The Legacy of Sebastian Kneipp: Linking Wellness, Naturopathic, and Allopathic Medicine

Trade-off between herbal and allopathic treatments: An ethnopharmacological case study in Rema-kalenga wildlife sanctuary, Bangladesh

The Rema-Kalenga Wildlife Sanctuary (RKWS) is a protected forest in Bangladesh that houses a variety of rare flora and fauna and supports the sustenance of 13 ethnic communities. This forest's indigenous and other inhabitants traditionally have a strong cultural connection to the plants, particularly medicinal plants. Due to modern allopathic medicine's rapid growth and commercial tree species prioritization, many medicinal plants are now on the verge of endangerment. Under such circumstances, it is crucial to explore how the local community perceives the importance of herbal treatments in contrast to allopathy, the underlying reasons for their perceptions, and the specific ailments for which they use the plants. The main objectives are: 1) to evaluate the perceptions of the local community towards allopathy and herbal medicine using Nussbaum's central capabilities approach, 2) to identify medicinal plant diversity, therapeutic usages, and quantitative indices, 3) to determine the factors that influence the use of medicinal plants. Repeated interviews and field surveys were conducted at the RKWS, interviewing 145 people, including the indigenous community (72.42 %) and traditional healers (8.27 %) from the surrounding seven villages. The study identified 51 medicinal plant species belonging to 39 families for their potent medicinal properties in treating various ailments. The predominant parts of the plants used in the treatments were leaves and roots. The uses were classified into 12 categories according to Nussbaum's central capabilities. The findings identified Aloe vera, Phyllanthus emblica, and Azadirachta indica as highly culturally important species. In contrast, Terminalia arjuna, Swertia chirata, and Azadirachta indica were found to have the highest relative importance. The underlying determinants influencing the preferences of individual users towards herbal medicine were income from agroforestry, beliefs, knowledge, and ethnicity, as revealed by the analysis of the ordinal logit model. The respondents viewed their strong inclination toward herbal medicine with many positive attitudes. Herbal medicine users held a negative perception of allopathy except for affiliation and practical reasons being viewed as the positive outcomes. Conversely, allopathic medicine users expressed mixed perceptions towards the treatment, with both positive and negative aspects being identified. Promoting the sustainable use of medicinal plants and their conservation efforts is imperative for the benefit of present and future generations in this region.

The untapped potential of cold water therapy as part of a lifestyle intervention for promoting healthy aging

Healthy aging is a crucial goal in aging societies of the western world, with various lifestyle strategies being employed to achieve it. Among these strategies, hydrotherapy stands out for its potential to promote cardiovascular and mental health. Cold water therapy, a hydrotherapy technique, has emerged as a lifestyle strategy with the potential capacity to evoke a wide array of health benefits. This review aims to synthesize the extensive body of research surrounding cold water therapy and its beneficial effects on various health systems as well as the underlying biological mechanisms driving these benefits. We conducted a search for interventional and observational cohort studies from MEDLINE and EMBASE up to July 2024. Deliberate exposure of the body to cold water results in distinct physiological responses that may be linked to several health benefits. Evidence, primarily from small interventional studies, suggests that cold water therapy positively impacts cardiometabolic risk factors, stimulates brown adipose tissue and promotes energy expenditure-potentially reducing the risk of cardiometabolic diseases. It also triggers the release of stress hormones, catecholamines and endorphins, enhancing alertness and elevating mood, which may alleviate mental health conditions. Cold water therapy also reduces inflammation, boosts the immune system, promotes sleep and enhances recovery following exercise. The optimal duration and temperature needed to derive maximal benefits is uncertain but current evidence suggests that short-term exposure and lower temperatures may be more beneficial. Overall, cold water therapy presents a potential lifestyle strategy to enhancing physical and mental well-being, promoting healthy aging and extending the healthspan, but definitive interventional evidence is warranted.

Effect of the health and wellness Kneipp concept on health promotion and reduction of sick days for kindergarten children: a cluster randomized controlled trial protocol

Background

The holistic health and wellness Kneipp concept, has a long tradition in Europe with demonstrated health benefits. Based on the five elements of the Kneipp concept, kindergartens in and around Germany are used to certify "Kneipp Kindergartens" that practice regular Kneipp applications and activities: cold water applications, exercise, nutrition, herbs and mind-body interventions. Little is known about the potential health benefits for children, however. This study protocol describes our study design and intervention of the Kita Kneipp Study to investigate the effect of the Kneipp concept on kindergarten children aged 2-6 years.

Methods and design

The Kita Kneipp Study, registered with the German Clinical Trial Register (DRKS-ID: DRKS00029275), is a confirmatory, mixed-method, two-armed, waitlist, clinical, cluster randomized controlled trial (RCT). Kindergartens in Berlin, Germany that would like to implement the Kneipp concept into their facility will be recruited and randomized to the intervention or control group. Changes in the number of kindergarten sick days will be the primary outcome measure. Kindergarten attendance and reason for absence including illness will be collected on a weekly basis at two time points for 6 weeks from the parents and kindergarten directors: baseline and 1 year after baseline. Secondary outcomes will measure cold symptoms through the Common Cold Questionnaire (CCQ) and National Cancer Institute - Common Terminology Criteria for Adverse Events (NCI-CTCAE) Scales describing gastroenterological-based symptoms Kindergarten educator sick days will be aggregately reported for the same time period. Kneipp concept activities will be recorded on a weekly basis over the one-year intervention period. To understand the experience of Kneipp concept implementation and possible changes in the kindergarten, expert interviews will be conducted with intervention kindergarten educators and focused ethnographies will be planned to observe and analyze the intervention activities.

Discussion

This mixed method study design has potential to help identify if the Kneipp concept can be used for salutogenic purposes among young children and provide insights and experience of the implementation and practicing a holistic health and wellness concept in a kindergarten setting.

Grounding (earthing) as related to electromagnetic hygiene: An integrative review

There are a growing number of studies investigating how grounding (earthing) the body may benefit biological performance and aid the treatment of non-communicable diseases. Research also indicates how biological grounding initiatives can sometimes be compromised, or inappropriate, and the need to take additional factors into account as potential contributory factors, or confounders, to expected results. It is proposed that expanding electromagnetic hygiene measures beyond biological grounding alone may help reduce spread of communicable diseases, incidence of respiratory conditions, neurodegenerative disease and all-cause mortality. Identifying potential synergies that exist could enable multilevel interventions to further increase the efficacy of measures. It is hoped that this review will help act as a catalyst to inspire and inform multi-disciplinary research within these topic areas, best practices and policies to help drive medical innovation, reduce health burdens, improve bioelectromagnetic-based therapies, and influence the general design of the built environment and next-generation technologies.

The Effect of Cold-Water Hydrotherapy According to Sebastian Kneipp for Immune Stimulation: A Nonrandomized, Controlled, Explorative, Mixed-Methods Clinical Study

Highlights Home-based hydrotherapy leads to fewer missed kindergarten-days in total. In the application group, more fever days could be registered. Hydrotherapy, according to the hormesis principle by Sebastian Kneipp, aims to reduce infections of the lower respiratory tract. Parents participation motivated by increase in applicable health knowledge for their children. Objectives: This study investigates the effect of cold-water hydrotherapy stimulation according to the hormesis principle by Sebastian Kneipp on the number of missing kindergarten-days, fever days, and respiratory tract infections in children aged 3-6 years. Study design: A nonrandomized, controlled, explorative, mixed-methods clinical study. Intervention: The hydrotherapeutic intervention treated children aged 3-6 years with Kneipp arm affusions over 6 weeks. The control group received no intervention. Number of missed kindergarten-days, fever days, and respiratory tract infections were assessed by means of a digital diary. Through a self-developed structured questionnaire, sociodemographic data of both groups were compared and reason for participation in the study was recorded and qualitatively evaluated. Results: Twenty children participants and their parents in the intervention group and 18 in the control group were evaluated. The intervention was conducted at home by the parents. Statistical analysis revealed no significant differences between the groups but still showed intermediate effect sizes (indicating an underpowered study). These effect sizes point to a potentially lower proportion of children in the application group versus the control group with missed kindergarten-days in total (d = 0.67), days missed due to fever (d = 0.29), and infections of the lower respiratory tract (d = 0.60). In a future study, these parameters will thus serve as promising factors for evaluation. Parent's stated reasons for participation interest were to improve health, increase their own health knowledge, and because of their interest in alternative therapies and to support research. Conclusions: Cold-water hydrotherapy stimulation, according to the hormesis principle by Sebastian Kneipp, did reduce the number of days absent in kindergarten in total in the intervention group and lower respiratory tract infections occurred less frequently. Parent' participation interest demonstrated a desire to increase health literacy and implement this with their own children. Due to the small sample size, the results should be interpreted cautiously. Clinical Trial Registration Number: German Register of Clinical Trials (DRKS): ID 00017562.

Mapping of Research in the Field of Forest Therapy-Related Issues: A Bibliometric Analysis for 2007-2021

Exposure to forest environments promotes human health. The number of relevant studies in this area has increased rapidly. However, an overall review of relevant analyses from the perspectives of bibliometrics and visualization is lacking. A scientometric analysis of 2,545 publications from 2007 to 2021 via the Web of Science database was conducted to identify the knowledge structure and frontiers objectively. The publications were subsequently analyzed in terms of the distribution of journals and countries, citation bursts, major subject areas, and evolutionary stages. The findings showed that the knowledge foundation of forest therapy was multidisciplinary with most published in the fields of environmental sciences and ecology but lacking input from social disciplines. The research hotspots evolved from the early focus on individual benefits obtained from nature to increasing attention on human well-being at the social-ecological scale. More rigorous experiments with strict randomized controlled trials and blinding are needed to accommodate the trend of forest therapy toward non-pharmacological treatments. According to Shneider's four-stage theory, forest therapy research is in the third stage of the scientific research process. More future studies utilizing novel technologies and decision-making frameworks to solve practical issues are needed for introducing health into policies and promoting human well-being.

Accelerating the Nature Deficit or Enhancing the Nature-Based Human Health during the Pandemic Era: An International Study in Cambodia, Indonesia, Japan, South Korea, and Myanmar, following the Start of the COVID-19 Pandemic

In modern society, the opportunity to experience nature is separate from everyday life, requiring time and effort. Since the start of the COVID-19 pandemic, restrictions on freedom of activity and communication around the world have become a crisis, causing a nature deficit by accelerating the process of separation from nature. At the same time, the pandemic has increased people’s motivation to return to nature, providing an opportunity to seek experiences and health recovery in nature. The authors conducted an international cross-sectional study in five Asian countries, investigating changes in the perception of recreational activities and health restoration in the natural environment, one of the many effects of the COVID-19 pandemic on human society. An online survey, completed by 524 respondents, has confirmed the efficacy of the SEM model, which includes COVID-19 stress, increased indoor activity, a preference for the natural environment, and the perception of health recovery. Although the five countries had different response values for each theme, the stress caused by restricted activities and communication during the pandemic was linked to a preference for natural experiences and the motivation to visit natural environments in all five countries, ultimately affecting perceptions of health recovery in nature. This study has shown that the COVID-19 pandemic, a disaster afflicting all human civilization, has changed people’s perceptions by enhancing their preference for natural recreational activities and health. It has accelerated people’s return to nature and fostered a positive perception of nature’s ability to promote good health.

The effect of Kneipp treatment hydrotherapy on secretory IgA in young children: A controlled, non-randomized clinical pilot study

OBJECTIVES

This pilot study analyses the effect and feasibility of hydrotherapeutic Kneipp arm affusions on secretory immunoglobulin A (sIgA) and classic cold symptoms in children 3-6 years of age.

STUDY DESIGN

A controlled, non-randomized, clinical pilot study was undertaken.

INTERVENTION

This descriptive hydrotherapeutic intervention treated children aged 3-6 with Kneipp arm affusions over four weeks. The control group received no intervention. At baseline and after the intervention, secretory IgA was measured, cold symptoms were assessed by means of the Common Cold Questionnaire (CCQ), and a semi-structured follow-up qualitative interview of the parents in the intervention group was conducted on acceptance and susceptibility to infection of the respiratory tract.

RESULTS

Fifteen participants were included in the intervention group and 15 were in the control group. The Kneipp arm affusions intervention was conducted at home and well-accepted by the children. No differences developed between the groups regarding sIgA. Comparing the symptoms by means of CCQ did not show symptoms of respiratory tract infections. In the intervention group, rhinitis occurred less frequently (26.7 % vs. 66.7 %, p = 0.057). In the qualitative analysis, 9/13 parents described an improvement in susceptibility to infections of the respiratory tract.

CONCLUSION

Due to the pilot character of this study, home hydrotherapy (Kneipp arm affusions) in healthy children is feasible but did not influence sIgA levels. The influence on infections of the respiratory tract after the intervention phase should be interpreted carefully. In qualitative interviews, parents described less susceptibility to infections of the respiratory tract by their children.

[Effekte der Kneipp-Therapie: Ein systematischer Review der aktuellen wissenschaftlichen Erkenntnisse (2000-2019)]

Einleitung: Ziel dieser systematischen Übersicht war die Bewertung der verfügbaren Evidenz zur Wirkung der Kneipp-Therapie. Methoden: MEDLINE, Embase, Web of Science, Cochrane-Library und CAMbase wurden nach relevanten Artikeln, veröffentlicht zwischen 2000 und 2019, durchsucht. Graue Literatur wurde über Google Scholar und andere Tools bezogen. Studien mit jeglicher Art von Studiendesign, die die Effekte der Kneipp-Therapie untersuchten, wurden eingeschlossen. Die Qualitätsbewertung erfolgte mittels EPHPP-QAT. Ergebnisse: 25 Quellen, darunter 14 kontrol-lierte Studien, wurden eingeschlossen. Gemäß EPHPP-QAT wurden 3 Studien "stark", 13 "moderat" und 9 "schwach" bewertet. Neun (64%) der kontrollierten Studien berichteten signifikante Verbesserungen nach Kneipp-Therapie im Gruppenvergleich bei chronisch-venöser Insuffizienz, Hypertonie, leichter Herzinsuffizienz, menopausalen Be-schwerden und Schlafstörungen in verschiedenen Patientenkollektiven sowie verbesserte Immunparameter bei gesunden Probanden. Im Hinblick auf Depression und Angst bei Mammakarzinom-Patientinnen mit klimakterischen Beschwerden, Lebensqualität bei Post-Polio-Syndrom, krankheitsbedingten polyneuropathischen Beschwerden und Inzidenz von Erkältungsepisoden bei Kindern konnten keine signifikanten Gruppenunterschiede festgestellt werden. Elf unkontrollierte Studien berichteten Verbesse-rungen bei allergischen Symptomen, Dyspepsie, Lebens-qualität, Herzratenvariabilität, Infekten, Hypertonie, Wohlbefinden, Schmerz und polyneuropathischen Beschwerden. Diskussion/Schlussfolgerung: Die Kneipp-Therapie scheint bei zahlreichen Beschwerdebildern in verschiedenen Patientenkollektiven positive Effekte zu bewirken. Zukünftige Studien sollten noch stärker auf eine methodisch sorgfältige Studienplanung achten (Kontrollgruppen, Randomisierung, adäquate Fallzahlen, Verblindung), um Verzerrungen entgegenzuwirken.

INTRODUCTION

The aim of this systematic review was to evaluate the available evidence on the effect of Kneipp therapy.

METHODS

MEDLINE, Embase, Web of Science, Cochrane Library and CAMbase were searched for relevant articles published between 2000 and 2019. Grey literature was obtained through Google Scholar and other tools. Studies with any kind of study design that examined the effects of Kneipp therapy were included. The quality assessment was carried out using EPHPP-QAT.

RESULTS

25 sources, including 14 controlled studies, were included. According to EPHPP-QAT, 3 studies were rated as “strong,” 13 as “moderate” and 9 as “weak.” Nine (64%) of the controlled studies reported significant improvements after Kneipp therapy in a between-group comparison in chronic venous insufficiency, hypertension, mild heart failure, menopausal complaints, and sleep disorders in different patient collectives as well as improved immune parameters in healthy subjects. Regarding depression and anxiety in breast cancer patients with climacteric complaints, quality of life in post-polio syndrome, disease-related polyneuropathic complaints and incidence of cold episodes in children, no significant group differences were found. Eleven uncontrolled studies reported improvements in allergic symptoms, dyspepsia, quality of life, heart rate variability, infections, hypertension, well-being, pain and polyneuropathic complaints.

DISCUSSION/CONCLUSION

Kneipp therapy seems to be beneficial for numerous symptoms in different patient groups. Future studies should pay even more attention to methodologically careful study planning (control groups, randomisation, adequate case numbers, blinding) to counteract bias.

Analysis of Oncological Second Opinions in a Certified University Breast and Gynecological Cancer Center in Relation to Complementary and Alternative Medicine

INTRODUCTION

Oncological second opinions are becoming increasingly important given more complex treatment strategies, simultaneously more patients use complementary and alternative medicine (CAM), and many comprehensive cancer centers initiate integrative medicine programs. The present study focuses on analyzing the effects of a second opinion in relation to attitudes toward CAM.

METHODS

In this prospective study patients (n = 97) with a diagnosis of breast cancer or gynecological malignancies who had requested a second opinion received a questionnaire before and after the second opinion concerning their attitudes toward CAM.

RESULTS

The majority of patients had breast cancer (72.2%, n = 70). Only 6.2% (n = 6) stated that they had been informed about CAM by the doctors who treated them first, 21.6% (n = 21) had received information about it when seeking the second opinion. After the first opinion, 42.3% (n = 41) wanted to try CAM, the same proportion trusted orthodox medicine alone. After the second opinion, 24 patients (24.7%) wanted to try CAM, while 38.1% (n = 37) relied exclusively on orthodox medicine. There was a significant correlation between an increased patients' need for information and interest in CAM (p = 0.02).

CONCLUSIONS

Today, aspects of CAM still are very often no part of oncological first and second opinions. This might hence lead to discouraging patients to try out CAM and therefore integrative medicine programs in comprehensive cancer centers might be problem-solving.

Applied Pediatric Integrative Medicine: What We Can Learn from the Ancient Teachings of Sebastian Kneipp in a Kindergarten Setting

Pediatric integrative medicine focuses on the whole child and the environment in which the child grows up during the treatment of a child’s illness. Nowadays, many different treatment modalities are applied even in children, and doctors need to know about them and, ideally, be able to apply different approaches in the process of treating a child themselves. The program Pediatric Integrative Medicine in Residency (PIMR) already provides residents with several tools to provide this kind of service for the child. In our PIMR pilot program in Germany, we chose to diversify our knowledge about treatment and prevention options by visiting a Kneipp-certified kindergarten in Germany. The philosophy of Sebastian Kneipp focuses on five pillars of health, which incorporate aspects of prevention, self-awareness, self-responsibility, and consciousness of health by means of hydrotherapy, herbal medicine, exercise, nutrition, and lifestyle-medicine. These are being taught to the children during the early years they spend in kindergarten, and represent integral parts of integrative medicine. Integration of Kneipp-based health programs within a kindergarten setting can work well and provides an effective means of early prevention education in childhood.