal diseases: a retrospective study of 819 patients. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:1945-1956. [PMID: 28560466 DOI: 10.1007/s00484-017-1384-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 05/16/2017] [Accepted: 05/19/2017] [Indexed: 05/28/2023]
Abstract
The objective of this study is to determine the use and efficacy of spa therapy in patients with a wide spectrum of rheumatic and musculoskeletal diseases under real-life clinical practice circumstances. In this retrospective observational study at the Medical Ecology and Hydroclimatology Department of Istanbul Faculty of Medicine, the records of all adult patients with rheumatic and musculoskeletal diseases who were prescribed a spa therapy in various health resorts in Turkey between 2002 and 2012 were analyzed. Patients sojourned to and stayed at a health resort and followed a usual 2-week course of spa therapy. The patients were examined within a week before and after the spa therapy at the department by the physicians and outcome measures were pain intensity (visual analog scale, VAS), patient's general evaluation (VAS), physician's general evaluation (VAS), Health Assessment Questionnaire (HAQ), Lequesne's Functional Index (LFI), Western Ontario and McMaster Universities Index (WOMAC), Waddell Index (WI), Neck Pain and Disability Scale (NPDS), Shoulder Disability Questionnaire (SDQ), Fibromyalgia Impact Questionnaire (FIQ), and Beck's Depression Inventory (BDI). In total, 819 patients were included in the analysis. The diagnoses were 536 osteoarthritis; 115 fibromyalgia; 50 lumbar disc herniation; 34 cervical disc herniation; 23 nonspecific low back pain; 22 ankylosing spondylitis; 16 rheumatoid arthritis; 9 rotator cuff tendinitis; and 14 other conditions/diseases including scoliosis, stenosing flexor tenosynovitis, congenital hip dislocation in adult, Behçet's disease, de Quervain tendinopathy, psoriatic arthritis, osteoporosis, fracture rehabilitation, and diffuse idiopathic skeletal hyperostosis. Statistically significant decrease in pain scores was found in all patients except hip osteoarthritis (p = 0.063) and rheumatoid arthritis (p = 0.134) subgroups; and statistically significant improvement in function in all patients except hip osteoarthritis (p = 0.068), rheumatoid arthritis (p = 0.111), and rotator cuff tendinitis (p = 0.078) subgroups. In daily clinical practice, spa therapy is prescribed and practiced mainly for osteoarthritis, then fibromyalgia, lumbar/cervical disc herniation, and nonspecific low back pain; and less for ankylosing spondylitis, rheumatoid arthritis, and rotator cuff tendinitis. The study results suggest that real-life spa therapy may be effective in a variety of rheumatic and musculoskeletal diseases by improving pain and function.
Collapse
Affiliation(s)
- Mine Karagülle
- Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, Istanbul, Turkey.
- Tıbbi Ekoloji ve Hidroklimatoloji A.B.D. İstanbul Tıp Fakültesi, Fatih/Capa, 34093, İstanbul, Turkey.
| | - Sinan Kardeş
- Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, Istanbul, Turkey
| | - Müfit Zeki Karagülle
- Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, Istanbul, Turkey
| |
Collapse
|
104
|
Microbiological analysis, antimicrobial activity, and heavy-metals content of Jordanian Ma’in hot-springs water. J Infect Public Health 2017; 10:789-793. [DOI: 10.1016/j.jiph.2017.01.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 12/14/2016] [Accepted: 01/07/2017] [Indexed: 11/18/2022] Open
|
105
|
Xu L, Wu L, Liu T, Xing W, Cao X, Zhang S, Su Z. Effect of a 21-day balneotherapy program on blood cell counts, ponogen levels, and blood biochemical indexes in servicemen in sub-health condition. J Phys Ther Sci 2017; 29:1573-1577. [PMID: 28931990 PMCID: PMC5599823 DOI: 10.1589/jpts.29.1573] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 06/08/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of our study was to explore the changes in the blood of servicemen in
sub-health conditions during a 21-day balneotherapy program. [Subjects and Methods] For
this study, 129 servicemen in sub-health condition were recruited. The subjects were
randomly divided into either the balneotherapy group (70) or the control group (59).
Subjects in the balneotherapy group received whole-body immersion bath therapy in
thermomineral water (30 min daily) for 21 days. Their blood samples were examined 1 day
before and after balneotherapy. The parameters studied included mean corpuscular
hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), white blood cell
(WBC), lactic acid (LAC), alanine aminotransferase (ALT), glucose (GLU), and triglycerides
(TG) levels. [Results] After 21 days of balneotherapy, MCH levels and MCHC increased
significantly and WBC counts increased significantly. LAC levels decreased significantly.
ALT, GLU, and TG levels decreased significantly. In the control group, there were no
statistical differences before and after tap water baths following the same procedure.
[Conclusion] A 21-day balneotherapy program significantly improved blood cell counts and
blood biochemical indexes and reduced ponogen levels in servicemen in sub-health
condition.
Collapse
Affiliation(s)
- Li Xu
- Department of Aerospace Biodynamics, Fourth Military Medical University, China.,Department of Medical Affairs, Lintong Sanatorium of Lanzhou Military Region, China
| | - Lin Wu
- Department of Medical Psychology, Fourth Military Medical University, China
| | - Tingting Liu
- Department of Aerospace Biodynamics, Fourth Military Medical University, China
| | - Wenrong Xing
- Department of Medical Affairs, Lintong Sanatorium of Lanzhou Military Region, China
| | - Xinsheng Cao
- Department of Aerospace Biodynamics, Fourth Military Medical University, China
| | - Shu Zhang
- The Key Laboratory of Aerospace Medicine, Chinese Ministry of Education: 17 Changle Xi Rd., Xi'an, Shaanxi 710032, China
| | - Zongyi Su
- Selection and Training Office, Shihezi University, China
| |
Collapse
|
106
|
Metin Ökmen B, Kasapoğlu Aksoy M, Güneş A, Eröksüz R, Altan L. Effectiveness of PELOID therapy in carpal tunnel syndrome: A randomized controlled single blind study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:1403-1410. [PMID: 28210859 DOI: 10.1007/s00484-017-1317-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 01/09/2017] [Accepted: 01/26/2017] [Indexed: 06/06/2023]
Abstract
Carpal tunnel syndrome(CTS) is the most common neuromuscular cause of upper extremity disability. We aimed to investigate the effectiveness of peloid therapy in patients with CTS. This randomized, controlled, single-blind study enrolled 70 patients between the ages of 30 to 65 who had a diagnosis of either mild, mild-to-moderate, or moderate CTS. The patients were randomized into two groups using random number table. In the first group, (Group 1)(n = 35), patients were given splint (every night for 6 weeks) + peloid treatment(five consecutive days a week for 2 weeks) and in the second group, (Group 2)(n = 28), patients received splint treatment(every night for 6 weeks) alone. The patients were assessed by using visual analog scale(VAS) for pain, electroneuromyography(ENMG), the Boston Carpal Tunnel Syndrome Questionnaire(BCTSQ), hand grip strength(HGS), finger grip strength(FGS), and Short Form-12(SF-12). The data were obtained before treatment(W0), immediately after treatment(W2), and one month after treatment(W6). Both in Group 1 and 2, there was a statistically significant improvement in all the evaluation parameters at W2 and W6 when compared to W0(p < 0.05). Comparison of the groups with each other revealed significantly better results for VAS, BCTSQ, mSNCV, SF-12 in Group 1 than in Group 2 at W2(p < 0.05). There was also a statistically significant difference in favor of Group 1 for VAS, BCTSQ, FGS and MCS at W6 when compared to W0 (p < 0.05). The results of our study demonstrated that in patients with CTS; peloid + splint treatment was more effective than splint treatment alone in pain, functionality and life quality both at after treatment(W2) and one month after treatment (W6). We may suggest peloid as a supplementary therapeutic agent in CTS.
Collapse
Affiliation(s)
- Burcu Metin Ökmen
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
| | - Meliha Kasapoğlu Aksoy
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Aygül Güneş
- Department of Neurology, University of Health Sciences Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Riza Eröksüz
- Department of Medical Ecology and Hydroclimatology, University of Health Sciences Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
- Department of Physical Medicine and Rehabilitation, Uludag University Faculty of Medicine, Bursa, Turkey
| |
Collapse
|
107
|
Physical Education in a Thermal Spa Resort to Maintain an Active Lifestyle at Home: A One-Year Self-Controlled Follow-Up Pilot Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:1058419. [PMID: 28539960 PMCID: PMC5429946 DOI: 10.1155/2017/1058419] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 04/09/2017] [Indexed: 01/06/2023]
Abstract
The self-controlled follow-up pilot study was set up to examine the maintenance of engagement in physical activity by a group of older adults in a thermal spa resort, as a consequence of the inclusion of additional physical education sessions within their usual care offers. A cohort of 42 participants (70.4 ± 4.5 years) underwent three weeks of thermal treatment with additional physical education (PE) sessions. Measurements were established during the intervention in 2 periods (baseline and final thermal treatment evaluation) and 4 periods of measurements in the follow-up (+15 days, +2 months, +6 months, and +1 year). Physical measures (anthropometrics, flexibility, and 6-minute walk test) and intrapersonal and psychosocial factors as well as health-related quality of life (HQOL) and physical activity (PA) were self-reported by participants. Only HQOL and PA were assessed during the follow-up. One year after a 3-week PE session combined with the usual thermal care, 64% of the participants exhibited a higher volume of PA than at baseline. The components of the HQOL changed during the follow-up. This strategy to maintain PA engagement appears to be feasible in a population of thermal care older adults. This work demonstrates the feasibility of a study conducted to maintain physical activity engagement after a thermal treatment.
Collapse
|
108
|
Sulphurous Mineral Waters: New Applications for Health. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:8034084. [PMID: 28484507 PMCID: PMC5397653 DOI: 10.1155/2017/8034084] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/17/2017] [Accepted: 03/28/2017] [Indexed: 12/12/2022]
Abstract
Sulphurous mineral waters have been traditionally used in medical hydrology as treatment for skin, respiratory, and musculoskeletal disorders. However, driven by recent intense research efforts, topical treatments are starting to show benefits for pulmonary hypertension, arterial hypertension, atherosclerosis, ischemia-reperfusion injury, heart failure, peptic ulcer, and acute and chronic inflammatory diseases. The beneficial effects of sulphurous mineral waters, sulphurous mud, or peloids made from sulphurous mineral water have been attributed to the presence of sulphur mainly in the form of hydrogen sulphide. This form is largely available in conditions of low pH when oxygen concentrations are also low. In the organism, small amounts of hydrogen sulphide are produced by some cells where they have numerous biological signalling functions. While high levels of hydrogen sulphide are extremely toxic, enzymes in the body are capable of detoxifying it by oxidation to harmless sulphate. Hence, low levels of hydrogen sulphide may be tolerated indefinitely. In this paper, we review the chemistry and actions of hydrogen sulphide in sulphurous mineral waters and its natural role in body physiology. This is followed by an update of available data on the impacts of exogenous hydrogen sulphide on the skin and internal cells and organs including new therapeutic possibilities of sulphurous mineral waters and their peloids.
Collapse
|
109
|
Kälsch J, Pott LL, Takeda A, Kumamoto H, Möllmann D, Canbay A, Sitek B, Baba HA. Bathing in carbon dioxide-enriched water alters protein expression in keratinocytes of skin tissue in rats. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:739-746. [PMID: 27709349 DOI: 10.1007/s00484-016-1252-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 09/19/2016] [Accepted: 09/22/2016] [Indexed: 06/06/2023]
Abstract
Beneficial effects of balneotherapy using naturally occurring carbonated water (CO2 enriched) have been known since the Middle Ages. Although this therapy is clinically applied for peripheral artery disease and skin disorder, the underlying mechanisms are not fully elucidated.Under controlled conditions, rats were bathed in either CO2-enriched water (CO2 content 1200 mg/L) or tap water, both at 37 °C, for 10 min daily over 4 weeks. Proliferation activity was assessed by Ki67 immunohistochemistry of the epidermis of the abdomen. The capillary density was assessed by immunodetection of isolectin-positive cells. Using cryo-fixed abdominal skin epidermis, follicle cells and stroma tissue containing capillaries were separately isolated by means of laser microdissection and subjected to proteomic analysis using label-free technique. Differentially expressed proteins were validated by immunohistochemistry.Proliferation activity of keratinocytes was not significantly different in the epidermis after bathing in CO2-enriched water, and also, capillary density did not change. Proteomic analysis revealed up to 36 significantly regulated proteins in the analyzed tissue. Based on the best expression profiles, ten proteins were selected for immunohistochemical validation. Only one protein, far upstream element binding protein 2 (FUBP2), was similarly downregulated in the epidermis after bathing in CO2-enriched water with both techniques. Low FUBP2 expression was associated with low c-Myc immune-expression in keratinocytes.Long-term bathing in CO2-enriched water showed a cellular protein response of epithelial cells in the epidermis which was detectable by two different methods. However, differences in proliferation activity or capillary density were not detected in the normal skin.
Collapse
Affiliation(s)
- Julia Kälsch
- Institute of Pathology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
- Department for Gastroenterology and Hepatology, Center for Internal Medicine, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Leona L Pott
- Institute of Pathology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medizinisches Proteom-Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Atsushi Takeda
- Faculty of Health Sciences, Department of Rehabilitation Sciences, University of Tokyo Health Sciences, Tokyo, Japan
| | | | - Dorothe Möllmann
- Institute of Pathology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Ali Canbay
- Department for Gastroenterology and Hepatology, Center for Internal Medicine, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Barbara Sitek
- Medizinisches Proteom-Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Hideo A Baba
- Institute of Pathology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
| |
Collapse
|
110
|
Uzunoglu E, Yentur S, Kayar AH, Turan M, Donmez A, Direskeneli GS, Erdogan N. Effect of mild heat stress on heat shock protein 70 in a balneotherapy model. Eur J Integr Med 2017. [DOI: 10.1016/j.eujim.2016.11.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
111
|
Karagülle M, Kardeş S, Karagülle O, Dişçi R, Avcı A, Durak İ, Karagülle MZ. Effect of spa therapy with saline balneotherapy on oxidant/antioxidant status in patients with rheumatoid arthritis: a single-blind randomized controlled trial. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:169-180. [PMID: 27324882 DOI: 10.1007/s00484-016-1201-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 06/01/2016] [Accepted: 06/15/2016] [Indexed: 06/06/2023]
Abstract
Oxidative stress has been shown to play a contributory role in the pathogenesis of rheumatoid arthritis (RA). Recent studies have provided evidence for antioxidant properties of spa therapy. The purpose of this study is to investigate whether spa therapy with saline balneotherapy has any influence on the oxidant/antioxidant status in patients with RA and to assess clinical effects of spa therapy. In this investigator-blind randomized controlled trial, we randomly assigned 50 patients in a 1:1 ratio to spa therapy plus standard drug treatment (spa group) or standard drug treatment alone (control group). Spa group followed a 2-week course of spa therapy regimen consisting of a total of 12 balneotherapy sessions in a thermal mineral water pool at 36-37 °C for 20 min every day except Sunday. All clinical and biochemical parameters were assessed at baseline and after spa therapy (2 weeks). The clinical parameters were pain intensity, patient global assessment, physician global assessment, Health Assessment Questionnaire disability index (HAQ-DI), Disease Activity Score for 28-joints based on erythrocyte sedimentation rate (DAS28-4[ESR]). Oxidative status parameters were malondialdehyde (MDA), nonenzymatic superoxide radical scavenger activity (NSSA), antioxidant potential (AOP), and superoxide dismutase (SOD). The NSSA levels were increased significantly in the spa group (p = 0.003) but not in the control group (p = 0.509); and there was a trend in favor of spa therapy for improvements in NSSA levels compared to control (p = 0.091). Significant clinical improvement was found in the spa group compared to the control in terms of patient global assessment (p = 0.011), physician global assessment (p = 0.043), function (HAQ-DI) (p = 0.037), disease activity (DAS28-4[ESR]) (0.044) and swollen joint count (0.009), and a trend toward improvement in pain scores (0.057). Spa therapy with saline balneotherapy exerts antioxidant effect in patients with RA as reflected by the increase in NSSA levels after spa therapy; whether this antioxidant effect contributes to the clinical improvements observed remains to be verified.
Collapse
Affiliation(s)
- Mine Karagülle
- Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, Tıbbi Ekoloji ve Hidroklimatoloji A.B.D. İstanbul Tıp Fakültesi Fatih, Capa, 34093, İstanbul, Turkey.
| | - Sinan Kardeş
- Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, Tıbbi Ekoloji ve Hidroklimatoloji A.B.D. İstanbul Tıp Fakültesi Fatih, Capa, 34093, İstanbul, Turkey
| | | | - Rian Dişçi
- Department of Biostatistics, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Aslıhan Avcı
- Department of Biochemistry, Ankara University Faculty of Medicine, Ankara, Turkey
| | - İlker Durak
- Department of Biochemistry, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Müfit Zeki Karagülle
- Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, Tıbbi Ekoloji ve Hidroklimatoloji A.B.D. İstanbul Tıp Fakültesi Fatih, Capa, 34093, İstanbul, Turkey
| |
Collapse
|
112
|
Fioravanti A, Karagülle M, Bender T, Karagülle MZ. Balneotherapy in osteoarthritis: Facts, fiction and gaps in knowledge. Eur J Integr Med 2017. [DOI: 10.1016/j.eujim.2017.01.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
113
|
Ultrasound with mineral water or aqua gel to reduce pain and improve the WOMAC of knee osteoarthritis. Future Sci OA 2016; 2:FSO110. [PMID: 28031953 PMCID: PMC5137950 DOI: 10.4155/fsoa-2016-0003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 02/09/2016] [Indexed: 12/30/2022] Open
Abstract
AIMS Osteoarthritis is the most degenerative joint disease. The aim was to investigate the effects of ultrasound using mineral water or aqua sonic gel on severity of knee pain, measured by the visual analog scale and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). MATERIALS AND METHODS Thirty women with bilateral osteoarthritis of the knee were assigned to two groups: ultrasound with mineral water (group 1, n = 15) or with aqua sonic gel (group 2, n = 15). Both groups underwent 4 weeks intervention, three per week. The participants were assessed using the visual analog scale and the WOMAC. Tests were performed before and after interventions. RESULTS Both groups had significantly reduced pain and improved WOMAC compared with preintervention values. DISCUSSION The ultrasound with mineral water group had more pronounced improvement at p-value < 0.001. CONCLUSION Ultrasound with mineral water is preferable in treatment of knee OA.
Collapse
|
114
|
Blain H, Bernard PL, Canovas G, Raffort N, Desfour H, Soriteau L, Noguès M, Camuzat T, Mercier J, Dupeyron A, Quéré I, Laffont I, Hérisson C, Solimene H, Bousquet J. Combining balneotherapy and health promotion to promote active and healthy ageing: the Balaruc-MACVIA-LR ® approach. Aging Clin Exp Res 2016; 28:1061-1065. [PMID: 27380506 PMCID: PMC5099369 DOI: 10.1007/s40520-016-0596-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 05/23/2016] [Indexed: 12/03/2022]
Abstract
Scaling up and replication of successful innovative integrated care models for chronic diseases is one of the targets of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA). MACVIA-LR® (MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon) is a Reference Site of the EIP on AHA. The main objective of MACVIA-LR® is to develop innovative solutions in order to (1) improve the care of patients affected by chronic diseases, (2) reduce avoidable hospitalization and (3) scale up the innovation to regions of Europe. The MACVIA-LR® project also aims to assess all possible aspects of medicine—including non-pharmacologic approaches—in order to maintain health and prevent chronic diseases. These approaches include hydrotherapy and balneotherapy which can be of great importance if health promotion strategies are considered. Balneotherapy at Balaruc-les-Bains focusses on musculoskeletal diseases and chronic venous insufficiency of the lower limbs. Each year, over 46,000 people attend an 18-day course related to a new falls prevention initiative combining balneotherapy and education. On arrival, each person receives a flyer providing information on the risk of fall and, depending on this risk, a course is proposed combining education and physical activity. A pilot study assesses the impact of the course 6 and 12 months later. This health promotion strategy for active and healthy ageing follows the FEMTEC (World Federation of Hydrotherapy and Climatotherapy) concept.
Collapse
Affiliation(s)
- H Blain
- Department of Geriatrics, Montpellier University Hospital, Montpellier, France
- EUROMOV. EA 2991, Euromov, University Montpellier, Montpellier, France
| | - P L Bernard
- EUROMOV. EA 2991, Euromov, University Montpellier, Montpellier, France
| | | | - N Raffort
- Société Publique Locale d'Exploitation de Balaruc-les-Bains, Balaruc-Les-Bains, France
| | - H Desfour
- Société Publique Locale d'Exploitation de Balaruc-les-Bains, Balaruc-Les-Bains, France
| | - L Soriteau
- Société Publique Locale d'Exploitation de Balaruc-les-Bains, Balaruc-Les-Bains, France
| | - M Noguès
- Caisse Assurance Retraite et Santé Au Travail Languedoc-Roussillon (CARSAT-LR), Montpellier, France
| | - T Camuzat
- , Montpellier, Région Languedoc-Roussillon-Midi-Pyrénées, France
| | - J Mercier
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, Montpellier, France
| | - A Dupeyron
- EUROMOV. EA 2991, Euromov, University Montpellier, Montpellier, France
- Department of Physical and Medical Rehabilitation, Nîmes University Hospital, Nîmes, France
| | - I Quéré
- Internal Medicine Department, Montpellier University Hospital, Montpellier, France
| | - I Laffont
- EUROMOV. EA 2991, Euromov, University Montpellier, Montpellier, France
- Department of Physical and Medical Rehabilitation, Montpellier University Hospital, Montpellier, France
| | - C Hérisson
- Department of Physical and Medical Rehabilitation, Montpellier University Hospital, Montpellier, France
| | - H Solimene
- School Of Medicine, State University of Milan, Milan, Italy
- WHO Collaborating Center For Traditional an Complementary Medicine, Milan, Italy
- FEMTEC (World Federation of Hydrotherapy and Climatotherapy), Milan, Italy
| | - J Bousquet
- University Hospital, Montpellier, France.
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France.
- INSERM, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, U1168, Paris, France.
- UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Versailles, France.
- CHRU Montpellier, 34295, Montpellier, Cedex 5, France.
| |
Collapse
|
115
|
Kovács C, Bozsik Á, Pecze M, Borbély I, Fogarasi A, Kovács L, Tefner IK, Bender T. Effects of sulfur bath on hip osteoarthritis: a randomized, controlled, single-blind, follow-up trial: a pilot study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2016; 60:1675-1680. [PMID: 27324883 DOI: 10.1007/s00484-016-1158-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Revised: 03/09/2016] [Accepted: 03/16/2016] [Indexed: 06/06/2023]
Abstract
The effects of balneotherapy were evaluated in patients with osteoarthritis of the hip. This randomized, controlled, investigator-blinded study enrolled outpatients with hip osteoarthritis according to ACR criteria. In addition to home exercise therapy, one patient group received balneotherapy for 3 weeks on 15 occasions. The mineral water used in this study is one of the mineral waters with the highest sulfide ion content (13.2 mg/L) in Hungary. The control group received exercise therapy alone. The WOMAC Likert 3.1 index and the EQ-5D quality of life self-administered questionnaire were completed three times during the study: prior to first treatment, at the end of the 3-week treatment course, and 12 weeks later. The main endpoint was achievement of Minimal Clinically Important Improvement (MCII) at 12 weeks, defined as ≥7.9 points in a normalized WOMAC function score. The intention to treat analysis included 20 controls and 21 balneotherapy patients. At 12 weeks, 17 (81 %) balneotherapy group patients had Minimal Clinically Important Improvement and 6 (30 %) of controls (p = 0.001). Comparing the results of the two groups at the end of treatment, there was a significant difference in the WOMAC stiffness score only, whereas after 12 weeks, the WOMAC pain, stiffness, function, and total scores also showed a significant difference in favor of the balneotherapy group. The difference between the two groups was significant after 12 weeks in point of EQVAS score, too. The results of our study suggest that the combination of balneotherapy and exercise therapy achieves more sustained improvement of joint function and decreases in pain than exercise therapy alone.
Collapse
Affiliation(s)
- Csaba Kovács
- Musculoskeletal Rehabilitation Center, Mezőkövesd, Hungary
| | - Ágnes Bozsik
- Musculoskeletal Rehabilitation Center, Mezőkövesd, Hungary
| | - Mariann Pecze
- Musculoskeletal Rehabilitation Center, Mezőkövesd, Hungary
| | - Ildikó Borbély
- Musculoskeletal Rehabilitation Center, Mezőkövesd, Hungary
| | | | - Lajos Kovács
- Musculoskeletal Rehabilitation Center, Mezőkövesd, Hungary
| | | | - Tamás Bender
- Polyclinic of Brother of St. John of God Hospitals, Budapest, Hungary.
| |
Collapse
|
116
|
Karagülle M, Kardeş S, Dişçi R, Gürdal H, Karagülle MZ. Spa therapy for elderly: a retrospective study of 239 older patients with osteoarthritis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2016; 60:1481-1491. [PMID: 26813884 DOI: 10.1007/s00484-016-1138-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 01/07/2016] [Accepted: 01/14/2016] [Indexed: 06/05/2023]
Abstract
Very few studies tested the effectiveness of spa therapy in older patients with osteoarthritis. Therefore, we aimed to evaluate the short-term effects of spa therapy in patients aged 65 years and older with generalized, knee, hip, and cervical and lumbar spine osteoarthritis. In an observational retrospective study design at the Medical Ecology and Hydroclimatology Department of Istanbul Medical Faculty, we analyzed the records of 239 patients aged over 65 years with the diagnosis of all types of osteoarthritis who were prescribed a spa therapy course in some spa resorts in Turkey between 7 March 2002 and 31 December 2012. They travelled to a spa resort where they stayed at a thermal spa hotel and followed the usual therapy packages for 2 weeks. Patients were assessed by an experienced physician within a week before the spa journey and within a week after the completion of the spa therapy. Compared with baseline in whole sample, statistically significant improvements were observed in pain (visual analog scale, VAS), patient and physician global assessments (VAS), Health Assessment Questionnaire disability index (HAQ-DI), Lequesne algofunctional index (LAFI) for knee, Western Ontario and McMaster Universities index (WOMAC), Waddell disability index (WDI), and Neck Pain and Disability Scale (NPAD). According to Outcome Measures in Rheumatology-Osteoarthritis Research Society International (OMERACT-OARSI) Set of Responder Criteria, responder rate were 63.8 % (51/80) in generalized, 52 % (13/25) in knee, 50 % (2/4) in hip, 66.7 % (8/12) in lumbar, and 100 % (6/6) in cervical osteoarthritis subgroups. Spa therapy improved pain and physical functional status in older patients with osteoarthritis, especially generalized osteoarthritis and multiple joint osteoarthritis with involvement of knee. This improvement was clinically important in majority of the patients. To confirm the results of this preliminary study, there is a need of a randomized controlled clinical study comparing spa therapy with usual care in the elderly population with osteoarthritis.
Collapse
Affiliation(s)
- Mine Karagülle
- Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, Tıbbi Ekoloji ve Hidroklimatoloji A.B.D. İstanbul Tıp Fakültesi Fatih/Capa, İstanbul, 34093, Turkey.
| | - Sinan Kardeş
- Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, Tıbbi Ekoloji ve Hidroklimatoloji A.B.D. İstanbul Tıp Fakültesi Fatih/Capa, İstanbul, 34093, Turkey
| | - Rian Dişçi
- Department of Biostatistics, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Hatice Gürdal
- Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, Tıbbi Ekoloji ve Hidroklimatoloji A.B.D. İstanbul Tıp Fakültesi Fatih/Capa, İstanbul, 34093, Turkey
| | - Müfit Zeki Karagülle
- Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, Tıbbi Ekoloji ve Hidroklimatoloji A.B.D. İstanbul Tıp Fakültesi Fatih/Capa, İstanbul, 34093, Turkey
| |
Collapse
|
117
|
Santos I, Cantista P, Vasconcelos C. Balneotherapy in rheumatoid arthritis-a systematic review. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2016; 60:1287-301. [PMID: 26607275 DOI: 10.1007/s00484-015-1108-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 10/23/2015] [Accepted: 11/03/2015] [Indexed: 05/24/2023]
Abstract
Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by persistent inflammation of synovial joints with pain, often leading to joint destruction and disability, and despite intensive research, the cause of RA remains unknown. Balneotherapy-also called mineral baths or spa therapy-uses different types of mineral water compositions like sulphur, radon, carbon dioxin, etc. The role of balneotherapy is on debate; Sukenik wrote that the sulphur mineral water has special proprieties to rheumatologic diseases, including in the course of active inflammatory phases in RA. The aim of this review is to summarize the available evidence on the effects of balneotherapy on patients with rheumatoid arthritis. We have made a systematic search of the articles published from 1980 to 2014 on this topic in PubMed, Scopus, CRD, PEDro, Web of Science and Embase databases. We have followed the method set by the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA). These that have compared balneotherapy with other therapeutic modalities or with no intervention were considered. The inclusion criteria of these papers were randomized control trial (RCT); languages: English, French, Spanish, Italian and Portuguese; evaluation of efficacy (analysis of outcomes); use of natural mineral water baths; and participants with RA. A total of eight articles documenting RCTs were found and included for full review and critical appraisal involving a total of 496 patients. The studies selected highlighted an important improvement and statistically significant in several clinical parameters, in spite of their heterogeneity between the various studies. One study emphasized an important improvement on functional capacity up to 6 months of follow-up (FU). Some of the studies (std.) reveal an improvement on morning stiffness (5 std.), number of active joints (3 std.), Ritchie index (2 std.) and activities of daily living (2 std.) up to 3 months of FU. Three studies reveal the improvement on handgrip strength up to 1 month of FU. About pain (VAS), the three studies which evaluated this parameter were inconclusive about real significant improvement. Our tables summarize the published papers about this topic. Different authors emphasize the same problems: methodologies differing from study to study, treatment modalities, outcomes and their analysis. On the one hand, it is particularly difficult to have homogeneity on this population in all the parameters (patient's clinical heterogeneity, diverse clinical course of the disease, variety of the drugs), and on the other hand, natural mineral water composition is always unique with potential specific biological effects. This comprehensive review has revealed that there are very few published studies about the use of natural mineral water in RA. International multicentre studies, using the same methodologies, could be achieved by carrying the scientific arguments to support our clinical practice.
Collapse
Affiliation(s)
- Isabel Santos
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.
- Hospital Escola, Fernando Pessoa University, Porto, Portugal.
- , Rua da Póvoa, 850, Macieira, 4520-707, Souto, VFR, Portugal.
| | - Pedro Cantista
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
- Hospital Santo António, Porto, Portugal
| | - Carlos Vasconcelos
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
- Hospital Santo António, Porto, Portugal
| |
Collapse
|
118
|
Comment on: Clinical Efficacy of Mudpack Therapy in Treating Knee Osteoarthritis: A Meta-analysis of Randomized Controlled Studies. Am J Phys Med Rehabil 2016; 96:e9-e10. [PMID: 27196383 DOI: 10.1097/phm.0000000000000551] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
119
|
Rość D, Adamczyk P, Boinska J, Szafkowski R, Ponikowska I, Stankowska K, Góralczyk B, Ruszkowska-Ciastek B. CRP, but not TNF-α or IL-6, decreases after weight loss in patients with morbid obesity exposed to intensive weight reduction and balneological treatment. J Zhejiang Univ Sci B 2016; 16:404-11. [PMID: 25990058 DOI: 10.1631/jzus.b1400219] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the concentrations of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and the degree of homeostasis model assessment-insulin resistance (HOMA-IR) in patients with morbid obesity exposed to a three-week low-calorie diet and balneotherapy. METHODS The study included 33 patients (25 females and 8 males; mean age 46 years) with body mass index (BMI) values of >40 kg/m(2). Evaluations of CRP, IL-6, TNF-α, lipid profile, HOMA-IR, and fasting glucose were carried out before (baseline data) and three weeks after the treatment. The control group consisted of 20 healthy volunteers (15 females and 5 males) with a mean age of 39 years and BMI values of ≤24.9 kg/m(2). RESULTS In the blood of patients with morbid obesity we found significantly elevated levels of CRP, TNF-α, triglycerides, HOMA-IR and fasting glucose, but a decreased level of high density lipoprotein (HDL)-cholesterol, compared with the healthy individuals. The treatment resulted in about a 9.4% reduction in body weight from 122.5 to 111.0 kg and a significant decrease in the concentration of CRP, but no change in TNF-α or IL-6. HOMA-IR was significantly reduced. CONCLUSIONS The decrease in CRP level without changes in TNF-α or IL-6 concentrations after the low-calorie diet and balneological treatment, suggests that an essential amount of adipose tissue must be removed before proper adipocyte function is restored. The decrease in HOMA-IR indicates an improvement in insulin sensitivity, which is beneficial in obese patients.
Collapse
Affiliation(s)
- Danuta Rość
- Department of Pathophysiology, Faculty of Pharmacy, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz PL 85-094, Poland; Clinic of Balneology and Physical Medicine, Faculty of Health Science, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz PL 85-094, Poland
| | | | | | | | | | | | | | | |
Collapse
|
120
|
Szromek AR, Romaniuk P, Hadzik A. The privatization of spa companies in Poland - An evaluation of policy assumptions and implementation. Health Policy 2016; 120:362-8. [PMID: 26972546 DOI: 10.1016/j.healthpol.2016.02.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 01/17/2016] [Accepted: 02/18/2016] [Indexed: 11/29/2022]
Abstract
The aim of this article is to present the course of privatization of spa companies in Poland during the period 2001-2011. We discuss assumptions of the privatization process, as well as actual implementation, having identified the process as chaotic and inconsistent with prior legal provisions. We found that in its applied form the process resulted in limitation of the therapeutic potential of spas, and reduction of the State's ability to implement health policy in a legally determined form. We also found that privatization potentially improved spa infrastructure standards and increases the tourist potential of spa resorts. We recommend that clear eligibility criteria are applied to institutions in the privatization process, as well as the provision of legal guarantees for access to spa services financed from public resources. Such guarantees should be made a public obligation, to ensure the availability of services for insured persons, and there should be an obligation to maintain a specific part of a given institution's potential for the needs of patients funded by public health insurance.
Collapse
Affiliation(s)
- Adam R Szromek
- Silesian University of Technology in Gliwice, Faculty of Organization and Management in Zabrze, ul. Roosevelta 26-28, 41-800 Zabrze, Poland.
| | - Piotr Romaniuk
- Medical University of Silesia in Katowice, School of Public Health in Bytom, Department of Health Policy, 18 Piekarska Street (ul. Piekarska 18), 41-902 Bytom, Poland.
| | - Andrzej Hadzik
- Academy of Physical Education in Katowice, School of Physical Education, Department of Sport and Tourism, Mikołowska 72A, 40-065 Katowice, Poland.
| |
Collapse
|
121
|
Galli E, Neri I, Ricci G, Baldo E, Barone M, Belloni Fortina A, Bernardini R, Berti I, Caffarelli C, Calamelli E, Capra L, Carello R, Cipriani F, Comberiati P, Diociaiuti A, El Hachem M, Fontana E, Gruber M, Haddock E, Maiello N, Meglio P, Patrizi A, Peroni D, Scarponi D, Wielander I, Eichenfield LF. Consensus Conference on Clinical Management of pediatric Atopic Dermatitis. Ital J Pediatr 2016; 42:26. [PMID: 26936273 PMCID: PMC4776387 DOI: 10.1186/s13052-016-0229-8] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 02/14/2016] [Indexed: 01/01/2023] Open
Abstract
The Italian Consensus Conference on clinical management of atopic dermatitis in children reflects the best and most recent scientific evidence, with the aim to provide specialists with a useful tool for managing this common, but complex clinical condition. Thanks to the contribution of experts in the field and members of the Italian Society of Pediatric Allergology and Immunology (SIAIP) and the Italian Society of Pediatric Dermatology (SIDerP), this Consensus statement integrates the basic principles of the most recent guidelines for the management of atopic dermatitis to facilitate a practical approach to the disease. The therapeutical approach should be adapted to the clinical severity and requires a tailored strategy to ensure good compliance by children and their parents. In this Consensus, levels and models of intervention are also enriched by the Italian experience to facilitate a practical approach to the disease.
Collapse
Affiliation(s)
- Elena Galli
- Pediatric Allergy Unit, Research Center, San Pietro Hospital - Fatebenefratelli, Rome, Italy.
| | - Iria Neri
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
| | - Giampaolo Ricci
- Pediatric Unit - Department of Medical and Surgical Sciences, S. Orsola Malpighi Hospital, University of Bologna, Pad. 16, Via Massarenti, 11 - 40138, Bologna, Italy.
| | - Ermanno Baldo
- Pediatric Department, "S. Maria del Carmine" Hospital of Rovereto, APSS (Provincial Agency for Health Services), Trento, Italy.
| | | | - Anna Belloni Fortina
- Pediatric Dermatology Unit, Department of Medicine, University of Padua, Padua, Italy.
| | | | - Irene Berti
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
| | - Carlo Caffarelli
- Pediatric Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy.
| | - Elisabetta Calamelli
- Pediatric Unit - Department of Medical and Surgical Sciences, S. Orsola Malpighi Hospital, University of Bologna, Pad. 16, Via Massarenti, 11 - 40138, Bologna, Italy.
| | - Lucetta Capra
- Department of Medical Sciences, Section of Paediatrics, University of Ferrara, Ferrara, Italy.
| | - Rossella Carello
- Pediatric Allergy Unit, Research Center, San Pietro Hospital - Fatebenefratelli, Rome, Italy.
| | - Francesca Cipriani
- Pediatric Unit - Department of Medical and Surgical Sciences, S. Orsola Malpighi Hospital, University of Bologna, Pad. 16, Via Massarenti, 11 - 40138, Bologna, Italy.
| | | | - Andrea Diociaiuti
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Maya El Hachem
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Elena Fontana
- Pediatric Dermatology Unit, Department of Medicine, University of Padua, Padua, Italy.
| | - Michaela Gruber
- Department of Pediatrics, Central Hospital of Bolzano, Bolzano, Italy.
| | - Ellen Haddock
- Departments of Pediatrics and Dermatology, School of Medicine, University of California, San Diego, CA, USA.
| | - Nunzia Maiello
- Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy.
| | - Paolo Meglio
- Primary Care Pediatrician, Health National Service, Rome, Italy.
| | - Annalisa Patrizi
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
| | - Diego Peroni
- Department of Medical Sciences, Section of Paediatrics, University of Ferrara, Ferrara, Italy.
| | - Dorella Scarponi
- Pediatric Unit - Department of Medical and Surgical Sciences, S. Orsola Malpighi Hospital, University of Bologna, Pad. 16, Via Massarenti, 11 - 40138, Bologna, Italy.
| | - Ingrid Wielander
- Department of Pediatrics, Central Hospital of Bolzano, Bolzano, Italy.
| | - Lawrence F Eichenfield
- Departments of Pediatrics and Dermatology, School of Medicine, University of California, San Diego, CA, USA.
| |
Collapse
|
122
|
Vaks K, Sjöström R. Rheumatoid arthritis patients' experience of climate care. J Exerc Rehabil 2016; 11:337-44. [PMID: 26730385 PMCID: PMC4697783 DOI: 10.12965/jer.150228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 11/01/2015] [Indexed: 11/22/2022] Open
Abstract
The purpose of this qualitative study was to understand and examine how patients with rheumatoid arthritis (RA) experience climate care and its effects. A qualitative approach was chosen for the study. Two men and six women were interviewed according to a semistructured interview guide. The text was analyzed using a manifest content analysis. The analysis resulted in four categories and 10 subcategories. The interviewees experienced climate care positively. The training was perceived increasing gradually. The patients felt that they performed to a maximum capacity during training and were impressed by the staff’s enthusiasm and encouragement. The patients felt that they were involved in the goal setting and the choice of treatment, and the staff noticed individual needs. There was a feeling among the patients of being acknowledged by the staff. Information about the disease was perceived as individualized. The climate and beautiful surroundings were viewed as encouraging physical activity and a feeling of well-being. Patients made new friends, had fun together and also shared experiences about their disease. Furthermore, the patients described a sense of belonging to a group as well as a feeling of not being the only one that was sick among the healthy. Not having to do everyday tasks and having time to themselves were perceived positively. Several factors contributed to the positive experiences of climate care; climate, environment, physical activity, social context, staff involvement, and information about the disease were described as interacting together and resulting in a sense of well-being. A proposal for future research would be to examine if/how the various factors might interact and affect the RA patients’ illness and quality of life.
Collapse
Affiliation(s)
- Katrin Vaks
- Department of Sports Science, Linnaeus University, Kalmar/Växjö, Sweden
| | - Rita Sjöström
- Region Jämtland Härjedalen, Unit of Research, Education, and Development, Östersund, Sweden
| |
Collapse
|
123
|
Fortunati NA, Fioravanti A, Seri G, Cinelli S, Tenti S. May spa therapy be a valid opportunity to treat hand osteoarthritis? A review of clinical trials and mechanisms of action. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2016; 60:1-8. [PMID: 26156832 DOI: 10.1007/s00484-015-1030-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 06/10/2015] [Accepted: 06/16/2015] [Indexed: 05/24/2023]
Abstract
Osteoarthritis (OA) is the most common form of arthritis and its current treatment includes non-pharmacological and pharmacological modalities. Spa therapy represents a popular treatment for many rheumatic diseases. The aim of this review was to summarize the currently available information on clinical effects and mechanisms of action of spa therapy in OA of the hand. We conducted a search of the literature to extract articles describing randomized clinical trials (RCTs) in hand OA published in the period 1952-2015. We identified three assessable articles reporting RCTs on spa therapy in hand OA. Data from these clinical trials support a beneficial effect of spa therapy on pain, function and quality of life in hand OA. Spa therapy seems to have a role in the treatment of hand OA. However, additional RCTs are necessary to clarify the mechanisms of action and the effects of the application of thermal treatments.
Collapse
Affiliation(s)
| | - Antonella Fioravanti
- Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Policlinico "Le Scotte", Viale Bracci 1, 53100, Siena, Italy
| | - Gina Seri
- Spa Centre of Fonteverde Natural Spa Resort, San Casciano Terme, Siena, Italy
| | - Simone Cinelli
- Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Policlinico "Le Scotte", Viale Bracci 1, 53100, Siena, Italy
| | - Sara Tenti
- Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Policlinico "Le Scotte", Viale Bracci 1, 53100, Siena, Italy.
| |
Collapse
|
124
|
Hayta E, Yılmaz MB, Yayıkçı İ, Özer Z, Şahin Ö. Is There a Clinically Meaningful Change in the Blood Pressure of Osteoarthritis Patients with Comorbid Hypertension During the Course of Balneotherapy? NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2015; 7:517-23. [PMID: 26713300 PMCID: PMC4683807 DOI: 10.4103/1947-2714.170616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Balneotherapy (BT) is a treatment modality that uses the physical and chemical effects of water, including thermomineral, acratothermal, and acratopegal waters. It has many effects on cardiovascular system. Aim: The aim of the study is to investigate the effects of 3-week BT on blood pressure of osteoarthritis (OA) patients with no hypertension (HT), and controlled or uncontrolled HT. Materials and Methods: The OA patients (n = 270) were divided into three groups: No HT, controlled HT, and uncontrolled HT. All the groups received BT in the facilities of our university hospital at the same time every day (10:00-11:30 AM) for 10 min per day, 5 days per week, for a total duration of 15 days in a 3-week period. Systolic and diastolic blood pressures and pulse rates were measured before and after BT on daily basis. Results: Overall, (1) the pulse rates of study groups measured after BT were significantly increased compared to before BT; (2) the systolic blood pressures of study groups measured before and after BT were found as comparable; and (3) the diastolic blood pressures of no HT and controlled HT groups measured before and after BT were not statistically significant (P > 0.05); however, in the uncontrolled HT group, the diastolic blood pressure showed a decreasing trend after BT (P < 0.05). Conclusions: In patients with OA, BT can be safely used without resulting in any meaningful changes in systolic and diastolic blood pressures in patients with normal and controlled HT but a decrease in diastolic blood pressure of patients with uncontrolled HT. This may be an advantage in OA patients having HT as comorbid disease.
Collapse
Affiliation(s)
- Emrullah Hayta
- Department of Physical Medicine and Rehabilitation, Sivas Numune State Hospital, Sivas, Turkey
| | - Mehmet Birhan Yılmaz
- Department of Cardiology, Cumhuriyet University, Sivas Numune State Hospital, Sivas, Turkey
| | - İlker Yayıkçı
- Department of Physical Medicine and Rehabilitation, Sivas Numune State Hospital, Sivas, Turkey
| | - Zafer Özer
- Department of Physical Medicine and Rehabilitation, Sivas Numune State Hospital, Sivas, Turkey
| | - Özlem Şahin
- Department of Physical Medicine and Rehabilitation, Sivas Numune State Hospital, Sivas, Turkey
| |
Collapse
|
125
|
Stier-Jarmer M, Kus S, Frisch D, Sabariego C, Schuh A. Health resort medicine in non-musculoskeletal disorders: is there evidence of its effectiveness? INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:1523-44. [PMID: 25605408 DOI: 10.1007/s00484-015-0953-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 12/23/2014] [Accepted: 01/02/2015] [Indexed: 05/21/2023]
Abstract
Health resort medicine (HRM; in German: Kurortmedizin) is a field of medicine with long-lasting tradition in several European countries. A number of systematic reviews have shown the effectiveness of HRM in musculoskeletal conditions. Reviews focusing on the effectiveness of HRM in non-musculoskeletal disorders are rare. This systematic review aims to provide an overview about all types of health resort treatments applied in non-musculoskeletal conditions, to summarize evidence for its effectiveness and to assess the quality of published studies. MEDLINE, Web of Knowledge and Embase were searched for articles published between January 2002 and December 2013. We used a broad search strategy in order to find studies investigating the effects of HRM in non-musculoskeletal disorders. Two authors independently extracted data and assessed quality using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies (EPHPP-QAT). Forty-one studies (19 of them with control group) from eight countries examining the efficacy of various forms of spa treatment for 12 disease groups were included. The studies are markedly heterogeneous regarding study design, population and treatment. HRM treatment is associated with clinical improvement in diseases of the skin, respiratory, circulatory, digestive and nervous system among others. However, small samples, the lack of control groups and an insufficient follow-up often limit the generated evidence. The scientific literature of the last decade has shown that a number of non-musculoskeletal disorders are treated with different kinds of HRM. The challenge for the future will be to carry out thoroughly designed studies in larger patient populations to corroborate the impact of HRM treatment on non-musculoskeletal disorders.
Collapse
Affiliation(s)
- Marita Stier-Jarmer
- Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig Maximilians University, Marchioninistr. 17, 81377, Munich, Germany.
| | - Sandra Kus
- Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig Maximilians University, Marchioninistr. 17, 81377, Munich, Germany
| | - Dieter Frisch
- Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig Maximilians University, Marchioninistr. 17, 81377, Munich, Germany
| | - Carla Sabariego
- Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig Maximilians University, Marchioninistr. 17, 81377, Munich, Germany
| | - Angela Schuh
- Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig Maximilians University, Marchioninistr. 17, 81377, Munich, Germany
| |
Collapse
|
126
|
de Carvalho AM, Duarte MCT, Ponezi AN. Quality assessment of sulfurous thermal waters in the city of Poços de caldas, Minas gerais, Brazil. ENVIRONMENTAL MONITORING AND ASSESSMENT 2015; 187:563. [PMID: 26255269 DOI: 10.1007/s10661-015-4743-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 07/14/2015] [Indexed: 06/04/2023]
Abstract
Currently, the quality of the water consumed by the population, and also the water used for both leisure and therapeutic bathing, are known. In the city of Poços de Caldas, Minas Gerais, Brazil, the population has two sources of sulfurous thermal water, with free access for various purposes, including drinking. Since 1882, the system has retained the same structural characteristics, and at this time, there appears to be a risk of anthropogenic contamination due to population increase near the springs. The aim of this study was to evaluate the water quality of the sulfurous hot springs distributed in Pedro Botelho fountain, located in Thermas Antônio Carlos, and Monkey fountain, located in Mario Mourao bathhouse, for microbiological and bacteriological components, physical and chemical composition, and radionuclides for a period of 12 months and to compare their quality with Brazilian water quality laws. The results showed that all the values are within the prescribed water quality parameters, except fluoride and sodium, whose levels are above those permitted by law. Excess fluoride in consumed water can cause dental fluorosis and skeletal fluorosis. As for sodium, which exceeded the permissible limits by 20 to 25 %, it can be detrimental to hypertensive individuals. An important fact to consider is that water from sulfurous hot springs cannot be consumed without medical supervision because its chemical characteristics may cause damage to health, and it should only be used as medicinal mineral water.
Collapse
Affiliation(s)
- Adriana Moneira de Carvalho
- Faculty of Civil Engineering, Architecture and Urbanism, Environment and Sanitation Department, State University of Campinas, Av. Albert Einstein, 951, PO Box: 6021, CEP: 13083-852, Campinas, SP, Brazil,
| | | | | |
Collapse
|
127
|
Erol FB, Forestier RJ, Güneri FD, Karagülle MZ, Erdoğan N. Spa Therapy for Generalized Osteoarthritis: an Open, Observational, Preliminary Study. Therapie 2015; 70:273-81. [DOI: 10.2515/therapie/2014213] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 10/06/2014] [Indexed: 11/20/2022]
|
128
|
Cuando el radón es beneficioso para la salud. GACETA SANITARIA 2015; 29:232-3. [DOI: 10.1016/j.gaceta.2014.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 11/21/2014] [Accepted: 11/25/2014] [Indexed: 11/18/2022]
|
129
|
Verhagen AP, Bierma‐Zeinstra SMA, Boers M, Cardoso JR, Lambeck J, de Bie R, de Vet HCW. Balneotherapy (or spa therapy) for rheumatoid arthritis. Cochrane Database Syst Rev 2015; 2015:CD000518. [PMID: 25862243 PMCID: PMC7045434 DOI: 10.1002/14651858.cd000518.pub2] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND No cure for rheumatoid arthritis (RA) is known at present, so treatment often focuses on management of symptoms such as pain, stiffness and mobility. Treatment options include pharmacological interventions, physical therapy treatments and balneotherapy. Balneotherapy is defined as bathing in natural mineral or thermal waters (e.g. mineral baths, sulphur baths, Dead Sea baths), using mudpacks or doing both. Despite its popularity, reported scientific evidence for the effectiveness or efficacy of balneotherapy is sparse. This review, which evaluates the effects of balneotherapy in patients with RA, is an update of a Cochrane review first published in 2003 and updated in 2008. OBJECTIVES To perform a systematic review on the benefits and harms of balneotherapy in patients with RA in terms of pain, improvement, disability, tender joints, swollen joints and adverse events. SEARCH METHODS We searched the Cochrane 'Rehabilitation and Related Therapies' Field Register (to December 2014), the Cochrane Central Register of Controlled Trials (2014, Issue 1), MEDLIINE (1950 to December 2014), EMBASE (1988 to December 2014), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to December 2014), the Allied and Complementary Medicine Database (AMED) (1985 to December 2014), PsycINFO (1806 to December 2014) and the Physiotherapy Evidence Database (PEDro). We applied no language restrictions; however, studies not reported in English, Dutch, Danish, Swedish, Norwegian, German or French are awaiting assessment. We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform for ongoing and recently completed trials. SELECTION CRITERIA Studies were eligible if they were randomised controlled trials (RCTs) consisting of participants with definitive or classical RA as defined by the American Rheumatism Association (ARA) criteria of 1958, the ARA/American College of Rheumatology (ACR) criteria of 1988 or the ACR/European League Against Rheumatism (EULAR) criteria of 2010, or by studies using the criteria of Steinbrocker.Balneotherapy had to be the intervention under study, and had to be compared with another intervention or with no intervention.The World Health Organization (WHO) and the International League Against Rheumatism (ILAR) determined in 1992 a core set of eight endpoints in clinical trials concerning patients with RA. We considered pain, improvement, disability, tender joints, swollen joints and adverse events among the main outcome measures. We excluded studies when only laboratory variables were reported as outcome measures. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials, performed data extraction and assessed risk of bias. We resolved disagreements by consensus and, if necessary, by third party adjudication. MAIN RESULTS This review includes two new studies and a total of nine studies involving 579 participants. Unfortunately, most studies showed an unclear risk of bias in most domains. Four out of nine studies did not contribute to the analysis, as they presented no data.One study involving 45 participants with hand RA compared mudpacks versus placebo. We found no statistically significant differences in terms of pain on a 0 to 100-mm visual analogue scale (VAS) (mean difference (MD) 0.50, 95% confidence interval (CI) -0.84 to 1.84), improvement (risk ratio (RR) 0.96, 95% CI 0.54 to 1.70) or number of swollen joints on a scale from 0 to 28 (MD 0.60, 95% CI -0.90 to 2.10) (very low level of evidence). We found a very low level of evidence of reduction in the number of tender joints on a scale from 0 to 28 (MD -4.60, 95% CI -8.72 to -0.48; 16% absolute difference). We reported no physical disability and presented no data on withdrawals due to adverse events or on serious adverse events.Two studies involving 194 participants with RA evaluated the effectiveness of additional radon in carbon dioxide baths. We found no statistically significant differences between groups for all outcomes at three-month follow-up (low to moderate level of evidence). We noted some benefit of additional radon at six months in terms of pain frequency (RR 0.6, 95% CI 0.4 to 0.9; 31% reduction; improvement in one or more points (categories) on a 4-point scale; moderate level of evidence) and 9.6% reduction in pain intensity on a 0 to 100-mm VAS (MD 9.6 mm, 95% CI 1.6 to 17.6; moderate level of evidence). We also observed some benefit in one study including 60 participants in terms of improvement in one or more categories based on a 4-point scale (RR 2.3, 95% CI 1.1 to 4.7; 30% absolute difference; low level of evidence). Study authors did not report physical disability, tender joints, swollen joints, withdrawals due to adverse events or serious adverse events.One study involving 148 participants with RA compared balneotherapy (seated immersion) versus hydrotherapy (exercises in water), land exercises or relaxation therapy. We found no statistically significant differences in pain on the McGill Questionnaire or in physical disability (very low level of evidence) between balneotherapy and the other interventions. No data on improvement, tender joints, swollen joints, withdrawals due to adverse events or serious adverse events were presented.One study involving 57 participants with RA evaluated the effectiveness of mineral baths (balneotherapy) versus Cyclosporin A. We found no statistically significant differences in pain intensity on a 0 to 100-mm VAS (MD 9.64, 95% CI -1.66 to 20.94; low level of evidence) at 8 weeks (absolute difference 10%). We found some benefit of balneotherapy in overall improvement on a 5-point scale at eight weeks of 54% (RR 2.35, 95% CI 1.44 to 3.83). We found no statistically significant differences (low level of evidence) in the number of swollen joints, but some benefit of Cyclosporin A in the number of tender joints (MD 8.9, 95% CI 3.8 to 14; very low level of evidence). Physical disability, withdrawals due to adverse events and serious adverse events were not reported. AUTHORS' CONCLUSIONS Overall evidence is insufficient to show that balneotherapy is more effective than no treatment, that one type of bath is more effective than another or that one type of bath is more effective than mudpacks, exercise or relaxation therapy.
Collapse
Affiliation(s)
- Arianne P Verhagen
- Erasmus Medical CenterDepartment of General PracticePO Box 2040RotterdamNetherlands3000 CA
| | | | - Maarten Boers
- VU University Medical CenterDepartment of Clinical EpidemiologyPO Box 7057AmsterdamNetherlands1007 MB
| | - Jefferson R Cardoso
- Universidade Estadual de LondrinaLaboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research GroupAv. Robert Koch 60LondrinaParanaBrazil86038‐350
| | - Johan Lambeck
- Katholieke Universiteit Leuven, TervuursevestFaculty of Kinesiology and Rehabilitation Sciences101LeuvenBelgium3001
| | - Rob de Bie
- Maastricht UniversityDepartment of EpidemiologyP.O. Box 616MaastrichtNetherlands6200 MD
| | - Henrica CW de Vet
- VU UniversityDepartment of Epidemiology and Biostatistics, EMGO Institute for Health and Care ResearchPO Box 7057AmsterdamNetherlands1007 MB
| | | |
Collapse
|
130
|
The reduction of distress using therapeutic geothermal water procedures in a randomized controlled clinical trial. Adv Prev Med 2015; 2015:749417. [PMID: 25866680 PMCID: PMC4383502 DOI: 10.1155/2015/749417] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Revised: 02/03/2015] [Accepted: 02/10/2015] [Indexed: 11/29/2022] Open
Abstract
Stress is an element of each human's life and an indicator of its quality. Thermal mineral waters have been used empirically for the treatment of different diseases for centuries. Aim of the Study. To investigate the effects of highly mineralised geothermal water balneotherapy on distress and health risk. Methodology. A randomized controlled clinical trial was performed with 130 seafarers: 65 underwent 2 weeks of balneotherapy with 108 g/L full-mineralisation bath treatment; the others were in control group. The effect of distress was measured using the General Symptoms Distress Scale. Factorial and logistic regression analyses were used for statistical analysis. Results. A significant positive effect on distress (P < 0.001) was established after 2 weeks of treatment: the number of stress symptoms declined by 60%, while the intensity of stress symptoms reduced by 41%, and the control improved by 32%. Health risks caused by distress were reduced, and resources increased, whereas the probability of general health risk decreased by 18% (P = 0.01). Conclusion. Balneotherapy with highly mineralised geothermal water reduces distress, by reducing the health risk posed by distress by 26%, increasing the health resources by 11%, and reducing probability of general health risk by 18%. Balneotherapy is an effective preventive tool and can take a significant place in integrative medicine.
Collapse
|
131
|
Latorre-Román PÁ, Rentero-Blanco M, Laredo-Aguilera JA, García-Pinillos F. Effect of a 12-day balneotherapy programme on pain, mood, sleep, and depression in healthy elderly people. Psychogeriatrics 2015; 15:14-9. [PMID: 25515521 DOI: 10.1111/psyg.12068] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 08/17/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND The main purpose of this study is to analyze the effect of a 12-day balneotherapy programme on pain, mood state, sleep, and depression in older adults. METHODS In this study, 52 elderly adults from different areas of Spain participated in a social hydrotherapy programme created by the government's Institute for Elderly and Social Services, known as IMSERSO; participants included 23 men (age, 69.74 ± 5.19 years) and 29 women (age, 70.31 ± 6.76 years). Pain was analyzed using the visual analogue scale. Mood was assessed using the Profile of Mood Status. Sleep was assessed using the Oviedo Sleep Questionnaire. Depression was assessed using the Geriatric Depression Scale. The balneotherapy programme was undertaken at Balneario San Andrés (Jaén, Spain). The water at Balneario San Andrés, according to the Handbook of Spanish Mineral Water, is a hypothermic (≥20°C) hard water of medium mineralization, with bicarbonate, sulfate, sodium, and magnesium as the dominant ions. RESULTS Balneotherapy produced significant improvements (P < 0.05) for all variables (pain, mood state, sleep, and depression) in the total sample. A differential effect was found between the sexes regarding pain improvement, with men, but not women, having significantly improvement (P < 0.01) after treatment. With regard to improving mood, sex differences were also shown, with women, but not men, significantly improved (P < 0.05) in both depression and fatigue. CONCLUSIONS In conclusion, a 12-day balneotherapy programme has a positive effect on pain, mood, sleep quality, and depression in healthy older people.
Collapse
|
132
|
Karagülle M, Karagülle MZ. Effectiveness of balneotherapy and spa therapy for the treatment of chronic low back pain: a review on latest evidence. Clin Rheumatol 2014; 34:207-14. [DOI: 10.1007/s10067-014-2845-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 12/04/2014] [Accepted: 12/06/2014] [Indexed: 11/30/2022]
|
133
|
Naumann J, Sadaghiani C. Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome: a qualitative systematic review and meta-analysis of randomized controlled trials. Arthritis Res Ther 2014; 16:R141. [PMID: 25000940 PMCID: PMC4227103 DOI: 10.1186/ar4603] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 07/01/2014] [Indexed: 12/12/2022] Open
Abstract
Introduction In the present systematic review and meta-analysis, we assessed the effectiveness of different forms of balneotherapy (BT) and hydrotherapy (HT) in the management of fibromyalgia syndrome (FMS). Methods A systematic literature search was conducted through April 2013 (Medline via Pubmed, Cochrane Central Register of Controlled Trials, EMBASE, and CAMBASE). Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Results Meta-analysis showed moderate-to-strong evidence for a small reduction in pain (SMD −0.42; 95% CI [−0.61, −0.24]; P < 0.00001; I2 = 0%) with regard to HT (8 studies, 462 participants; 3 low-risk studies, 223 participants), and moderate-to-strong evidence for a small improvement in health-related quality of life (HRQOL; 7 studies, 398 participants; 3 low-risk studies, 223 participants) at the end of treatment (SMD −0.40; 95% CI [−0.62, −0.18]; P = 0.0004; I2 = 15%). No effect was seen at the end of treatment for depressive symptoms and tender point count (TPC). BT in mineral/thermal water (5 studies, 177 participants; 3 high-risk and 2 unclear risk studies) showed moderate evidence for a medium-to-large size reduction in pain and TPC at the end of treatment: SMD −0.84; 95% CI [−1.36, −0.31]; P = 0.002; I2 = 63% and SMD −0.83; 95% CI [−1.42, −0.24]; P = 0.006; I2 = 71%. After sensitivity analysis, and excluding one study, the effect size for pain decreased: SMD −0.58; 95% CI [−0.91, −0.26], P = 0.0004; I2 = 0. Moderate evidence is given for a medium improvement of HRQOL (SMD −0.78; 95% CI [−1.13, −0.43]; P < 0.0001; I2 = 0%). A significant effect on depressive symptoms was not found. The improvements for pain could be maintained at follow-up with smaller effects. Conclusions High-quality studies with larger sample sizes are needed to confirm the therapeutic benefit of BT and HT, with focus on long-term results and maintenance of the beneficial effects.
Collapse
|
134
|
Bender T, Bálint G, Prohászka Z, Géher P, Tefner IK. Evidence-based hydro- and balneotherapy in Hungary--a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2014; 58:311-23. [PMID: 23677421 PMCID: PMC3955132 DOI: 10.1007/s00484-013-0667-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2012] [Revised: 03/21/2013] [Accepted: 03/31/2013] [Indexed: 05/21/2023]
Abstract
Balneotherapy is appreciated as a traditional treatment modality in medicine. Hungary is rich in thermal mineral waters. Balneotherapy has been in extensive use for centuries and its effects have been studied in detail. Here, we present a systematic review and meta-analysis of clinical trials conducted with Hungarian thermal mineral waters, the findings of which have been published by Hungarian authors in English. The 122 studies identified in different databases include 18 clinical trials. Five of these evaluated the effect of hydro- and balneotherapy on chronic low back pain, four on osteoarthritis of the knee, and two on osteoarthritis of the hand. One of the remaining seven trials evaluated balneotherapy in chronic inflammatory pelvic diseases, while six studies explored its effect on various laboratory parameters. Out of the 18 studies, 9 met the predefined criteria for meta-analysis. The results confirmed the beneficial effect of balneotherapy on pain with weight bearing and at rest in patients with degenerative joint and spinal diseases. A similar effect has been found in chronic pelvic inflammatory disease. The review also revealed that balneotherapy has some beneficial effects on antioxidant status, and on metabolic and inflammatory parameters. Based on the results, we conclude that balneotherapy with Hungarian thermal-mineral waters is an effective remedy for lower back pain, as well as for knee and hand osteoarthritis.
Collapse
Affiliation(s)
- T Bender
- Polyclinic of the Hospitaller Brothers of St. John of God, Budapest, Hungary,
| | | | | | | | | |
Collapse
|
135
|
Fioravanti A, Tenti S, Giannitti C, Fortunati NA, Galeazzi M. Short- and long-term effects of mud-bath treatment on hand osteoarthritis: a randomized clinical trial. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2014; 58:79-86. [PMID: 23314489 DOI: 10.1007/s00484-012-0627-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 12/19/2012] [Accepted: 12/20/2012] [Indexed: 05/28/2023]
Abstract
The aim of this study was to evaluate both the short-term and the long-term effectiveness of spa therapy in patients with primary hand osteoarthritis (OA). This was a prospective randomized, single blind controlled trial. Sixty outpatients with primary bilateral hand OA were included in the study and randomized to one of two groups. One group (n = 30) was treated with 12 daily local mud packs and generalized thermal baths with a sulfate-calcium-magnesium-fluorides mineral water added to usual treatment. The control group (n = 30) continued regular outpatient care routine (exercise, NSAIDs and/or analgesics). Each patient was examined at baseline, after 2 weeks, and after 3, 6, 9 and 12 months. Primary outcome measures were global spontaneous hand pain on a visual analogue scale (VAS) and the functional index for hand osteoarthritis (FIHOA) score; secondary outcomes were health assessment questionnaire (HAQ), duration of morning stiffness, medical outcomes study 36-item short form (SF-36) and symptomatic drugs consumption. Our results demonstrated that the efficacy of spa therapy was significant in all the assessed parameters, both at the end of therapy and after 3 months; the values of FIHOA, HAQ and drugs consumption continued to be significantly better after 6 months in comparison with baseline. There were no significant modifications of the parameters throughout the follow-up in the control group. Differences between the two groups were significant for all parameters at the 15th day and at 3 months follow-up; regarding FIHOA, HAQ, and symptomatic drugs consumption, the difference between the two groups persisted and was significant at 6month follow-up. Tolerability of spa therapy seemed to be good. In conclusion, our results confirm that the beneficial effects of spa therapy in patients with hand OA last over time.
Collapse
Affiliation(s)
- Antonella Fioravanti
- Rheumatology Unit, Department of Clinical Medicine and Immunological Sciences, University of Siena, Viale Bracci,1, 53100, Siena, Italy,
| | | | | | | | | |
Collapse
|
136
|
Tefner IK, Kovács C, Gaál R, Koroknai A, Horváth R, Badruddin RM, Borbély I, Nagy K, Bender T. The effect of balneotherapy on chronic shoulder pain. A randomized, controlled, single-blind follow-up trial. A pilot study. Clin Rheumatol 2013; 34:1097-108. [PMID: 24343457 DOI: 10.1007/s10067-013-2456-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Revised: 11/25/2013] [Accepted: 12/03/2013] [Indexed: 11/30/2022]
Abstract
The effects of balneotherapy on chronic shoulder pain were studied. In this single-blind, randomized, follow-up study involving 46 patients with chronic shoulder pain, one group of patients received physiotherapy--exercise and transcutaneous electrical nerve stimulation--and the other group received balneotherapy in addition to physiotherapy for 4 weeks on 15 occasions. The following parameters were recorded before treatment (at week 0) and after treatment (at weeks 4, 7, and 13): Shoulder Pain and Disability Index (SPADI), the Short Form (36) Health Survey (SF-36) and EuroQuol-5D (EQ-5D) quality of life questionnaires, pain at rest and on movement on the visual analog scale (VAS), and active and passive range of motion. The SPADI pain, function, and total scores and the VAS scores at rest and on movement significantly improved in both groups after treatments. A greater improvement was observed in the balneotherapy group compared to the control group; regarding some parameters (VAS score on movement and SPADI function score at visit 2; VAS score at rest at visits 3 and 4), the difference between the groups was significant. The improvement of SF-36 and EQ-5D quality of life scores and the active range of motion was more pronounced in the balneotherapy group, the difference between the groups was not significant, except for EQ-5D at visit 2. Improvement of passive range of motion was not significant. Balneotherapy may have a beneficial effect on the clinical parameters and quality of life of patients with chronic shoulder pain. The number of patients should be increased.
Collapse
|
137
|
Maraver F, Corvillo I, Martín-Megías AI, Armijo F. Hidrología Médica, una especialidad poco conocida. Med Clin (Barc) 2013; 141:556-7. [DOI: 10.1016/j.medcli.2013.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 03/18/2013] [Accepted: 03/21/2013] [Indexed: 10/26/2022]
|
138
|
Cuesta-Vargas AI, Travé-Mesa A, Vera-Cabrera A, Cruz-Terrón D, Castro-Sánchez AM, Fernández-de-las-Peñas C, Arroyo-Morales M. Hydrotherapy as a recovery strategy after exercise: a pragmatic controlled trial. Altern Ther Health Med 2013; 13:180. [PMID: 23866725 PMCID: PMC3720553 DOI: 10.1186/1472-6882-13-180] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 07/16/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND Our aim was to evaluate the recovery effects of hydrotherapy after aerobic exercise in cardiovascular, performance and perceived fatigue. METHODS A pragmatic controlled repeated measures; single-blind trial was conducted. Thirty-four recreational sportspeople visited a Sport-Centre and were assigned to a Hydrotherapy group (experimental) or rest in a bed (control) after completing a spinning session. Main outcomes measures including blood pressure, heart rate, handgrip strength, vertical jump, self-perceived fatigue, and body temperature were assessed at baseline, immediately post-exercise and post-recovery. The hypothesis of interest was the session*time interaction. RESULTS The analysis revealed significant session*time interactions for diastolic blood pressure (P=0.031), heart rate (P=0.041), self perceived fatigue (P=0.046), and body temperature (P=0.001); but not for vertical jump (P=0.437), handgrip (P=0.845) or systolic blood pressure (P=0.266). Post-hoc analysis revealed that hydrotherapy resulted in recovered heart rate and diastolic blood pressure similar to baseline values after the spinning session. Further, hydrotherapy resulted in decreased self-perceived fatigue after the spinning session. CONCLUSIONS Our results support that hydrotherapy is an adequate strategy to facilitate cardiovascular recovers and perceived fatigue, but not strength, after spinning exercise. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01765387.
Collapse
|
139
|
The effect of Neydharting mud-pack therapy on knee osteoarthritis: a randomized, controlled, double-blind follow-up pilot study. Rheumatol Int 2013; 33:2569-76. [DOI: 10.1007/s00296-013-2776-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 05/04/2013] [Indexed: 11/25/2022]
|
140
|
Aquatic exercise & balneotherapy in musculoskeletal conditions. Best Pract Res Clin Rheumatol 2013; 26:335-43. [PMID: 22867930 DOI: 10.1016/j.berh.2012.05.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 05/25/2012] [Indexed: 12/19/2022]
Abstract
This is a best-evidence synthesis providing an evidence-based summary on the effectiveness of aquatic exercises and balneotherapy in the treatment of musculoskeletal conditions. The most prevalent musculoskeletal conditions addressed in this review include: low back pain, osteoarthritis, fibromyalgia and rheumatoid arthritis. Over 30 years of research demonstrates that exercises in general, and specifically aquatic exercises, are beneficial for reducing pain and disability in many musculoskeletal conditions demonstrating small to moderate effect sizes ranging between 0.19 and 0.32. Balneotherapy might be beneficial, but the evidence is yet insufficient to make a definitive statement about its use. High-quality trials are needed on balneotherapy and aquatic exercises research especially in specific patient categories that might benefit most.
Collapse
|
141
|
|
142
|
Silva A, Queiroz SSD, Andersen ML, Mônico-Neto M, Campos RMDS, Roizenblatt S, Tufik S, Mello MTD. Passive body heating improves sleep patterns in female patients with fibromyalgia. Clinics (Sao Paulo) 2013; 68:135-40. [PMID: 23525306 PMCID: PMC3584263 DOI: 10.6061/clinics/2013(02)oa03] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 08/19/2012] [Accepted: 10/08/2012] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To assess the effect of passive body heating on the sleep patterns of patients with fibromyalgia. METHODS Six menopausal women diagnosed with fibromyalgia according to the criteria determined by the American College of Rheumatology were included. All women underwent passive immersion in a warm bath at a temperature of 36 ±1 °C for 15 sessions of 30 minutes each over a period of three weeks. Their sleep patterns were assessed by polysomnography at the following time-points: pre-intervention (baseline), the first day of the intervention (acute), the last day of the intervention (chronic), and three weeks after the end of the intervention (follow-up). Core body temperature was evaluated by a thermistor pill during the baseline, acute, chronic, and follow-up periods. The impact of this treatment on fibromyalgia was assessed via a specific questionnaire termed the Fibromyalgia Impact Questionnaire. RESULTS Sleep latency, rapid eye movement sleep latency and slow wave sleep were significantly reduced in the chronic and acute conditions compared with baseline. Sleep efficiency was significantly increased during the chronic condition, and the awakening index was reduced at the chronic and follow-up time points relative to the baseline values. No significant differences were observed in total sleep time, time in sleep stages 1 or 2 or rapid eye movement sleep percentage. The core body temperature and Fibromyalgia Impact Questionnaire responses did not significantly change over the course of the study. CONCLUSION Passive body heating had a positive effect on the sleep patterns of women with fibromyalgia.
Collapse
Affiliation(s)
- Andressa Silva
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | | | | | | | | | | | | |
Collapse
|
143
|
One-year effectiveness of a 3-week balneotherapy program for the treatment of overweight or obesity. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:150839. [PMID: 23346190 PMCID: PMC3544175 DOI: 10.1155/2012/150839] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 11/28/2012] [Indexed: 12/02/2022]
Abstract
Objective. To assess the one-year effectiveness on weight loss of a 3-week balneotherapy program (BT). Method. A Zelen double consent randomised controlled trial to compare one-year BMI loss between a 3-week BT program versus usual care (UC) for overweight or obese patients (BMI: 27–35 kg/m2), associated or not with a dietary motivational interview (DMI) during the follow-up, using a 2 × 2 factorial design. Main analysis was a per protocol analysis comparing patients attending BT to patients managed by UC, matched on sex, overweight or obese status, DMI randomisation and a propensity score to attend BT or to be managed by UC. Results. From the 257 patients who completed the follow-up, 70 patients of each group could be matched. Mean BMI loss was 1.91 kg/m2 [95%CI: 1.46; 2.35] for the BT patients and 0.20 kg/m2 [−0.24; 0.64] for the UC patients (P < 0.001), corresponding to a significant BT benefit of 1.71 kg/m2 [1.08; 2.33]. There was no significant effect of DMI and no interaction with BT or UC. No adverse reaction was observed for patients attending BT. Conclusion. A 3-week BT program provided a significant one-year benefit over the usual GP dietary advice for overweight and obese patients.
Collapse
|
144
|
Shimodozono M, Matsumoto S, Ninomiya K, Miyata R, Ogata A, Etoh S, Watanabe S, Kawahira K. Acute effects of a single warm-water bath on serum adiponectin and leptin levels in healthy men: a pilot study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2012; 56:933-939. [PMID: 22038315 DOI: 10.1007/s00484-011-0502-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Revised: 09/29/2011] [Accepted: 10/10/2011] [Indexed: 05/31/2023]
Abstract
To preliminarily assess the acute effects of a single warm-water bath (WWB) on serum adipokine activity, we measured serum adiponectin, leptin and other metabolic profiles before, immediately after and 30 minutes after WWB in seven healthy male volunteers (mean age, 39.7 ± 6.0 years; mean body mass index, 21.6 ± 1.8 kg/m(2)). The subjects were immersed in tap water at 41°C for 10 minutes. Two weeks later, the same subjects underwent a single WWB with a bath additive that included inorganic salts and carbon dioxide (WWB with ISCO(2)) by the same protocol as for the first WWB. Leptin levels significantly increased immediately after WWB with tap water and ISCO(2) (both P < 0.05), and remained significantly higher than those at baseline even 30 minutes after WWB with tap water (P < 0.05). Adiponectin levels showed a slight, but not significant, increase both immediately after and 30 minutes after WWB with tap water or ISCO(2). Some parameters, such as serum total cholesterol, red blood cell count, hemoglobin and hematocrit significantly increased immediately after WWB with tap water or ISCO(2) (all P < 0.05), but they all returned to the baseline levels 30 minutes after bathing under both conditions. The sublingual temperature rose significantly after 10 minutes of WWB with tap water (0.96 ± 0.16°C relative to baseline, P < 0.01) and after the same duration of WWB with ISCO(2) (1.24 ± 0.34°C relative to baseline, P < 0.01). These findings suggest that a single WWB at 41°C for 10 minutes may modulate leptin and adiponectin profiles in healthy men.
Collapse
Affiliation(s)
- Megumi Shimodozono
- Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kirishima, Kagoshima, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
145
|
Horváth K, Kulisch Á, Németh A, Bender T. Evaluation of the effect of balneotherapy in patients with osteoarthritis of the hands: a randomized controlled single-blind follow-up study. Clin Rehabil 2011; 26:431-41. [DOI: 10.1177/0269215511425961] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To evaluate the effectiveness of thermal mineral water compared with magnetotherapy without balneotherapy as control, in the treatment of hand osteoarthritis. Design: Randomized controlled single-blind follow-up study. Setting: Rheumatology specialist clinic of Gunaras Health Spa. Subjects: Patients between 50 and 70 years of age with hand osteoarthritis, randomly assigned into three groups. Interventions: The subjects in the first two groups bathed in thermal mineral water of two different temperatures (36°C and 38°C) for three weeks five times a week for 20 minutes a day and received magnetotherapy to their hands three times weekly. The third group received only magnetotherapy. Outcome measures: Visual analogue scale scores, handgrip strength, pinchgrip strength, the number of swollen and tender joints of the hand, the duration of morning joint stiffness, Health Assessment Questionnaire, and Short Form-36 questionnaire. The study parameters were administered at baseline, immediately after treatment and after 13 weeks. Results: The study included 63 patients. Statistically significant improvement was observed in several studied parameters after the treatment and during the follow-up study in the thermal water groups versus the control group. The 38°C thermal water treatment significantly improved the pinch strength of the right hand (0.6 (95% confidence interval (CI) 0.2 to 1.1) vs. 0.03 (95% CI −0.3 to 0.4), P < 0.05) and the Health Assessment Questionnaire parameters (−0.4 (95% CI −0.6 to −0.2) vs. −0.1 (95% CI −0.2 to 0.1), P < 0.01) even in the long term. Conclusions: Balneotherapy combined with magnetotherapy improved the pain and function as well as the quality of life in patients with hand osteoarthritis.
Collapse
Affiliation(s)
- Katalin Horváth
- Zsigmondy Vilmos Harkány Medicinal Spa Hospital, Harkány, Hungary
| | - Ágota Kulisch
- Spa Hévíz and St. Andrew Hospital for Rheumatic Diseases P.U.C., Hévíz, Hungary
| | | | - Tamás Bender
- Polyclinic of the Hospitaller Brothers of St. John of God, Budapest, Hungary
| |
Collapse
|
146
|
The effect of spa therapy in chronic low back pain: a randomized controlled, single-blind, follow-up study. Rheumatol Int 2011; 32:3163-9. [DOI: 10.1007/s00296-011-2145-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Accepted: 09/10/2011] [Indexed: 10/17/2022]
|
147
|
Varga C. The Balneology paradox. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2011; 55:105-106. [PMID: 20960211 DOI: 10.1007/s00484-010-0378-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Revised: 09/28/2010] [Accepted: 09/28/2010] [Indexed: 05/30/2023]
|
148
|
Maraver F, Michán A, Morer C, Aguilera L. Is thalassotherapy simply a type of climatotherapy? INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2011; 55:107-108. [PMID: 21038100 DOI: 10.1007/s00484-010-0382-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Revised: 10/05/2010] [Accepted: 10/06/2010] [Indexed: 05/30/2023]
|