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PubMed2001

[Balneotherapy with arsenical-ferruginous water in chronic cervico-vaginitis. A case-control study].

BACKGROUND: The aim of this study was to evaluate the efficacy and tolerability of vaginal irrigations with arsenical-ferruginose water from the spa at Terme di Levico in chronic cervico-vaginitis in order to assess the validity of balneotherapy in improving the symptoms and quality of life of patients. METHODS: An open comparative study was performed in 30 patients with symptoms attributable to aspecific chronic vaginitis (in child-bearing age) or vulvovaginal dystrophy (perimenopausal age). Twenty patients (Group A) received balneotherapy and 10 (Group B) were treated with placebo vaginal suppositories. All patients were required to fill in a questionnaire on symptoms. A thorough gynecological examination was performed, together with a Pap-test and vaginal secretion sample for bacterioscopic and microbiological tests. The same tests were repeated at the end of treatment. RESULTS: Post-treatment results showed a general reduction in the extent of gynecological symptoms reported by patients. A statistically significant reduction was only observed in patients receiving balneotherapy for the following symptoms: vaginal burning , vulvar burning , vaginal itch , vulvar itch , leukorrhea . An analysis of the cytological tests performed in patients enrolled in the study highlighted a high prevalence of phlogistic type findings, often in association with varying degrees of atrophy in postmenopausal patients. Those patients suffering from chronic vaginitis undergoing balneotherapy showed a reduction in the prevalence of phlogistic findings after treatment. CONCLUSIONS: Treatment with arsenical-ferruginose water led lo a marked reduction in the subjective symptoms reports by the study population (particular evident in patients with chronic leukorrhea), as was confirmed by objective signs (clinical, cytological and microbiological) of phlogosis. This was accompanied by excellent tolerability. These results justify the use of balneotherapy, according to the classic techniques and methods, in chronic cervicovaginal phlogistic processes.

Adult↗
PubMed2001

The effect of balneotherapy at the Dead Sea on the quality of life of patients with fibromyalgia syndrome.

Fibromyalgia (FS) is an idiopathic chronic pain syndrome defined by widespread non-articular musculoskeletal pain and generalised tender points. As there is no effective treatment, patients with this condition have impaired quality of life (QoL). The aim of this study was to assess the possible effect of balneotherapy at the Dead Sea area on the QoL of patients with FS. Forty-eight subjects participated in the study; half of them received balneotherapy, and half did not. Their QoL (using SF-36), psychological well-being and FS-related symptoms were assessed prior to arrival at the spa hotel in the Dead Sea area, at the end of the 10-day stay, and 1 and 3 months later. A significant improvement was reported on most subscales of the SF-36 and on most symptoms. The improvement in physical aspects of QoL lasted usually 3 months, but on psychological measures the improvement was shorter. Subjects in the balneotherapy group reported higher and longer-lasting improvement than subjects in the control group. In conclusion, staying at the Dead Sea spa, in addition to balneotherapy, can transiently improve the QoL of patients with FS. Other studies with longer follow-up are needed to support our findings.

Balneology↗
PubMed2004

The effect of balneotherapy on osteoarthritis. Is an intermittent regimen effective?

Background: Balneotherapy is used as a treatment modality for various musculoskeletal disorders. The aim of this study was to evaluate the effectiveness of intermittent balneotherapy in patients with knee osteoarthritis (OA). Methods: Seventy-two patients with knee OA were included in the study. Patients were divided into two groups: group A (48 patients) was given intermittent once weekly treatment for 6 weeks; group B (24 patients) served as a control group. Evaluation was done prior to study entry, at weeks 4 and 6, and 4 weeks following completion of treatment (week 10). Assessment included global pain score (VAS), WOMAC index, Lequesne's functional index, patients' and physician's disease severity score, and NSAID/analgesic consumption. Results: Following balneotherapy, a statistically significant improvement, determined by the reduction in the mean changes of most outcome parameters (VAS, WOMAC, and Lequesne's index), was noted in group A at weeks 4 and 6 and was sustained 4 weeks after cessation of treatment (week 10). Significant improvement in both physician's and patients' disease severity scores, as well as a reduction in analgesic and NSAID consumption, were also noted in group A. No improvement was found in the control group in any of the tested parameters. Conclusions: Intermittent balneotherapy appears to be effective in the treatment of knee OA.

Journal Article↗
PubMed2006

The efficacy of balneotherapy and mud-pack therapy in patients with knee osteoarthritis.

OBJECTIVES: Knee osteoarthritis (OA) is a common chronic degenerative disorder. There are various treatment modalities. This study was planned to investigate the efficacy of balneotherapy, mud-pack therapy in patients with knee OA. METHODS: A total of 80 patients with knee OA were included. Their ages ranged between 39-78. The patients were separated in to three groups. Group I (n=25) received balneotherapy, group II (n=29) received mud-pack therapy and group III (n=26) was hot-pack therapy group. The therapies were applied for 20 min duration, once a day, five times per week and a total of 10 session. Patients were assessed according to pain, functional capacity and quality of life parameters. Pain was assessed by using Visual Analogue Scale (VAS) and Western Ontario McMaster Osteoarthritis Index (WOMAC) pain scale (0-4 likert scale). Functional capacity was assessed by using WOMAC functional capacity and WOMAC global index. Quality of life was evaluated by Nottingham Health Profile (NHP) self-administered questionnaire. Also physician's global assessment and the maximum distance that patient can walk without pain, were evaluated. The assessment parameters were evaluated before and after three months. RESULTS: There were statistically significant improvement in VAS and WOMAC pain scores in group I (p<0.001), group II and III (p<0.05). The WOMAC functional and global index also decreased in group I (p<0.05), group II (p<0.001) and hot-pack group (p<0.05). Quality of life results were significantly improved in balneotherapy and mud-pack therapy groups (p<0.05). No difference was observed in hot-pack therapy group (p>0.05). The maximum distance was improved both in group I and II (p<0.05) but not in group III. Also physician's global assessment was found to be improved in all groups (p<0.05). CONCLUSIONS: Balneotherapy and mud-pack therapy were effective in treating patients with knee OA.

Adult↗
PubMed2004

[Balneotherapy and spa therapy of rheumatic diseases in Turkey: a systematic review].

AIM: Turkey has a lot of thermal and mineral springs and is looking back on a still vivid tradition of spa therapy and balneotherapy, applied especially for the treatment of rheumatic diseases. This tradition is predominantly empiric and intuitive, however, it has assumed some important aspects of modern balneotherapeutic methods as well. This article is aimed at presenting the characteristics of traditional and modern balneological and spa therapy forms in Turkey. METHOD: The studies which have been conducted between 1990 and 2000 in different spas in Turkey on the efficacy and effectiveness of spa therapy and balneotherapy for rheumatic diseases have been searched and analyzed independent of their design. A descriptive evaluation of the studies was carried out. RESULTS: A total of 15 published studies have been found and analyzed. The investigations have been carried out in 8 different spa resorts in Turkey. In these studies the effectiveness and efficacy of different balneological and spa therapies on a variety of rheumatic diseases (from osteoarthritis to fibromyalgia and from rheumatoid arthritis to low back pain) could be shown. Nearly all studied balneotherapeutic modalities were applied as bathing cures. Only in one study peloid therapy was applied. Balneotherapeutic therapy was applied in a modern and traditional way, and both open and stationary spa therapy forms were used at the same time. CONCLUSIONS: The review has shown the effectiveness of the investigated spa therapy and balneotherapy forms. It could be concluded that nearly all forms of spa therapy and balneotherapy used for the treatment of rheumatic diseases in Turkey are effective. A definitive conclusion, however, is not possible because of the heterogeneity of the study designs, methodological flaws, and the publication bias. In future good quality randomized controlled trials are needed.

Balneology↗
PubMed2005

Effectiveness of balneotherapy in chronic low back pain -- a randomized single-blind controlled follow-up study.

OBJECTIVE: Balneotherapy, a domain of medical science, focuses on utilizing the beneficial effects of medicinal waters. Low back pain is among the most prevalent musculoskeletal disorders affecting a large proportion of the population during their lifetime. Although small in number, all controlled studies published on this subject have demonstrated the benefits of balneotherapy. This present study was undertaken to compare the effects of hydrotherapy with mineral water vs. tap water on low back pain. PATIENTS AND METHODS: A single-blind clinical study was carried out to appraise the therapeutic efficacy of reduced sulphurous water on 60 patients with low back pain. 30 subjects took baths in reduced sulphurous mineral water, whereas the other 30 patients used modified tap water of matching odor. Parameters determined at baseline, after balneo-/hydrotherapy, and at the end of the 3-month follow-up period included the results of the Visual Analogue Scale (VAS) score, the modified Oswestry index, mobility of the spine, antalgic posture, tenderness of the paravertebral muscles on palpation, the dose requirements for analgesics, and the efficacy assessed by the investigators and by the patients. RESULTS: Bathing in mineral water resulted in a statistically significant improvement. This was reflected by the VAS (p < 0.01) and manifested by the mitigation of muscle spasm (p < 0.01), the alleviation of local tenderness (p < 0.01), the enhanced flexion-extension and rotation of the spine (p < 0.01) as well as by the improvement of the Schober's index (p < 0.01). All these beneficial changes persisted as long as 3 months after the completion of balneotherapy. By contrast, hydrotherapy with tap water resulted only in the temporary improvement of just a single parameter: the VAS score improved significantly (p < 0.01). CONCLUSIONS: Balneotherapy in itself can alleviate low back pain. As demonstrated by this study, the analgesic efficacy and improvement of mobility accomplished by the use of mineral water is significantly superior to that afforded by hydrotherapy with tap water. Our results clearly establish the beneficial effects of mineral water. Moreover, it is a valuable adjunct to other forms of physical treatment as well as to pharmacotherapy.

Balneology↗
PubMed2004

[Efficacy and safety of hydrogen sulfide balneotherapy in ischemic heart disease the arid zone].

AIM: To evaluate efficacy of hydrogen sulfide (HS) balneotherapy in patients with coronary heart disease (CHD) in conditions of heat discomfort. MATERIAL AND METHODS: The study included 72 CHD patients aged 35 to 60 years with stable angina pectoris of the second functional class taking balneotherapy in summer under arid climatic conditions. Before and after balneotherapy the patients were examined with estimation of clinical symptoms, stress bicycle exercise (SBE) parameters, number of nitroglycerine tablets. RESULTS: The balneotherapy resulted in a significant prolongation of SBE (p < 0.0018), in longer time to depression of the ST segment by 1 mm (p < 0.01), to an anginal attack in the course of SBE (p < 0.0036), shorter duration of pain after SBE (p < 0.001), less number of anginal attacks (p < 0.0002) and reduced need in short-acting nitrates (p < 0.0002). CONCLUSION: In a hot climate of the arid zone use of moderate HS baths raises tolerance of CHD patients to exercise, attenuates clinical manifestations of CHD and, consequently, reduces daily need in nitrates.

Adult↗
PubMed1997

Taking baths: the efficacy of balneotherapy in patients with arthritis. A systematic review.

OBJECTIVE: To review English, French, German, and Dutch language studies of the effectiveness of balneotherapy. Balneotherapy (hydrotherapy or spa therapy) is one of the oldest forms of therapy for patients with arthritis. One of the aims of balneotherapy is to relieve pain. METHODS: We performed a systematic review that included randomized and nonrandomized studies. Quality scores of the studies were determined using a criteria list. RESULTS: Most studies report positive findings, but all studies showed methodological flaws. A quality of life measurement was never reported as an outcome measure. None of the randomized clinical trials included intention-to-treat analysis or comparison of effects between groups. CONCLUSION: Because of the methodological flaws a conclusion about the efficacy of balneotherapy cannot be provided from studies we reviewed. We conclude that most flaws found could be avoidable in future research.

Arthritis↗
PubMed1994

[Innovative balneotherapy with reduced bath volume: foil baths].

Balneo-phototherapy, in which salt baths are followed by UV-B irradiation, has proved successful in the treatment of psoriasis. Because of practical problems, the major one of which is the large turnover of bath solution volumes, balneotherapy has so far been limited to specialized treatment centres. With the aid of a polyethylene foil the volume of bathing solutions needed can be reduced to a total of 41 per bath. Balneotherapy using small bath solution volumes for total body treatment can now be applied as an outpatient regimen for salt bath and bath-PUVA therapy. The methods for establishing balneotherapy with restricted water volumes and the advantages of bath-PUVA over conventional oral psoralen therapy are described.

Balneology↗
PubMed2006

Spa therapy and balneotherapy for treating low back pain: meta-analysis of randomized trials.

OBJECTIVES: Low back pain is a major public health concern and complementary treatments are frequently used for this condition. The objective of this systematic review and meta-analysis was to assess the evidence for or against the effectiveness of spa therapy and balneotherapy for treating low back pain. METHODS: Systematic searches were conducted on Medline, Embase, Amed Cochrane Central, the UK National Research Register and ClincalTrials.gov (all until July 2005). Hand searches were performed and experts contacted. Methodological quality was assessed using a standard scale. RESULTS: Five randomized clinical trials met all inclusion criteria. Quantitative data synthesis was performed. The data for spa therapy, assessed on a 100 mm visual analogue scale (VAS), suggest significant beneficial effects compared with waiting list control groups (weighted mean difference 26.6 mm, 95% confidence interval 20.4-32.8, n=442) for patients with chronic low back pain. For balneotherapy the data, assessed on a 100 mm VAS, also suggest beneficial effects compared with control groups (weighted mean difference 18.8 mm, 95% confidence interval 10.3-27.3, n=138). CONCLUSIONS: Even though the data are scarce, there is encouraging evidence suggesting that spa therapy and balneotherapy may be effective for treating patients with low back pain. These data are not compelling but warrant rigorous large-scale trials.

Adult↗
PubMedDate not supplied

[Balneotherapy in the treatment of subjective symptoms of lumbar syndrome].

INTRODUCTION: Chronic low back pain is a degenerative rheumatic disease and is characterized by various symptoms and clinical signs. BALNEOTHERAPY: Balneotherapy represents a therapy by various hot or warm baths in natural mineral waters of specific physical and chemical characteristics. When used externally, they have mechanical, chemical and thermic effects. Balneotherapy of lumbar syndrome includes: individual baths, swimming in the pool, hydrokinesitherapy, underwater massage, underwater extension, mud therapy, mud baths. The therapy should be closely monitored for optimal efficacy and it is necessary to examine: functional status of the lumbosacral region, general functional status (level of activity), lower extremities, pain measurement, use of non-steroid antirheumatic and analgesic agents. In order to follow-up the effects of therapy and establish the prognosis it is important to perform: detailed anamnesis, anthropometric measurements, socio-epidemiological research, clinical examinations. CONCLUSION: Lumbar syndrome is usually caused by a degenerative disease of the spinal column. More than 25% of people under 45 years of age are unable to work due to chronic low back pain. That is why preventive measures, prompt diagnosis and adequate therapy are of utmost importance.

Balneology↗
PubMed1997

[Inpatient rehabilitation with balneotherapy in the elderly--our experience over the last 10 years].

We describe 308 patients hospitalized for rehabilitation incorporating balneotherapy in our hospital between 1986 and 1996, with respect to age, place of residence, disease, duration of impairment, duration of hospitalization, reason for hospitalization, person taking care of the patient, and family size. Patients in eighth decade of life were the most common and 41% of the patients were residents of Kusatsu. Cerebral diseases were the most common (36%). The average length of hospitalization was 72 days. The reason for hospitalization, person taking care of patient and family size were compared between patients 60 to 79 years old and patients 80 years old or older. Many patients came from afar to our hospital with expectation of rehabilitation using balneotherapy. More than half of the patients 80 years old or older were admitted at their own request without a doctor's letter of introduction. The person who most often took care of a patient 80 years old or older was the patient's daughter in law. The average length of hospitalization of patients who were taken care of by their wife, husband, daughter, son, daughter in law, and nobody were 58, 71, 75, 114, 86, and 124 days, respectively. Many patients 60 to 79 years old lived alone or with another family member, but most of those 80 years old or older lived with at least 2 other family members. The lack of a definite goal for rehabilitation might have prolonged these patients' hospital stays. Balneotherapy might have given them an incentive to continue their rehabilitation and made their quality of life better.

Aged↗
PubMed2002

The effects of balneotherapy on fibromyalgia patients.

Fibromyalgia syndrome (FMS) is a very common rheumatological diagnosis. There are various treatment modalities. This study was planned to investigate the effects of balneotherapy in the treatment of FMS. A total of 42 primary fibromyalgia patients diagnosed according to American College of Rheumatology criteria were included in the study. Their ages ranged between 30 and 55 years. Patients were randomly assigned to two groups. None of them had had a cardiovascular disease before. Group 1 n=22) received 20-min bathing, once a day and five times per week. Patients participated in the study for 3 weeks (total of 15 sessions). Group 2 (n=20) was accepted as the control group. Patients were evaluated by the number of tender points, Visual Analogue Scale for pain, Beck's Depression Index for depression, and Fibromyalgia Impact Questionnaire for functional capacity. Measurements were assessed initially, after the therapy, and at the end of the 6th month. In group 1, there were statistically significant differences in numbers of tender points, Visual Analogue scores, Beck's Depression Index, and Fibromyalgia Impact Questionnaire scores after the therapy program (P<0.001). Also, 6 months later in group 1, there was still an improvement in the number of tender points (P<0.001), Visual Analogue scores, and Fibromyalgia Impact Questionnaire (P<0.005). But there was not a statistical difference in Beck's Depression Index scores compared to the control group (P>0.05). Patients with FMS mostly complain about pain, anxiety, and the difficulty in daily living activities. This study shows that balneotherapy is effective and may be an alternative method in treating fibromyalgia patients.

Activities of Daily Living↗
PubMed2005

Balneotherapy in rheumatic diseases--an overview of novel and known aspects.

Balneotherapeutic applications to treat rheumatic diseases have a long-term tradition and are based on established scientific principles, and the majority of rheumatic diseases most frequently include balneotherapy. However, as other therapeutic strategies, balneological interventions require scientific proof of their effect and efficacy. Notably, recent studies providing evidence of the thermic and chemical effects on the immune system and cytokine milieu have enforced the revival of the traditional balneological interventions. This review provides an overview of the known as well as the novel aspects of balneotherapy and their clinical relevance in the treatment of rheumatic diseases.

Balneology↗
PubMed2005

Improvement of the clinical outcome in Ankylosing spondylitis by balneotherapy.

AIMS: This study is designed to show the efficacy of balneotherapy and balneotherapy (BT) + nonsteroid antiinflammatory drug (NSAID) use in Ankylosing spondylitis (AS) patients. METHODS: In this prospective study, BT, BT+ NSAID and NSAID therapy in 61 patients with AS were evaluated by ASAS core set. BT group (21 patients) was treated only with BT for 20 min, once a day, 5 days a week, over a period of 3 weeks. BT+NSAID group (20 patients) was treated with 1000 mg naproxen as well as BT. NSAID group (20 patients) was treated with 1000 mg naproxen. All of the participants did respiratory and postural exercises for 20 min a day and for the whole study period. Each patient was evaluated on admission (before treatment), at the end of the therapy and 6 months after the treatment. RESULTS: At the end of the study, statistically significant improvement was observed in all the clinical parameters of the patients in BT (G1), BT+NSAID (G2) and NSAID (G3) groups. This significant symptomatic and clinical improvement was maintained even 6 months after the treatment. The changes from baseline to follow up were similar in G1 and G2 except duration of morning stiffness (DMS) and chest expansion (CE). Improvements in CE and DMS were better in G1 and G2, respectively. Improvements observed in G1 and G2 were superior to the improvements observed in G3 for the variables of morning pain, nocturnal pain, DMS, global well being of the patient, occiput-wall distance, CE, finger to floor distance and functional index. In Schober test, improvement observed in G1 was statistically superior to G3. CONCLUSION: We concluded that BT can be suggested as an effective symptomatic treatment modality in patients with AS. Furthermore, sufficient improvement in clinical parameters can be obtained by BT alone.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1992

[Treatment of acute salpingitis with tetracycline/metronidazole with or without additional balneotherapy, Augmentin or ciprofloxacin/metronidazole: a second-look laparoscopy study].

110 patients suffering from laparoscopical verified salpingitis and desire for a baby, were treated with tetracycline (oxytetracycline or doxycycline; TC)/metronidazole (n = 67), augmentan (n = 22) or cipropfloxacin/metronidazole (n = 21). After an average period of 11.6 weeks, all patients underwent second-look laparoscopy with dye insufflation. In 34 patients treated with TC/metronidazole, the effects of additional physio-therapeutical measures were examined under conditions as they prevail in a Spa. 33 patients without balneotherapy served as controls. All the 4 groups were comparable (p greater than 0.05) in respect of mean age, percentage, share of nulliparous women, salpingitis gonorrhoica, contraceptive behaviour and also of the stage of salpingitis. All antibiotic regimens used resulted in a prompt decrease of inflammatory clinical signs after five days (temperature, blood sedimentation rate, leukocytes). Only 2 of 34 patients treated by additional cure at a Spa reported complaints, whereas complaints were reported by 14 of 33 control patients (p less than 0.01), 7 of 22 (p less than 0.01) treated with augmentan and to 7 of 21 (p less than 0.01) treated with ciprofloxacin/metronidazole. The tubal occlusion rates amounted to 33.3% (TC/metronidazole), 32.3% (TC/metronidazole and balneotherapy), 22.7% (augmentan) and 23.8% ciprofloxacin/metronidazole. The differences did not attain statistical significance (p greater than 0.05). With regard to adhesions, there were, likewise, no significant differences between findings at first laparoscopy and second look-laparoscopy, respectively. It is concluded, that additional physiotherapeutic measures, after antibiotic therapy of acute salpingitis, reduce the frequency of lower abdominal pain, but do not result in an improvement of tubal occlusion and reduction of adhesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Modification to the erythrocyte membrane lipids in patients with cardiovascular pathology during balneotherapy].

Erythrocyte phospholipids (FL) composition and their elements polyunsaturated fatty acids of omega-6 and omega-3 type were studied in the course of combined balneotherapy of neurocirculatory dystonia and ischemic heart disease (IHD) patients. The balneological factors promoted FL concentration normalization under positive dynamics in clinical symptoms in 62% of patients with neurocirculatory dystonia. The modulating effect occurred in IHD only in those patients who, in addition to balneotherapy, took alimentary omega-3 fatty acids made of sea products as food additives. The intensity of the FL and fatty acid modification to the end of the treatment was related to the severity of the baseline metabolic abnormalities.

Adolescent↗
PubMedDate not supplied

[Possible use of balneotherapy for atherosclerosis prevention].

Balneotherapy was assessed as a method of primary prevention of atherosclerosis. The effectiveness of effervescent hydrocarbonate magnesium-calcium water was evaluated by modification of structural-functional state of red cell membrane in examinees with risk factors. It is shown that combined balneotherapy remodels abnormal lipid component of cellular membranes. This allows using this method in primary prevention of atherosclerosis in persons with risk factors in the absence of changes in serum lipid spectrum.

Adult↗