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Ramon Dupuy S, Cueille S, Dubourg K, Roques-Latrille CF, Bauduer F. Social Networks in French Balneotherapy: A Focus on Spa Doctors. Healthcare (Basel) 2023; 11:2613. [PMID: 37830650 PMCID: PMC10572274 DOI: 10.3390/healthcare11192613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/25/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023] Open
Abstract
Spa therapy is a medical treatment based on the use of natural mineral water. In France, spa therapy is delivered in spa care facilities (SCF) involving the intervention of several actors (stakeholders). Spa doctors are key stakeholders as they prescribe the treatments, follow spa patients and assess spa therapy with scientific studies. This study aimed to analyze the spa doctors' relationships in order to highlight their role in transferring information to other stakeholders, particularly to spa managers. For that purpose, we used the social network analysis (SNA) method by means of snowball data collection. We sent a questionnaire to all the spa therapy categories of actors. In total, 80 persons answered and declared 397 relationships. Our results, based on the categorization of respondents and of their relationships and on quantitative indicators (density, response rate), show that spa doctors demonstrate a very acceptable density of relations with spa managers and elected local authorities. However, they appear to be poorly involved in relations concerning the strategy and management of SCF, although they are essential actors in ensuring the medical relevance and sustainability of spa therapy. This research is of interest to patients' care as it recommends deeper involvement of spa doctors in the management of SCF in order to optimize access to informational resources, specifically regarding the evolution of treatments in accordance with scientific progress. Our data are of international scope because the organizational model of balneotherapy, based on the cooperation between spa doctors and SCF, is universal.
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Affiliation(s)
- Sybille Ramon Dupuy
- Institut du Thermalisme, University of Bordeaux, 40100 Dax, France; (K.D.); (F.B.)
| | - Sandrine Cueille
- Laboratoire de Recherche en Management (LIREM), University of Pau and Pays de l’Adour, E2S UPPA, 64100 Bayonne, France;
| | - Karine Dubourg
- Institut du Thermalisme, University of Bordeaux, 40100 Dax, France; (K.D.); (F.B.)
| | | | - Frédéric Bauduer
- Institut du Thermalisme, University of Bordeaux, 40100 Dax, France; (K.D.); (F.B.)
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Protano C, Fontana M, De Giorgi A, Marotta D, Cocomello N, Crucianelli S, Del Cimmuto A, Vitali M. Balneotherapy for osteoarthritis: a systematic review. Rheumatol Int 2023; 43:1597-1610. [PMID: 37301799 PMCID: PMC10348981 DOI: 10.1007/s00296-023-05358-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023]
Abstract
This systematic review is aimed to evaluate the effects of balneotherapy with thermal mineral water for managing the symptoms and signs of osteoarthritis located at any anatomical site. The systematic review was conducted according to the PRISMA Statement. The following databases were consulted: PubMed, Scopus, Web of Science, Cochrane Library, DOAJ and PEDro. We included clinical trials evaluating the effects of balneotherapy as a treatment for patients with osteoarthritis, published in English and Italian language, led on human subjects. The protocol was registered in PROSPERO. Overall, 17 studies have been included in the review. All of these studies were performed on adults or elderly patients suffering from osteoarthritis localized to knees, hips, hands or lumbar spine. The treatment assessed was always the balneotherapy with thermal mineral water. The outcomes evaluated were pain, palpation/pressure sensibility, articular tenderness, functional ability, quality of life, mobility, deambulation, ability to climb stairs, medical objective and patients' subjective evaluation, superoxide dismutase enzyme activity, serum levels of interleukin-2 receptors. The results of all the included studies agree and demonstrated an improvement of all the symptoms and signs investigated. In particular, pain and quality of life were the main symptoms evaluated and both improved after the treatment with thermal water in all the studies included in the review. These effects can be attributed to physical and chemical-physical properties of thermal mineral water used. However, the quality of many studies resulted not so high due and, consequently, it is necessary to perform new clinical trial in this field using more correct methods for conducting the study and for processing statistical data.
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Affiliation(s)
- Carmela Protano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Mario Fontana
- Department of Biochemical Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Andrea De Giorgi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Daniela Marotta
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Nicholas Cocomello
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Serena Crucianelli
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Angela Del Cimmuto
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Matteo Vitali
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
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Maccarone MC, Scanu A, Coraci D, Masiero S. The Potential Role of Spa Therapy in Managing Frailty in Rheumatic Patients: A Scoping Review. Healthcare (Basel) 2023; 11:1899. [PMID: 37444733 PMCID: PMC10340743 DOI: 10.3390/healthcare11131899] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
Frailty is not limited to the elderly, as patients with rheumatic diseases can also experience this condition. The present scoping review aimed to investigate the possibility of using the health resort setting as an alternative location for managing rheumatic patients with frailty. The research resulted in finding several in vitro, in vivo, and clinical studies, resulting in evidence supporting the effectiveness of spa treatments in reducing pain, improving function, and managing comorbidity in rheumatic diseases. Additionally, spa treatments were demonstrated to modulate the MAPK/ERK pathway and the NF-kB pathway's activation and to reduce proinflammatory molecules' secretion in rheumatic diseases, thus suggesting their potential effective role in the regulation of inflammaging in frailty. Moreover, the health resort setting may offer potential resources to reduce risk factors, such as drug consumption, inactivity, and disease severity, and may serve as a setting for developing prevention protocols for frailty. Future research should explore innovative approaches, such as exercise training and early diagnostics, for the overall management of frailty in rheumatic patients in the spa setting.
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Affiliation(s)
- Maria Chiara Maccarone
- Department of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Via Giustiniani 2, 35128 Padua, Italy;
| | - Anna Scanu
- Neurorehabilitation Unit, Department of Neuroscience, University of Padua, 35128 Padua, Italy; (A.S.); (D.C.)
- Department of Women’s and Children’s Health, University of Padua, 35128 Padua, Italy
| | - Daniele Coraci
- Neurorehabilitation Unit, Department of Neuroscience, University of Padua, 35128 Padua, Italy; (A.S.); (D.C.)
| | - Stefano Masiero
- Department of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Via Giustiniani 2, 35128 Padua, Italy;
- Neurorehabilitation Unit, Department of Neuroscience, University of Padua, 35128 Padua, Italy; (A.S.); (D.C.)
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Romay-Barrero H, Herrero-Lopez J, Llorente-Gonzalez JA, Melgar-Del Corral G, Palomo-Carrion R, Martinez-Galan I. Balneotherapy and Health-related Quality of Life in Adults with Knee Osteoarthritis: a Prospective Observational Study Into a Real Clinical Practice Condition. ACTA BALNEOLOGICA 2022. [DOI: 10.36740/abal202206103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Aim: To analyze the influence of balneotherapy applied in conditions of real clinical practice in Fitero’s Thermal Station (Spain) on HRQoL in adults with KOA.
Materials and Methods: This was a prospective observational study conducted under conditions of real clinical practice with a 9-month follow-up. The individuals were beneficiaries of the Spanish social thermalism programme. A total of 10 sessions were prescribed, individually, considering the clinical situation and preferences of each participant. In all cases, 10 bath sessions were administered, along with other techniques. The clinical assessments were conducted before initiating the balneotherapy and 1, 3, 6 and 9 months after. The main variable was HRQoL (Euroqol 5D-5L; WOMAC). The statistical analysis was performed by intention to treat.
Results: The study included 71 users. At 6 months, improvements were found in the following dimensions of the WOMAC questionnaire: pain (24.47%), stiffness (30.75%) and functional capacity (26.66%) (p<0.05). Pain and anxiety/depression showed statistically significant differences in the EQ 5D-5L throughout the study.
Conclusions: HRQoL in KOA would improve with the Balneotherapy, prevailing the effects for up to 6 months. The absence of adverse effects and the ease of completing the treatment provided by the Spanish social thermalism system make this treatment feasible.
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Güneri FD, Forestier FBE, Forestier RJ, Karaarslan F, Odabaşi E. YouTube as a source of information for water treatments. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:781-789. [PMID: 35094110 PMCID: PMC8800846 DOI: 10.1007/s00484-021-02236-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/21/2021] [Accepted: 12/25/2021] [Indexed: 05/05/2023]
Abstract
The purpose of the study was to investigate the quality and reliability of YouTube videos as a source of information in water treatments. We searched videos on YouTube ( www.youtube.com ) using the following keywords: "health resort medicine," "spa treatment," "spa therapy," "hydrotherapy," "thermal medicine," "balneology," and "balneotherapy" on June 17th, 2021. The global quality scale (GQS) was used to evaluate the quality of the videos. The assessment of reliability was evaluated using the modified DISCERN tool. Some other video parameters and sources of the videos were also recorded. One hundred twenty-one (121) videos were analyzed. The most common video source was advertisement (46.3%). GQS and modified DISCERN median scores were generally low. They were superior for "hydrotherapy" and "balneotherapy" and were also higher in videos uploaded by health-related persons or organizations (physicians, health-related professionals, and health-related websites). A statistically significant positive correlation was found between investigated parameters (like view ratio, number of likes, video power index, video length) and GQS. Only video length was correlated with modified DISCERN for investigated parameters. The median video power index scores were statistically higher for "spa therapy" and "spa treatment." The YouTube content linked with water treatments has poor quality and reliability most of time. The hydrotherapy and balneotherapy keywords have the best quality and reliability.We think that designers of water treatment videos should involve health professionals more often so that the content of their video will better explain the details of medical conditions or interventions.The scientific experts should ensure a consensus in terminology to straighten the awareness of water treatments for patients and physicians.
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Affiliation(s)
- Fulya Demircioğlu Güneri
- Department of Medical Ecology and Hydroclimatology, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
| | | | | | - Fatih Karaarslan
- Department of Medical Ecology and Hydroclimatology, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ersin Odabaşi
- Department of Medical Ecology and Hydroclimatology, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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D'Angelo D, Coclite D, Napoletano A, Fauci AJ, Latina R, Gianola S, Castellini G, Salomone K, Gambalunga F, Sperati F, Iacorossi L, Iannone P. The efficacy of balneotherapy, mud therapy and spa therapy in patients with osteoarthritis: an overview of reviews. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:1255-1271. [PMID: 33740137 DOI: 10.1007/s00484-021-02102-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 02/16/2021] [Accepted: 02/20/2021] [Indexed: 06/12/2023]
Abstract
Osteoarthritis is a degenerative disease considered a leading cause of functional disability. Its treatment is based on a combination of pharmacological and non-pharmacological interventions, but the role of these latter is still debated. This overview of systematic reviews aimed at evaluating the short-term efficacy of different thermal modalities in patients with osteoarthritis. We searched PubMed, Scopus, CINHAL, Web of Science, ProQuest and the Cochrane Database of Systematic Reviews from inception until October 2020, with no language restrictions. We selected the following outcomes a priori: pain, stiffness and quality of life. Seventeen systematic reviews containing 27 unique relevant studies were included. The quality of the reviews ranged from low to critically low. Substantial variations in terms of interventions studied, comparison groups, population, outcomes and follow-up between the included SRs were found. From a re-analysis of primary data, emerged that balneotherapy was effective in reducing pain and improving stiffness and quality of life, mud therapy significantly reduced pain and stiffness, and spa therapy showed pain relief. However, the evidence supporting the efficacy of different thermal modalities could be seriously flawed due to methodological quality and sample size, to the presence of important treatment variations, and to the high level of heterogeneity and the absence of a double-blind design. There is some encouraging evidence that deserves clinicians' consideration, suggesting that thermal modalities are effective on a short-term basis for treating patients with AO.
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Affiliation(s)
- Daniela D'Angelo
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, Via Giano della Bella, 34, 00162, Rome, Italy
| | - Daniela Coclite
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, Via Giano della Bella, 34, 00162, Rome, Italy
| | - Antonello Napoletano
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, Via Giano della Bella, 34, 00162, Rome, Italy
| | - Alice Josephine Fauci
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, Via Giano della Bella, 34, 00162, Rome, Italy
| | - Roberto Latina
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, Via Giano della Bella, 34, 00162, Rome, Italy
| | - Silvia Gianola
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Greta Castellini
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Katia Salomone
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, Via Giano della Bella, 34, 00162, Rome, Italy
| | | | - Francesca Sperati
- Biostatistics and Bioinformatic Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Laura Iacorossi
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, Via Giano della Bella, 34, 00162, Rome, Italy.
| | - Primiano Iannone
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, Via Giano della Bella, 34, 00162, Rome, Italy
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Fioravanti A. Meet Our Editorial Board Member. Curr Pharm Biotechnol 2021. [DOI: 10.2174/138920102205210326101516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Koç C, Kurt EE, Koçak FA, Erdem HR, Konar NM. Does balneotherapy provide additive effects to physical therapy in patients with subacute supraspinatus tendinopathy? A randomized, controlled, single-blind study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:301-310. [PMID: 33089368 PMCID: PMC7822764 DOI: 10.1007/s00484-020-02032-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/05/2020] [Accepted: 10/08/2020] [Indexed: 05/24/2023]
Abstract
This study assessed the additional contribution of balneotherapy on physical therapy in subacute supraspinatus tendinopathy. Ninety patients with subacute supraspinatus tendinopathy were included. They were randomized into two equal groups. In group 1 (n = 45), transcutaneous electrical nerve stimulation (TENS), hot pack, ultrasound treatments, and Codman's and range of motion (ROM) exercises were performed. In group 2 (n = 45), balneotherapy was added to the treatment program. In both groups, shoulder active ROM and handgrip strength were measured. Pain was evaluated using a Visual Analogue Scale (VAS) (rest, sleep, movement); functional assessment and quality of life were measured respectively with the Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire (QuickDASH), and the Short Form-36 health survey (SF 36) form. All measurements were repeated before and after 15 treatment sessions. There were statistically significant differences between the before and after assessment parameters in group 1 (all p < 0.05), but not for SF-36 General Health Perceptions, SF-36 Mental Health sub-parameters, and handgrip strengths. However, there were statistically significant differences between all the evaluation before and after the treatment in group 2 (all p < 0.05). When the two groups were compared in terms of alpha gains, statistically significant differences were observed in favor of group 2 in all measurements (all p < 0.05) except for SF-36 Emotional Role Difficulty and SF-36 Mental Health sub-parameters. This study shows that the addition of balneotherapy to physical therapy for subacute supraspinatus tendinopathy can make additional contributions to shoulder ROM, pain, handgrip strength, functional status, and quality of life.
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Affiliation(s)
- Cihan Koç
- Bahçe Physical Therapy and Rehabilitation Hospital, Osmaniye, Turkey.
| | - Emine Eda Kurt
- Ahi Evran University Faculty of Medicine, Kırşehir, Turkey
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Kamioka H, Mori Y, Horiuchi T, Hayashi T, Ohmura K, Yamaguchi S, Kato M. Association of Daily Home-Based Hot Water Bathing and Glycemic Control in Ambulatory Japanese Patients with Type 2 Diabetes Mellitus During the COVID-19 Pandemic: A Multicenter Cross-Sectional Study. Diabetes Metab Syndr Obes 2020; 13:5059-5069. [PMID: 33376375 PMCID: PMC7764630 DOI: 10.2147/dmso.s279270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 12/07/2020] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To clarify the relationship between daily hot water bathing (HWB) at home and glycemic control in middle-aged and elderly ambulatory patients with type 2 diabetes mellitus (T2DM). METHODS We defined hemoglobin A1c (HbA1c) as the main outcome. We set 7.0% based on the mean value of the dependent variable as the cut-off point for analysis. Frequency of HWB was an explanatory variable. A two-sample t-test was used to compare between groups with continuous variables. Multiple logistic regression analysis was performed for frequency, adjusted age, sex, BMI, T2DM duration (Model 1), and other confounding factors (Model 2). Odds ratio (OR) and 95% confidence interval (95% CI) were calculated. RESULTS Among 838 patients, there was a significant difference (p<0.001) in age between males (n=528, 62.8±8.7 years) and females (n=310, 65.0±8.1 years). In Model 1, compared with participants who used HWB more than seven times a week, those with poorly controlled HbA1c were significantly associated with low frequency of HWB: four to six times a week (OR 1.32, 95% CI 0.87-1.99) and less than three times a week (OR 1.43, 95% CI 0.98-2.10); p-value for overall trend was 0.041. In Model 2, p-value for overall trend was 0.138. CONCLUSION A higher frequency of HWB was moderately associated with a decreased risk of poor glycemic control in middle-aged and elderly ambulatory patients with T2DM.
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Affiliation(s)
- Hiroharu Kamioka
- Faculty of Regional Environment Science, Tokyo University of Agriculture, Tokyo, Japan
| | - Yasunori Mori
- Mie Prefecture Health and Environment Research Institute, Yokkaichi, Mie, Japan
| | - Takahiko Horiuchi
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Oita, Japan
| | - Takahito Hayashi
- Department of Legal Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Koichiro Ohmura
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Satoru Yamaguchi
- Department of Oriental Medicine, Saitama Medical University, Saitama, Japan
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NACAKOĞLU İ, KAYA E. Kaplıca Tedavisinin Romatizmal Hastalıklarda İlaç Terkine Olan Etkileri. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2020. [DOI: 10.30934/kusbed.558889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Gálvez I, Torres-Piles S, Ortega E. Effect of mud-bath therapy on the innate/inflammatory responses in elderly patients with osteoarthritis: a discussion of recent results and a pilot study on the role of the innate function of monocytes. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:927-935. [PMID: 31218395 DOI: 10.1007/s00484-019-01748-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/04/2019] [Accepted: 06/07/2019] [Indexed: 05/19/2023]
Abstract
Recent findings from our laboratory highlight the role of the modulation of the innate immune function and systemic inflammatory response in the effectiveness of balneotherapy in rheumatic diseases, specifically in elderly patients with osteoarthritis. Immune-neuroendocrine and stress mediators are involved in these effects. The 'bioregulatory effect of balneotherapy' has also been recently proposed as a mechanism of effectiveness that consists of a reduction in systemic pro-inflammatory mediators together with the achievement of an optimal innate response through stimulation (or at least lack of impairment) of the innate defences against pathogens (i.e. phagocytosis, microbicide activity) mediated by neutrophils, also generating immunophysiological adaptations through an optimal balance between the pro- and the anti-inflammatory responses in which regulatory T cells seem to have a crucial role. In the present paper, we aim to analyse the main conclusions related to how balneotherapy with the use of peloids (pelotherapy) affects the innate and inflammatory responses, constituting an immunophysiological mechanism underlying the proven clinical benefits of this intervention. We also introduce novel results regarding the innate response (phagocytic process) of monocytes in this therapy, an inflammatory cell that has not yet been studied in this context. Increased chemotaxis together with a decline in oxidative burst, without changes in phagocytosis, could be the main response induced by this modality of balneological intervention.
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Affiliation(s)
- Isabel Gálvez
- Immunophysiology Research Group, Department of Physiology, Faculty of Sciences, University of Extremadura, Avda. Elvas s/n, Badajoz, 06071, Spain
- Instituto Universitario de Investigación Biosanitaria de Extremadura (INUBE), Badajoz, Spain
| | - Silvia Torres-Piles
- Instituto Universitario de Investigación Biosanitaria de Extremadura (INUBE), Badajoz, Spain
- Immunophysiology Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine, University of Extremadura, Badajoz, Spain
| | - Eduardo Ortega
- Immunophysiology Research Group, Department of Physiology, Faculty of Sciences, University of Extremadura, Avda. Elvas s/n, Badajoz, 06071, Spain.
- Instituto Universitario de Investigación Biosanitaria de Extremadura (INUBE), Badajoz, Spain.
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Integrated Thermal Rehabilitation: A New Therapeutic Approach for Disabilities. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1251:29-38. [PMID: 31933146 DOI: 10.1007/5584_2019_465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
A mutual link between somatic and visceral neural pathways is known in medicine. This study addresses therapeutic effectiveness of an integrated rehabilitative approach of thermal aquatic environment, combined with neuromuscular manual stimulation, on activation of afferent sensory visceral and somatic efferent neuronal motor pathways in different pathologies of neuromuscular motor and respiratory systems. The study included 63 patients subjected to a protocol consisting of hydroponic treatment, hydrokinesitherapy associated with ozonized vascular pathway, and mud therapy associated with cardiorespiratory treatment performed in aquatic environment and aided by neuromuscular manual therapy. The therapeutic protocol consisted of rehabilitation sessions 5 days a week for 2 months. The outcome measures were spirometry tests and the following evaluation instruments: Tinetti Gait and Balance assessment scale, Functional Independence Measurement, visual analogue scale, and the EQ-5D-5 L instrument. The tests were applied before and after the protocol completion. The findings demonstrate a general increase in patients' everyday living autonomy and quality of life, with a particular improvement in respiratory function tests. We conclude that the integrated thermal approach holds promise in therapeutic rehabilitation of disabilities.
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Costantino M, Izzo V, Conti V, Manzo V, Guida A, Filippelli A. Sulphate mineral waters: A medical resource in several disorders. J Tradit Complement Med 2019; 10:320-326. [PMID: 32695648 PMCID: PMC7365777 DOI: 10.1016/j.jtcme.2019.04.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 04/05/2019] [Accepted: 04/21/2019] [Indexed: 12/02/2022] Open
Abstract
Based on their chemical composition, salus per aquam (spa) mineral waters (or medical mineral waters) can be classified as sulphurous, sulphate, bicarbonate etc. Sulphate mineral waters where the predominant element is sulphate anion SO42−, are frequently used in clinical therapy. In this review, we describe and analyze the current scientific knowledge concerning the therapeutic effect of sulphate mineral waters in the treatment of several disorders. Moreover, we underline how important is to integrate spa treatments with other therapeutic approaches to meet the various needs that can arise during a specific pathological state. Now, there is no systematic Review on Sulphate mineral waters in literature. The Review focuses on the importance of spa treatment as complementary therapy. The Review highlights the efficacy and tolerability of the spa in several disorders.
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Affiliation(s)
- Maria Costantino
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy
- Association non-profit F.I.R.S.Thermae (Interdisciplinary Training, Researches and spa Sciences) in Italian National Register of Research of MIUR, Naples, Via marziale 21, 80070, Bacoli, NA, Italy
- Corresponding author. Via S. Allende,1, 84081, Baronissi, SA, Italy.
| | - Viviana Izzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy
| | - Valentina Manzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy
| | - Antonella Guida
- General Directorate Health Protection, Campania Region, Centro Direzionale is C3, 80143, Naples, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy
- Association non-profit F.I.R.S.Thermae (Interdisciplinary Training, Researches and spa Sciences) in Italian National Register of Research of MIUR, Naples, Via marziale 21, 80070, Bacoli, NA, Italy
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Kamioka H, Mori Y, Nagata K, Iwanaga S, Uzura M, Yamaguchi S. Relationship of daily hot water bathing at home and hot water spa bathing with underlying diseases in middle-aged and elderly ambulatory patients: A Japanese multicenter cross-sectional study. Complement Ther Med 2019; 43:232-239. [PMID: 30935536 DOI: 10.1016/j.ctim.2019.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/05/2019] [Accepted: 02/05/2019] [Indexed: 01/17/2023] Open
Abstract
The purpose of this study was to clarify the relationship of daily hot water bathing at home (DHW) and hot water spa bathing (HSPA) with the number of underlying diseases in middle-aged and elderly ambulatory patients. We defined the number of underlying diseases as the main outcome and dependent (criterion) variable. The frequency and time of DHW and the frequency of HSPA were set as explanatory variables. Multiple logistic regression analysis was performed for each frequency and time, adjusted age and sex. Odds ratio (OR) and 95% confidence interval (95% CI) were calculated. Among the 1261 patients who participated, there was no significant difference in age between males (n = 508, 72.8 ± 6.8 years) and females (n = 753, 73.5 ± 6.9 years). There was also no significant age difference between males (number of diseases: 2.7 ± 2.0 pts.) and females (number of diseases: 2.7 ± 2.1 pts.) in the occurrence of underlying diseases. Frequency and time of DHW were not associated with the occurrence of underlying diseases. However, compared with participants who utilized hot water spa at least once a week, the occurrence of underlying diseases was significantly associated with bathing frequency: one to three times per month (OR 2.72, 95% CI 1.63-4.52); twice or five times a year (OR 1.92, 95% CI 1.25-2.94). In conclusion, lower frequency of HSPA was significantly associated with increased risk of the occurrence of underlying diseases in middle-aged and elderly ambulatory patients. However, the relationship between proactive use of hot water spa and patients' mental and physical support should be clarified by well-designed cohort studies. The present study was registered as UMIN000033018 by the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) in Japan (refer: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000037643).
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Affiliation(s)
- Hiroharu Kamioka
- Faculty of Regional Environment Science, Tokyo University of Agriculture, Japan.
| | - Yasunori Mori
- Mie Prefecture Health and Environment Research Institute, Japan
| | | | | | - Masahiko Uzura
- Department of Emergency Medicine, Jikei University School of Medicine Kashiwa Hospital, Japan
| | - Satoru Yamaguchi
- Department of Oriental Medicine, Saitama Medical University, Japan
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Zwolińska J, Weres A, Wyszyńska J. One-Year Follow-Up of Spa Treatment in Older Patients with Osteoarthritis: A Prospective, Single Group Study. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7492106. [PMID: 30065943 PMCID: PMC6051296 DOI: 10.1155/2018/7492106] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/12/2018] [Accepted: 06/03/2018] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Few studies evaluated the effects of spa therapy on pain perception and quality of life in older people with osteoarthritis. Therefore, the aim of the study was to evaluate the short- and long-term effects of spa therapy on quality of life and pain in patients aged 60 years and older with osteoarthritis. MATERIALS AND METHODS 70 patients with generalized osteoarthritis were enrolled in the study. Spa treatment lasted 3 weeks (15 days of treatment) and was applied during a session lasting 120 to 150 minutes a day. All the patients benefited from kinesiotherapy, physical agent modalities, massage, peloid therapy, hydrotherapy with mineral waters, and crenotherapy. Visual Analogue Scale (VAS) for pain, the Laitinen scale, and WHOQOL-BREF questionnaire were used to assess the condition of the patients. The examinations were performed three times: at the beginning of the spa treatment, after three months, and one year after the first examinations. RESULTS Statistically significant improvements were observed in pain (VAS) between consecutive assessments (p <.001). Laitinen scale also reported beneficial, statistically significant changes in the level of pain (p <.001). The WHOQOL-BREF questionnaire reported a statistically significant improvement in the domain of social relations in 2-3 and 1-3 periods (p = .025 and p = .011, resp.). A significant improvement was recorded in the domain of environment between 2-3 and 1-3 periods (p <.001). CONCLUSION Spa treatment reduced the level of pain in majority of the patients in short- and long-term follow-up and contributed to improving the quality of life in the domain of social relations and environment. To confirm the results of this study, there is a need for a randomized controlled trial comparing spa treatment with usual care in the older population with osteoarthritis. TRIAL REGISTRATION NUMBER This trial was retrospectively registered on 3 January 2018 with NCT03388801.
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Affiliation(s)
- Jolanta Zwolińska
- Institute of Physiotherapy, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | - Aneta Weres
- Institute of Physiotherapy, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | - Justyna Wyszyńska
- Institute of Physiotherapy, Medical Faculty, University of Rzeszów, Rzeszów, Poland
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Effects of balneotherapy and spa therapy on quality of life of patients with knee osteoarthritis: a systematic review and meta-analysis. Rheumatol Int 2018; 38:1807-1824. [DOI: 10.1007/s00296-018-4081-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 06/06/2018] [Indexed: 12/25/2022]
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Balneotherapy, Immune System, and Stress Response: A Hormetic Strategy? Int J Mol Sci 2018; 19:ijms19061687. [PMID: 29882782 PMCID: PMC6032246 DOI: 10.3390/ijms19061687] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 05/31/2018] [Accepted: 06/04/2018] [Indexed: 11/16/2022] Open
Abstract
Balneotherapy is a clinically effective complementary approach in the treatment of low-grade inflammation- and stress-related pathologies. The biological mechanisms by which immersion in mineral-medicinal water and the application of mud alleviate symptoms of several pathologies are still not completely understood, but it is known that neuroendocrine and immunological responses—including both humoral and cell-mediated immunity—to balneotherapy are involved in these mechanisms of effectiveness; leading to anti-inflammatory, analgesic, antioxidant, chondroprotective, and anabolic effects together with neuroendocrine-immune regulation in different conditions. Hormesis can play a critical role in all these biological effects and mechanisms of effectiveness. The hormetic effects of balneotherapy can be related to non-specific factors such as heat—which induces the heat shock response, and therefore the synthesis and release of heat shock proteins—and also to specific biochemical components such as hydrogen sulfide (H2S) in sulfurous water and radon in radioactive water. Results from several investigations suggest that the beneficial effects of balneotherapy and hydrotherapy are consistent with the concept of hormesis, and thus support a role for hormesis in hydrothermal treatments.
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Antonelli M, Donelli D. Effects of balneotherapy and spa therapy on levels of cortisol as a stress biomarker: a systematic review. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:913-924. [PMID: 29455296 DOI: 10.1007/s00484-018-1504-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/22/2018] [Accepted: 01/23/2018] [Indexed: 05/21/2023]
Abstract
Balneotherapy and spa therapy are well-known practices, even though limited evidence has been produced about their biological effects. This systematic review primarily aims at assessing if balneotherapy, mud/peloid therapy, and spa therapy may influence cortisol levels. Secondarily, it aims at understanding if these interventions may improve stress resilience. PubMed/Medline, Embase, and Cochrane Library were searched for relevant articles in English or Italian about studies involving healthy and sub-healthy subjects or patients with a diagnosed disease about effects of balneotherapy, mud/peloid therapy, and spa therapy on serum and salivary cortisol levels. Fifteen studies involving 684 subjects were included. Five studies investigated biological effects of balneotherapy alone. Two of them reported significant changes of cortisol levels in healthy participants. The other three studies reported no significant variations in patients with rheumatic conditions. No studies investigated biological effects of mud/peloid therapy alone. Ten studies investigated biological effects of spa therapy with or without included mud/peloid therapy, and in all but two studies, significant variations of cortisol levels were reported. Our main findings suggest that balneotherapy may have the potential to influence cortisol levels in healthy subjects, in such a way as to improve stress resilience. Spa therapy with or without included mud/peloid therapy demonstrated the same potential to influence cortisol levels also in sub-healthy subjects and in patients with a diagnosed disease. Therefore, balneotherapy and spa therapy may be considered as useful interventions for the management of stress conditions. Further investigation is needed because of limited available data.
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Affiliation(s)
- Michele Antonelli
- Laboratorio di Statistica Medica ed Epidemiologia Clinica, Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, 43126, Parma, Italy.
| | - Davide Donelli
- CdLM Medicina e Chirurgia, University of Parma, Parma, Italy
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Karaarslan F, Ozkuk K, Seringec Karabulut S, Bekpinar S, Karagulle MZ, Erdogan N. How does spa treatment affect cardiovascular function and vascular endothelium in patients with generalized osteoarthritis? A pilot study through plasma asymmetric di-methyl arginine (ADMA) and L-arginine/ADMA ratio. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:833-842. [PMID: 29218448 DOI: 10.1007/s00484-017-1484-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 11/20/2017] [Accepted: 11/26/2017] [Indexed: 05/24/2023]
Abstract
The study aims to investigate the effect of spa treatment on vascular endothelium and clinical symptoms of generalized osteoarthritis. Forty generalized osteoarthritis (GOA) patients referred to a government spa hospital, and 40 GOA patients followed on university hospital locomotor system disease ambulatory clinics were included as study and control groups, respectively. Study group received spa treatment including thermal water baths, physical therapy modalities, and exercises. Control group was followed with home exercises for 15 days. Plasma ADMA, L-arginine, L-arginine/ADMA ratio, routine blood analyses, 6-min walking test, including fingertip O2 saturation, systolic/diastolic blood pressure, and pulse rate, were measured at the beginning and at the end of treatment. Groups were evaluated with VAS pain, patient, and physician global assessment; HAQ; and WOMAC at the beginning, at the end, and after 1 month of treatment. In study group, L-arginine and L-arginine/ADMA ratio showed statistically significant increase after treatment. Plasma ADMA levels did not change. There is no significant difference in intergroup comparison. Study group displayed statistically significant improvements in all clinical parameters. The study showed that spa treatment does not cause any harm to the vascular endothelium through ADMA. Significant increase in plasma L-arginine and L-arginine/ADMA ratio suggests that balneotherapy may play a preventive role on cardiovascular diseases. Balneotherapy provides meaningful improvements on clinical parameters of GOA.
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Masiero S, Vittadini F, Ferroni C, Bosco A, Serra R, Frigo AC, Frizziero A. The role of thermal balneotherapy in the treatment of obese patient with knee osteoarthritis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:243-252. [PMID: 28940031 DOI: 10.1007/s00484-017-1445-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 09/13/2017] [Accepted: 09/13/2017] [Indexed: 05/21/2023]
Abstract
Osteoarthritis (OA) is the most common form of arthritis clinically characterized by joint pain, functional limitation, and reduced quality of life. Several studies have shown a clear link between obesity and higher risk of knee OA. According to the multifactorial OA pathogenesis, the management of this condition requires a multidisciplinary approach. The objective of this study is to evaluate hydrokinesitherapy effects in thermal setting in obese patients with knee OA. Fifty-three patients were assessed for eligibility, of which 33 refused the treatment, while 10 patients dropped out after the enrollment for personal reasons or inability to adhere to the program. Ten patients (8 females, 2 males, mean age of 59.4 years) with obesity (range BMI 30-45 kg/m2) and knee OA (II-III grade of Kellgren-Lawrence scale) treated with hydrokinetic therapy in thermal water (two sessions per week for 8 consecutive weeks) completed the study. Primary outcome measure was pain (VAS). Secondary outcomes were clinical knee evaluation (range of motion-ROM, lower-limb muscle strength), WOMAC, and Lequesne Algofunctional Index. Patellar tendon and peri-articular soft tissue ultrasound evaluation and gait analysis at baseline (T0), at the end of treatment (T1), and at 6 months of follow-up (T2) were performed. Significant decrease on VAS pain during walking on a flat surface and going up/down stairs was reached from baseline at T1 (p = 0.0039; p = 0.0098) and was maintained at T2 (p = 0.00954) exclusively for VAS pain during walking on a flat surface. WOMAC score showed a significant reduction between T0 and T1 (p = 0.0137) and between T0 and T2 (p = 0.006438), as ROM evaluations. Kinematic path assessment did not show significant results in individual gait steps, except for the space-time variables of the average speed and the values of ground reaction force (GRF) obtained with force platforms. Hydrokinesitherapy in thermal environment in obese patients with knee OA may determine pain relief, joint function improvement, and walking speed increase until 6 months of follow-up.
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Affiliation(s)
| | | | | | - Anna Bosco
- Universita degli Studi di Padova, Padua, Italy
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Kasapoğlu Aksoy M, Altan L, Eröksüz R, Metin Ökmen B. The efficacy of peloid therapy in management of hand osteoarthritis: a pilot study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:2145-2152. [PMID: 28779304 DOI: 10.1007/s00484-017-1419-9] [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: 05/12/2017] [Revised: 07/22/2017] [Accepted: 07/24/2017] [Indexed: 06/07/2023]
Abstract
Hand osteoarthritis (OA) is associated with pain, reduced grip strength, loss of range of motion (ROM), and joint stiffness, leading to impaired hand function and difficulty in performance of daily living activities. Mud bath therapy has been reported to play a primary role in the prevention and management of OA. Thus, we planned to conduct a study aimed at investigating the effects of peloid therapy on pain, functional state, grip strength, and the quality of life and performing a comparative analysis of the outcomes of peloid therapy. In this randomized, controlled, single-blind, pilot study, patients (n = 33) underwent peloid therapy over 2 weeks, 5 sessions a week, for a total of 10 sessions and home exercise program in group 1. Patients in group 2 (control, n = 30) received only the same home exercise program as in group 1. Patients were evaluated just before, and 2 and 6 weeks after the start of the study with Visual Analogue Scale (VAS), Australian/Canadian Hand Osteoarthritis Index (AUSCAN), Health Assessment Questionnaire (HAQ), hand grip strength (HGS), and pinch strength (PS). Statistically significant improvements were observed in all parameters assessed at week 2 and week 6 in the group 1 (p < 0.05). Statistically significant differences were observed in HGS scores in the group 2 at week 2 and in AUSCAN scores at week 6 (p < 0.05). Intergroup comparisons of the scores revealed significant differences between the peloid therapy group and control group in VAS, HAQ, AUSCAN, HGS, and PS scores at week 2 and week 6 (p < 0.05). This study demonstrates that peloid therapy might be an effective and confident treatment modality in the management of symptomatic osteoarthritis of the hand and may provide effective pain control and improvements in the hand functions, quality of life, and grip strength.
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Affiliation(s)
- Meliha Kasapoğlu Aksoy
- Department of Physical Therapy and Rehabilitation, Sağlık Bilimleri University Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey.
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Rıza Eröksüz
- Department of Medical Ecology and Hydroclimatology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Burcu Metin Ökmen
- Department of Physical Therapy and Rehabilitation, Sağlık Bilimleri University Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
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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.
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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.
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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.
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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
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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.
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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
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The effect of balneotherapy on pain relief, stiffness, and physical function in patients with osteoarthritis of the knee: a meta-analysis. Clin Rheumatol 2017; 36:1839-1847. [DOI: 10.1007/s10067-017-3592-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 02/18/2017] [Accepted: 02/23/2017] [Indexed: 10/20/2022]
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26
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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]
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27
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Forestier R, Erol-Forestier FB, Francon A. Current role for spa therapy in rheumatology. Joint Bone Spine 2017; 84:9-13. [DOI: 10.1016/j.jbspin.2016.05.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2016] [Indexed: 01/15/2023]
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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.
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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.
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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
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Forestier R, Erol Forestier FB, Francon A. Spa therapy and knee osteoarthritis: A systematic review. Ann Phys Rehabil Med 2016; 59:216-226. [DOI: 10.1016/j.rehab.2016.01.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/19/2016] [Accepted: 01/25/2016] [Indexed: 11/24/2022]
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Roques CF, Queneau P. Médecines thermales et douleurs des lombalgies chroniques, gonarthrose ou fibromyalgie. BULLETIN DE L ACADEMIE NATIONALE DE MEDECINE 2016. [DOI: 10.1016/s0001-4079(19)30733-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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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.
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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.
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Fioravanti A, Bacaro G, Giannitti C, Tenti S, Cheleschi S, Gui Delli GM, Pascarelli NA, Galeazzi M. One-year follow-up of mud-bath therapy in patients with bilateral knee osteoarthritis: a randomized, single-blind controlled trial. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:1333-43. [PMID: 25516113 DOI: 10.1007/s00484-014-0943-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 11/17/2014] [Accepted: 11/25/2014] [Indexed: 05/21/2023]
Abstract
The objective of this prospective parallel randomized single-blind study was to assess that a cycle of mud-bath therapy (MBT) provides any benefits over usual treatment in patients with bilateral knee osteoarthritis (OA). Patients with symptomatic primary bilateral knee OA, according to ACR criteria, were included in the study and randomized to one of two groups: one group received a cycle of MBT at spa center of Chianciano Terme (Italy) in addition to the usual treatment, and one group continued their regular care routine alone. Clinical assessments were performed 7 days before enrollment (screening visit), at the time of enrollment (basal time), after 2 weeks, and after 3, 6, 9, and 12 months after the beginning of the study. All assessments were conducted by two researchers blinded to treatment allocation. The primary efficacy outcomes were the global pain score evaluated by Visual Analog Scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) subscore for physical function (W-TPFS). Of the 235 patients screened, 103 met the inclusion criteria: 53 patients were included in the MBT group and 50 in the control group. In the group of patients treated with MBT, we observed a statistically significant (p < 0.001) reduction of VAS and W-TPFS score at the end of the treatment; this improvement was significant (p < 0.05) also at 3 months of follow-up. The control group did not show significant differences between baseline time and all other times. The differences between one group were significant for both primary parameters already from the 15th day and persisted up to the 9th month. This beneficial effect was confirmed by the significant reduction of symptomatic drug consumption. Tolerability of MBT seemed to be good, with light and transitory side effects. Our results confirm that a cycle of MBT added to usual treatment provides a beneficial effect on the painful symptoms and functional capacities in patients with knee OA that lasts over time. Mud-bath therapy can represent a useful backup to pharmacologic treatment of knee OA or a valid alternative for patients who do not tolerate pharmacological treatments.
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Affiliation(s)
- A Fioravanti
- Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico "Le Scotte," Viale Bracci 1, 53100, Siena, Italy,
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Tenti S, Cheleschi S, Galeazzi M, Fioravanti A. Spa therapy: can be a valid option for treating knee osteoarthritis? INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:1133-1143. [PMID: 25339582 DOI: 10.1007/s00484-014-0913-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 10/01/2014] [Accepted: 10/06/2014] [Indexed: 05/28/2023]
Abstract
Osteoarthritis (OA) continues to be one of the leading causes of 'years lived with disability' worldwide. Symptomatic knee OA is highly prevalent among people aged 50 years and over and is destined to become an ever more important healthcare problem. Current management of knee OA includes non-pharmacological and pharmacological treatments. Spa therapy is one of the most commonly used non-pharmacological approaches for OA in many European countries, as well as in Japan and Israel. Despite its long history and popularity, spa treatment is still the subject of debate and its role in modern medicine continues to be unclear. The objective of this review is to summarize the currently available information on clinical effects and mechanisms of action of spa therapy in knee OA. Various randomized controlled clinical trials (RCTs) were conducted to assess the efficacy and tolerability of balneotherapy and mud-pack therapy in patients with knee OA. Data from these clinical trials support a beneficial effect of spa therapy on pain, function and quality of life in knee OA that lasts over time, until 6-9 months after the treatment. The mechanisms by which immersion in mineral or thermal water or the application of mud alleviate suffering in OA are not fully understood. The net benefit is probably the result of a combination of factors, among which the mechanical, thermal and chemical effects are most prominent. In conclusion, spa therapy seems to have a role in the treatment of knee OA. Additional RCTs and further studies of mechanisms of action with high methodological quality are necessary to prove the effects of spa therapy.
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Affiliation(s)
- Sara Tenti
- Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, Policlinico "Le Scotte", University of Siena, Viale Bracci 1, 53100, Siena, Italy
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Thermalisme et douleur chronique en rhumatologie : revue des essais cliniques randomisés (ECR) et des méta-analyses. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s11724-015-0410-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Kamioka H, Tsutani K, Maeda M, Hayasaka S, Okuizum H, Goto Y, Okada S, Kitayuguchi J, Abe T. Assessing the quality of study reports on spa therapy based on randomized controlled trials by the spa therapy checklist (SPAC). Complement Ther Clin Pract 2014; 20:317-33. [PMID: 25179406 DOI: 10.1016/j.ctcp.2014.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 08/07/2014] [Indexed: 01/27/2023]
Abstract
The purpose of this study was to assess the quality of study reports on spa therapy based on randomized controlled trials by the spa therapy and balneotherapy checklist (SPAC), and to show the relationship between SPAC score and the characteristics of publication. We searched the following databases from 1990 up to September 30, 2013: MEDLINE via PubMed, CINAHL, Web of Science, Ichushi Web, Global Health Library, the Western Pacific Region Index Medicus, PsycINFO, and the Cochrane Database of Systematic Reviews. We used the SPAC to assess the quality of reports on spa therapy and balneotherapy trials (SPAC) that was developed using the Delphi consensus method. Fifty-one studies met all inclusion criteria. Forty studies (78%) were about "Diseases of the musculoskeletal system and connective)". The total SPAC score (full-mark; 19 pts) was 10.8 ± 2.3 pts (mean ± SD). The items for which a description was lacking (very poor; <50%) in many studies were as follows: "locations of spa facility where the data were collected"; "pH"; "scale of bathtub"; "presence of other facility and exposure than bathing (sauna, steam bath, etc.)"; "qualification and experience of care provider"; "Instructions about daily life" and "adherence". We clarified that there was no relationship between the publish period, languages, and the impact factor (IF) for the SPAC score. In order to prevent flawed description, SPAC could provide indispensable information for researchers who are going to design a research protocol according to each disease.
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Affiliation(s)
- Hiroharu Kamioka
- Faculty of Regional Environment Science, Tokyo University of Agriculture, Japan.
| | - Kiichiro Tsutani
- Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Japan
| | - Masaharu Maeda
- Department of Rehabilitation, International University of Health and Welfare Graduate School, Japan
| | | | | | | | - Shinpei Okada
- Physical Education and Medicine Research Foundation, Japan
| | - Jun Kitayuguchi
- Physical Education and Medicine Research Center Unnan, Japan
| | - Takafumi Abe
- Physical Education and Medicine Research Center Unnan, Japan
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Sánchez-Espejo R, Aguzzi C, Cerezo P, Salcedo I, López-Galindo A, Viseras C. Folk pharmaceutical formulations in western Mediterranean: identification and safety of clays used in pelotherapy. JOURNAL OF ETHNOPHARMACOLOGY 2014; 155:810-814. [PMID: 24960182 DOI: 10.1016/j.jep.2014.06.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 06/10/2014] [Accepted: 06/14/2014] [Indexed: 06/03/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Clays are naturally occurring ingredients of many natural health products, being included in most of ancient Mediterranean/European medical texts and currently used to prepare therapeutic hot-muds (peloids) in several thermal stations of the Mediterranean region. Clays are included in the formulation of peloids as vehicles of the mineral-medicinal water, to obtain inorganic gels with rheological and thermal properties suitable to be topically applied. Knowledge about formulations and preparation procedures of these traditional medicines has been orally transmitted since ancient times. Increasing recognition of the therapeutic utility of these traditional and natural health care substances make necessary a full ethnopharmaceutic research to ascertain those compositional characters that allow to establish quality attributes and corresponding requirements for these materials and products, including identity, purity, richness and safety. MATERIALS AND METHODS Five clay samples (A, B, C, D and E) currently used in various spa centers of southern European/Mediterranean countries were studied. X-Ray diffraction (XRD) and X-ray fluorescence (XRF) data were used to asses sample identity and richness. Elemental impurities and microbiological contaminants were also determined and compared to normative limits. Particle size distribution was related to their safety as powder materials. RESULTS Samples A, C, D and E were identified as "high purity clay", while sample B was identified as a mix of clay minerals and carbonates. The presence of carbonates in this sample could compromise its suitability for pelotherapy. The studied clays meet the main normative limits for metals impurities, with the exception of arsenic in sample A and nickel in sample B. The samples comply with the microbiological limits proposed by European legislation for medicinal products. According to the particle size of the studied samples, prevention and control of dust exposure must be considered. CONCLUSIONS Despite their demonstrated longevity, the use of clays in traditional medicine formulations as peloids greatly requires comprehension of their identity and safety attributes. Continuity of these mineral substances as recognized health care ingredients oblige to conduct interdisciplinary research to know the features that sustain their traditional use in the preparation of medicines (ethnopharmaceutics).
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Affiliation(s)
- Rita Sánchez-Espejo
- Andalusian Institute of Earth Sciences, CSIC-University of Granada, Avda. de las Palmeras 4, Armilla, 18100 Granada, Spain
| | - Carola Aguzzi
- Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, University of Granada, Campus of Cartuja s/n, 18071 Granada, Spain
| | - Pilar Cerezo
- Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, University of Granada, Campus of Cartuja s/n, 18071 Granada, Spain
| | - Inmaculada Salcedo
- Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, University of Granada, Campus of Cartuja s/n, 18071 Granada, Spain
| | - Alberto López-Galindo
- Andalusian Institute of Earth Sciences, CSIC-University of Granada, Avda. de las Palmeras 4, Armilla, 18100 Granada, Spain
| | - César Viseras
- Andalusian Institute of Earth Sciences, CSIC-University of Granada, Avda. de las Palmeras 4, Armilla, 18100 Granada, Spain; Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, University of Granada, Campus of Cartuja s/n, 18071 Granada, Spain.
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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.
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Affiliation(s)
- Antonella Fioravanti
- Rheumatology Unit, Department of Clinical Medicine and Immunological Sciences, University of Siena, Viale Bracci,1, 53100, Siena, Italy,
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Osteoarthritis year in review: outcome of rehabilitation. Osteoarthritis Cartilage 2013; 21:1414-24. [PMID: 23942064 DOI: 10.1016/j.joca.2013.08.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 07/09/2013] [Accepted: 08/03/2013] [Indexed: 02/02/2023]
Abstract
PURPOSE This review highlights seminal publications of rehabilitation interventions for osteoarthritis (OA) since April 2012. METHODS Medline in process, Embase, CINAHL and Cochrane databases were searched from April 2012 through February 2013 for English language publications using key words osteoarthritis, rehabilitation, physiotherapy, physical therapy, and exercise. Rehabilitation intervention studies included randomized trials or systematic reviews/meta-analyses or pre-post studies. Pilot randomized trials, feasibility studies and studies of surgical interventions unless they included evaluation of a rehabilitation intervention were excluded. RESULTS Twenty-five studies were identified for inclusion and grouped thematically. The short-term benefits (i.e., to 3 months) of variable types and dosages of exercise were demonstrated for a number of outcomes including pain, stiffness, function, balance, biomarkers, and executive function and dual task performance (related to falling) in people with knee OA. Modalities such as 890-nm radiation, interferential current, short wave diathermy, ultrasound and neuromuscular functional electrical stimulation did not demonstrate benefit over sham controls in those with knee OA. Spa therapy improved pain over the period of treatment in those with knee and hand OA. Supervised self-management based on cognitive therapy principles resulted in improved outcomes for people with knee OA. Shock absorbing insoles compared to normal footwear minimally improved knee pain and but not function and did not decrease knee load. Neuromuscular and motor training improved function in those with total hip replacement. Accelerated weight-bearing and rehabilitation (8 versus 11 weeks) was demonstrated to be safe and effective at 5 years following matrix autologous chondrocyte implantation for cartilage defects in the knee. CONCLUSIONS Exercise remains a mainstay of conservative management although most studies report only short-term outcomes. Self-management strategies also are beneficial in knee OA. There seems to be a placebo effect with most trials of physical modalities although spa therapy demonstrated very short-term effects.
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Efectos de la terapia con peloides sobre el dolor percibido y la calidad de vida relacionada con la salud en pacientes con artrosis de rodilla. ACTA ACUST UNITED AC 2013; 9:156-60. [DOI: 10.1016/j.reuma.2012.09.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Revised: 09/08/2012] [Accepted: 09/12/2012] [Indexed: 11/23/2022]
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Espejo-Antunez L, Cardero-Duran MA, Garrido-Ardila EM, Torres-Piles S, Caro-Puertolas B. Clinical effectiveness of mud pack therapy in knee osteoarthritis. Rheumatology (Oxford) 2012; 52:659-68. [DOI: 10.1093/rheumatology/kes322] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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The "MESACA" study: methylsulfonylmethane and boswellic acids in the treatment of gonarthrosis. Adv Ther 2011; 28:894-906. [PMID: 21986780 DOI: 10.1007/s12325-011-0068-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Osteoarthritis is a chronic rheumatoid disease mediated by metalloproteinases and inflammatory cytokines. Methylsulfonylmethane (MSM) and boswellic acids (BA) each show promise in the treatment of inflammatory processes, but the efficacy of combined treatment with these substances in the treatment of arthritis has not yet been studied. METHODS In this prospective randomized clinical trial, MESACA (for "methylsulfonylmethane and boswellic acids in the treatment of knee arthritis"), 60 subjects affected by arthritis of the knee were randomly assigned to an experimental group treated for 60 days with 5 g of MSM and 7.2 mg of BA daily, or a control group which was administered a placebo. At 2 and 6 months follow-up (FU), the efficacy of combined treatment with these two dietary supplements was assessed using the visual analog pain scale (VAS) and the Lequesne index (LI) for joint function, as well as monitoring the use of anti-inflammatory drugs (nonsteroidal anti-inflammatory drugs and anti-cyclooxygenase-2). RESULTS Pain, assessed with the VAS scale, was worse in the group treated with MSM and BA as compared with the placebo group at 2 months FU (3.8 vs. 2.7; P=0.04), whereas no difference between the two groups was observed at 6 months FU (2.7 vs. 3.6; P=0.2). No statistically significant differences were found in the LI between the two groups at either FU (2 months: 4.8 vs. 4.2; P=0.51; 6 months: 4.4 vs. 4.5; P=0.91). By contrast, a statistically significant difference in patients need for anti-inflammatory drugs was seen in the experimental as compared to the placebo group, even by 2 months FU (0.2 vs. 0.6 tablets/day; P<0.0001), that persisted up to the end of the study (0.1 vs. 0.6 tablets/day; P<0.0001). CONCLUSIONS Although the combined administration of MSM and BA in the treatment of gonarthrosis was not shown to be more efficacious than placebo in the management of the clinical and functional picture, it significantly reduced patients need for anti-inflammatory drugs.
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