CYBERMED LIFE - ORGANIC  & NATURAL LIVING

Spa Bathing

Spa Bathing: A spa is a location where mineral-rich spring water (and sometimes seawater) is used to give medicinal baths. Spa towns or spa resorts (including hot springs resorts) typically offer various health treatments, which are also known as balneotherapy. The belief in the curative powers of mineral waters goes back to prehistoric times. Such practices have been popular worldwide, but are especially widespread in Europe and Japan. Day spas are also quite popular, and offer various personal care treatments.

Spa therapies have existed since the classical times when taking bath with water was considered as a popular means to treat illnesses. The practice of traveling to hot or cold springs in hopes of effecting a cure of some ailment dates back to prehistoric times. Archaeological investigations near hot springs in France and Czech Republic revealed Bronze Age weapons and offerings. In Great Britain, ancient legend credited early Celtic kings with the discovery of the hot springs in Bath, England.

Many people around the world believed that bathing in a particular spring, well, or river resulted in physical and spiritual purification. Forms of ritual purification existed among the Native Americans, Babylonians, Egyptians, Greeks, and Romans. Today, ritual purification through water can be found in the religious ceremonies of Jews, Muslims, Christians, Buddhists, and Hindus. These ceremonies reflect the ancient belief in the healing and purifying properties of water. Complex bathing rituals were also practiced in ancient Egypt, in prehistoric cities of the Indus Valley, and in Aegean civilizations. Most often these ancient people did little building construction around the water, and what they did construct was very temporary in nature.

Bathing in Greek and Roman times

Some of the earliest descriptions of western bathing practices came from Greece. The Greeks began bathing regimens that formed the foundation for modern spa procedures. These Aegean people utilized small bathtubs, wash basins, and foot baths for personal cleanliness. The earliest such findings are the baths in the palace complex at Knossos, Crete, and the luxurious alabaster bathtubs excavated in Akrotiri, Santorini; both date from the mid-2nd millennium BC. They established public baths and showers within their gymnasium complexes for relaxation and personal hygiene. Greek mythology specified that certain natural springs or tidal pools were blessed by the gods to cure disease. Around these sacred pools, Greeks established bathing facilities for those desiring healing. Supplicants left offerings to the gods for healing at these sites and bathed themselves in hopes of a cure. The Spartans developed a primitive vapor bath. At Serangeum, an early Greek balneum (bathhouse, loosely translated), bathing chambers were cut into the hillside from which the hot springs issued. A series of niches cut into the rock above the chambers held bathers' clothing. One of the bathing chambers had a decorative mosaic floor depicting a driver and chariot pulled by four horses, a woman followed by two dogs, and a dolphin below. Thus, the early Greeks used the natural features, but expanded them and added their own amenities, such as decorations and shelves. During later Greek civilization, bathhouses were often built in conjunction with athletic fields.

The Romans emulated many of the Greek bathing practices. Romans surpassed the Greeks in the size and complexity of their baths. This came about by many factors: the larger size and population of Roman cities, the availability of running water following the building of aqueducts, and the invention of cement, which made building large edifices easier, safer, and cheaper. As in Greece, the Roman bath became a focal center for social and recreational activity. As the Roman Empire expanded, the idea of the public bath spread to all parts of the Mediterranean and into regions of Europe and North Africa. With the construction of the aqueducts, the Romans had enough water not only for domestic, agricultural, and industrial uses, but also for their leisurely pursuits. The aqueducts provided water that was later heated for use in the baths. Today, the extent of the Roman bath is revealed at ruins and in archaeological excavations in Europe, Africa, and the Middle East.

The Romans also developed baths in their colonies, taking advantage of the natural hot springs occurring in Europe to construct baths at Aix and Vichy in France, Bath and Buxton in England, Aachen and Wiesbaden in Germany, Baden, Austria, and Aquincum in Hungary, among other locations. These baths became centers for recreational and social activities in Roman communities. Libraries, lecture halls, gymnasiums, and formal gardens became part of some bath complexes. In addition, the Romans used the hot thermal waters to relieve their suffering from rheumatism, arthritis, and overindulgence in food and drink. The decline of the Roman Empire in the west, beginning in AD 337 after the death of Emperor Constantine, resulted in Roman legions abandoning their outlying provinces and leaving the baths to be taken over by the local population or destroyed.

Thus, the Romans elevated bathing to a fine art, and their bathhouses physically reflected these advancements. The Roman bath, for instance, included a far more complex ritual than a simple immersion or sweating procedure. The various parts of the bathing ritual — undressing, bathing, sweating, receiving a massage, and resting — required separated rooms which the Romans built to accommodate those functions. The segregation of the sexes and the additions of diversions not directly related to bathing also had direct impacts on the shape and form of bathhouses. The elaborate Roman bathing ritual and its resultant architecture served as precedents for later European and American bathing facilities. Formal garden spaces and opulent architectural arrangement equal to those of the Romans reappeared in Europe by the end of the 18th century. Major American spas followed suit a century later

Bathing in medieval times

With the decline of the Roman Empire, the public baths often became places of licentious behavior, and such use was responsible for the spread rather than the cure of diseases. A general belief developed among the European populace was that frequent bathing promoted disease and sickness. Medieval church authorities encouraged this belief and made every effort to close down public baths. Ecclesiastical officials believed that public bathing created an environment open to immorality and disease. Roman Catholic Church officials even banned public bathing in an unsuccessful effort to halt syphilis epidemics from sweeping Europe. Overall, this period represented a time of decline for public bathing.

People continued to seek out a few select hot and cold springs, believed to be holy wells, to cure various ailments. In an age of religious fervor, the benefits of the water were attributed to God or one of the saints. In 1326, Collin le Loup, an iron-master from Liège, Belgium, discovered the chalybeate springs of Spa, Belgium. Around these springs, a famous health resort eventually grew and the term "spa" came to refer to any health resort located near natural springs. During this period, individual springs became associated with the specific ailment that they could allegedly benefit.

Bathing procedures during this period varied greatly. By the 16th century, physicians at Karlsbad, Bohemia, prescribed that the mineral water be taken internally as well as externally. Patients periodically bathed in warm water for up to 10 or 11 hours while drinking glasses of mineral water. The first bath session occurred in the morning, the second in the afternoon. This treatment lasted several days until skin pustules formed and broke resulting in the draining of "poisons" considered to be the source of the disease. Then followed another series of shorter, hotter baths to wash the infection away and close the eruptions.

In the English coastal town of Scarborough in 1626, a Mrs. Elizabeth Farrow discovered a stream of acidic water running from one of the cliffs to the south of the town. This was deemed to have beneficial health properties and gave birth to Scarborough Spa. Dr Wittie's book about the spa waters published in 1660 attracted a flood of visitors to the town. Sea bathing was added to the cure, and Scarborough became Britain's first seaside resort. The first rolling bathing machines for bathers are recorded on the sands in 1735.

Bathing in the 18th century

In the 17th century, most upper-class Europeans washed their clothes with water often and washed only their faces (with linen), feeling that bathing the entire body was a lower-class activity; but the upper-class slowly began changing their attitudes toward bathing as a way to restore health later in that century. The wealthy flocked to health resorts to drink and bathe in the waters. In 1702, Anne, Queen of Great Britain, traveled to Bath, the former Roman development, to bathe. A short time later, Richard (Beau) Nash came to Bath. By the force of his personality, Nash became the arbiter of good taste and manners in England. He along with financier Ralph Allen and architect John Wood transformed Bath from a country spa into the social capital of England. Bath set the tone for other spas in Europe to follow. Ostensibly, the wealthy and famous arrived there on a seasonal basis to bathe in and drink the water; however, they also came to display their opulence. Social activities at Bath included dances, concerts, playing cards, lectures, and promenading down the street.

A typical day at Bath might be an early morning communal bath followed by a private breakfast party. Afterwards, one either drank water at the Pump Room (a building constructed over the thermal water source) or attended a fashion show. Physicians encouraged health resort patrons to bathe in and drink the waters with equal vigor. The next several hours of the day could be spent in shopping, visiting the lending library, attending concerts, or stopping at one of the coffeehouses. At 4:00 pm, the rich and famous dressed up in their finery and promenaded down the streets. Next came dinner, more promenading, and an evening of dancing or gambling.

Similar activities occurred in health resorts throughout Europe. The spas became stages on which Europeans paraded with great pageantry. These resorts became infamous as places full of gossip and scandals. The various social and economic classes selected specific seasons during the year's course, staying from one to several months, to vacation at each resort. One season aristocrats occupied the resorts; at other times, prosperous farmers or retired military men took the baths. The wealthy and the criminals that preyed on them moved from one spa to the next as the fashionable season for that resort changed.

During the 18th century, a revival in the medical uses of spring water was promoted by Enlightened physicians across Europe. This revival changed the way of taking a spa treatment. For example, in Karlsbad the accepted method of drinking the mineral water required sending large barrels to individual boardinghouses where the patients drank physician-prescribed dosages in the solitude of their rooms. Dr. David Beecher in 1777 recommended that the patients come to the fountainhead for the water and that each patient should first do some prescribed exercises. This innovation increased the medicinal benefits obtained and gradually physical activity became part of the European bathing regimen. In 1797, in England, Dr. James Currie published The Effects of Water, Cold and Warm, as a Remedy in Fever and other Diseases. As shown by M D Eddy, this book, along with numerous local pamphlets on composition of spa water, stimulated additional interest in water cures and advocated the external and internal use of water as part of the curing process.

 

Bathing in the 19th and 20th centuries

In the 19th century, bathing became a more accepted practice as physicians realized some of the benefits that cleanliness could provide. A cholera epidemic in Liverpool, England in 1842 resulted in a sanitation renaissance, facilitated by the overlapping hydropathy and sanitation movements, and the implementation of a series of statutes known collectively as "The Baths and Wash-houses Acts 1846 to 1896". The result was increased facilities for bathing and washed clothes, and more people participating in these activities.

Also in 1842, a house in Cincinnati, Ohio, received the first indoor bathtub in the United States. Bathing, however, was still not a universal custom. Only one year later — in 1843 — bathing between 1 November and 15 March was outlawed in Philadelphia, Pennsylvania, as a health measure, and in 1845 bathing was banned in Boston, Massachusetts, unless under the direct orders of a physician. The situation improved, however, and by 1867 in Philadelphia most houses of the well-to-do had tubs and indoor plumbing. In England, hot showers were installed in barracks and schools by the 1880s. The taboos against bathing disappeared with advancements in medical science; the worldwide medical community was even promoting the benefits of bathing. In addition, the Victorian taste for the exotic lent itself perfectly to seeking out the curative powers of thermal water.

In most instances, the formal architectural development of European spas took place in the 18th and 19th centuries. The architecture of Bath, England, developed along Georgian and Neoclassical lines, generally following Palladian structures. The most important architectural form that emerged was the "crescent" — a semi-elliptical street plan used in many areas of England. The spa architecture of Carlsbad, Marienbad, Franzensbad, and Baden-Baden was primarily Neoclassical, but the literature seems to indicate that large bathhouses were not constructed until well into the 19th century. The emphasis on drinking the waters rather than bathing in them led to the development of separate structures known as Trinkhallen (drinking halls) where those taking the cure spent hours drinking water from the springs.

By the mid-19th century, the situation had changed dramatically. Visitors to the European spas began to stress bathing in addition to drinking the waters. Besides fountains, pavilions, and Trinkhallen, bathhouses on the scale of the Roman baths were revived. Photographs of a 19th-century spa complex taken in the 1930s, detailing the earlier architecture, show a heavy use of mosaic floors, marble walls, classical statuary, arched openings, domed ceilings, segmental arches, triangular pediments, Corinthian columns, and all the other trappings of a Neoclassical revival. The buildings were usually separated by function — with the Trinkhalle, the bathhouse, the inhalatorium (for inhaling the vapors), and the Kurhaus or Conversationhaus that was the center of social activity. Baden-Baden featured golf courses and tennis courts, "superb roads to motor over, and drives along quaint lanes where wild deer are as common as cows to us, and almost as unafraid".

The European spa, then, started with structures to house the drinking function — from simple fountains to pavilions to elaborate Trinkhallen. The enormous bathhouses came later in the 19th century as a renewed preference for an elaborate bathing ritual to cure ills and improve health came into vogue. European architects looked back to Roman civilizations and carefully studied its fine architectural precedents. The Europeans copied the same formality, symmetry, division of rooms by function, and opulent interior design in their bathhouses. They emulated the fountains and formal garden spaces in their resorts, and they also added new diversions. The tour books always mentioned the roomy, woodsy offerings in the vicinity and the faster-paced evening diversions.

By the beginning of the 19th century, the European bathing regimen consisted of numerous accumulated traditions. The bathing routine included soaking in hot water, drinking the water, steaming in a vapor room, and relaxing in a cooling room. In addition doctors ordered that patients be douched with hot or cold water and given a select diet to promote a cure. Authors began writing guidebooks to the health resorts of Europe explaining the medical benefits and social amenities of each. Rich Europeans and Americans traveled to these resorts to take in cultural activities and the baths.

Each European spa began offering similar cures while maintaining a certain amount of individuality. The 19th-century bathing regimen at Karlsbad can serve as a general portrayal of European bathing practices during this century. Visitors arose at 6 am to drink the water and be serenaded by a band. Next came a light breakfast, bath, and lunch. The doctors at Karlsbad usually limited patients to certain foods for each meal. In the afternoon, visitors went sight-seeing or attended concerts. Nightly theatrical performances followed the evening meal. This ended around 9 pm with the patients returning to their boardinghouses to sleep until 6 the next morning. This regimen continued for as long as a month and then the patients returned home until the next year. Other 19th-century European spa regimens followed similar schedules.

At the beginning of the 20th century, European spas combined a strict diet and exercise regimen with a complex bathing procedure to achieve benefits for the patients. One example will suffice to illustrate the change in bathing procedures. Patients at Baden-Baden, which specialized in treating rheumatoid arthritis, were directed to see a doctor before taking the baths. Once this occurred, the bathers proceeded to the main bathhouse where they paid for their baths and stored their valuables before being assigned a booth for undressing. The bathhouse supplied bathers with towels, sheets, and slippers.

The Baden-Baden bathing procedure began with a warm shower. The bathers next entered a room of circulating, 140 °F (60 °C) hot air for 20 minutes, spent another ten minutes in a room with 150 °F (66 °C) temperature, partook of a 154 °F (68 °C) vapor bath, then showered and received a soap massage. After the massage, the bathers swam in a pool heated approximately to body temperature. After the swim, the bathers rested for 15 to 20 minutes in the warm "Sprudel" room pool . This shallow pool's bottom contained an 8-inch (200 mm) layer of sand through with naturally carbonated water bubbled up. This was followed by a series of gradually cooler showers and pools. After that, the attendants rubbed down the bathers with warm towels and then wrapped them in sheets and covered them with blankets to rest for 20 minutes. This ended the bathing portion of the treatment. The rest of the cure consisted of a prescribed diet, exercise, and water-drinking program.

The European spas provided various other diversions for guests after the bath, including gambling, horse racing, fishing, hunting, tennis, skating, dancing, golf, and horseback riding. Sight-seeing and theatrical performances served as further incentives for people to go to the spa. Some European governments even recognized the medical benefits of spa therapy and paid a portion of the patient's expenses. A number of these spas catered to those suffering from obesity and overindulgence in addition to various other medical complaints. In recent years, elegance and style of earlier centuries may have diminished, but people still come to the natural hot springs for relaxation and health. In Germany, the tradition survives to the present day. 'Taking a cure' (Kur) at a spa is covered 100% by both public and private health care insurance, as mandated by federal legislation. Typically, a doctor prescribes a few weeks, no less than two weeks, but generally four to six weeks, stay at a mineral spring or other natural setting where a patient's condition will be treated with healing spring waters and natural therapies. In addition to the treatment and accommodations even all meals and drinks as well as entertainment is paid for by the insurance. Most Germans are eligible every two to six years, depending on the severity of the condition. Germans get paid their regular salary during this time away from their job which is not taken out of their vacation days.

In colonial America

Some European colonists brought with them knowledge of the hot water therapy for medicinal purposes, and others learned the benefits of hot springs from the Native Americans. Europeans gradually obtained many of the hot and cold springs from the various Indian tribes. They then developed the spring to suit European tastes. By the 1760s, British colonists were traveling to hot and cold springs in Connecticut, Pennsylvania, New York, and Virginia in search of water cures. Among the more frequently visited of these springs were Bath, Yellow, and Bristol Springs in Pennsylvania; and Warm Springs, Hot Springs, and White Sulphur Springs (now in West Virginia) in Virginia. In the last decade of the 1700s, New York spas were beginning to be frequented by intrepid travelers, most notably Ballston Spa. Nearby Saratoga Springs and Kinderhook were yet to be discovered.

Colonial doctors gradually began to recommend hot springs for ailments. Dr. Benjamin Rush, American patriot and physician, praised the springs of Bristol, Pennsylvania, in 1773. Dr. Samuel Tenney in 1783 and Dr. Valentine Seaman in 1792 examined the water of Ballston Spa in New York and wrote of possible medicinal uses of the springs. Hotels were constructed to accommodate visitors to the various springs. Entrepreneurs operated establishments where the travelers could lodge, eat, and drink. Thus began the health resort industry in the United States.

Bathing in 19th- and 20th-century America

After the American Revolution, the spa industry continued to gain popularity. The first truly popular spa was Saratoga Springs, which, by 1815, had two large, four-story, Greek revival hotels. It grew rapidly, and by 1821 it had at least five hundred rooms for accommodation. Its relative proximity to New York City and access to the country's most developed steamboat lines meant that by the mid-1820s the spa became the country's most popular tourist destination, serving both the country's elite and a more middle-class audience. Although spa activity had been central to Saratoga in the 1810s, by the 1820s the resort had hotels with great ballrooms, opera houses, stores, and clubhouses. The Union Hotel (first built in 1803 but steadily expanded over the coming decades) had its own esplanade, and by the 1820s had its own fountain and formal landscaping, but with only two small bathhouses. As the resort developed as a tourist destination mineral bathhouses became auxiliary structures and not the central features of the resort, although the drinking of mineral water was at least followed as a pro-forma activity by most in attendance, despite nightly dinners that were elaborate and extensive. Although Saratoga and other spas in New York centered their developments around the healthful mineral waters, their real drawing card was a complex social life and a cultural cachet. However, the wider audience it garnered by the late 1820s began to take some of the bloom off the resort, and in the mid-1830s, as a successful bid to revive itself, it turned to horse racing.

By the mid-1850s hot and cold spring resorts existed in 20 states. Many of these resorts contained similar architectural features. Most health resorts had a large, two-story central building near or at the springs, with smaller structures surrounding it. The main building provided the guests with facilities for dining, and possibly, dancing on the first floor, and the second story consisted of sleeping rooms. The outlying structures were individual guest cabins, and other auxiliary buildings formed a semicircle or U-shape around the large building.

These resorts offered swimming, fishing, hunting, and horseback riding as well as facilities for bathing. The Virginia resorts, particularly White Sulphur Springs, proved popular before and after the Civil War. After the Civil War, spa vacations became very popular as returning soldiers bathed to heal wounds and the American economy allowed more leisure time. Saratoga Springs in New York became one of the main centers for this type of activity. Bathing in and drinking the warm, carbonated spring water only served as a prelude to the more interesting social activities of gambling, promenading, horse racing, and dancing.

During the last half of the 19th century, western entrepreneurs developed natural hot and cold springs into resorts — from the Mississippi River to the West Coast. Many of these spas offered individual tub baths, vapor baths, douche sprays, needle showers, and pool bathing to their guests. The various railroads that spanned the country promoted these resorts to encourage train travel. Hot Springs, Arkansas, became a major resort for people from the large metropolitan areas of St. Louis and Chicago.

The popularity of the spas continued into the 20th century. Some medical critics, however, charged that the thermal waters in such renowned resorts as Hot Springs, Virginia, and Saratoga Springs, New York, were no more beneficial to health than ordinary heated water. The various spa owners countered these arguments by developing better hydrotherapy for their patients. At the Saratoga spa, treatments for heart and circulatory disorders, rheumatic conditions, nervous disorders, metabolic diseases, and skin diseases were developed. In 1910, the New York state government began purchasing the principal springs to protect them from exploitation. When Franklin Delano Roosevelt was governor of New York, he pushed for a European type of spa development at Saratoga. The architects for the new complex spent two years studying the technical aspects of bathing in Europe. Completed in 1933, the development had three bathhouses — Lincoln, Washington, and Roosevelt — a drinking hall, the Hall of Springs, and a building housing the Simon Baruch Research Institute. Four additional buildings composed the recreation area and housed arcades and a swimming pool decorated with blue faience terra-cotta tile. Saratoga Spa State Park's Neoclassical buildings were laid out in a grand manner, with formal perpendicular axes, solid brick construction, and stone and concrete Roman-revival detailing. The spa was surrounded by a 1,200-acre (4.9 km2) natural park that had 18 miles (29 km) of bridle paths, "with measured walks at scientifically calculated gradients through its groves and vales, with spouting springs adding unexpected touches to its vistas, with the tumbling waters of Geyser Brook flowing beneath bridges of the fine roads. Full advantage has been taken of the natural beauty of the park, but no formal landscaping". Promotional literature again advertised the attractions directly outside the spa: shopping, horse races, and historic sites associated with revolutionary war history. New York Governor Herbert Lehman opened the new facilities to the public in July 1935.

Other leading spas in the U.S. during this period were French Lick, Indiana; Hot Springs and White Sulphur Springs, West Virginia; Hot Springs, Arkansas; and Warm Springs, Georgia. French Lick specialized in treating obesity and constipation through a combination of bathing and drinking the water and exercising. Hot Springs, Virginia, specialized in digestive ailments and heart diseases, and White Sulphur Springs, Virginia, treated these ailments and skin diseases. Both resorts offered baths where the water would wash continuously over the patients as they lay in a shallow pool. Warm Springs, Georgia, gained a reputation for treating infantile paralysis by a procedure of baths and exercise. President Franklin D. Roosevelt, who earlier supported Saratoga, became a frequent visitor and promoter of this spa.

  • Atrial natriuretic factor: one of the mechanisms of action of the phlebology bath at Barbotan

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    Abstract Title:

    [Atrial natriuretic factor: one of the mechanisms of action of the phlebology bath at Barbotan].

    Abstract Source:

    J Mal Vasc. 1991;16(2):99-104. PMID: 1830607

    Abstract Author(s):

    J Suffran, F X Galen, G Habrioux, C Norelle, D Mas, N Barbelet, C Bianchi, M T Capdepont, D Gautier, J Lachèze

    Abstract:

    The effect of thermal baths on oedema of the lower limbs might be explained by physical mechanisms of hydrostatic pressure resulting from the use of a deep bath and a centripetal underwater jet, by which the veins and lymph ducts are drained every day. The purpose of this experiment is to demonstrate the existence of hormonal mechanisms which would account for the diuretic effect of thermal baths. One of the effects observed with hydrotherapy is the physiological diuresis that follows each bath, this diuresis would appear to depend at least in part on the atrial natriuretic factor (ANF). The criteria by which assessment can be made essentially biological: ANF level and its biological effects on blood and urine; aldosterone level; plasma renin activity (PRA); creatinine clearance; hematocrit; proteinemia; and blood and urine electrolyte balance. The inclusion criteria are: subjects selected at random and willing cooperate. The criteria for exclusion are disease states which modify ANF kinesis: congestive heart failure, cardiac rhythm disorders, decompensated cirrhosis of liver, obesity, treatment antihypertensive drugs. METHODS: Thirty patients were put through the same experimental sequence, as follows: emptying of the bladder and ingestion of 200 cc of water; seated rest fort 30 mn, after which (to): blood sample; urine sample; ingestion of 200 cc of water; deep bath for 20 mn, i.e. the basic hydro treatment in phlebology at Barbotan. The deep bath is specific to Barbotan and the patient is subjected to maximum immersion in water at a mesothermal temperature of 34.5 degrees C, followed by (t1): blood and urine sample; ingestion of 200 cc of water; supine rest for 90 mn, followed by (t2): blood and urine sample. RESULTS: Data from twenty-eight patients were usable. In this protocol, we use variance analysis with repeated measurements and a 95% confidence limit. The mean value of the principal parameters studies are set out in the following table; these value are accompanied by the degree of significance of the modification at (t1) and (t2). Our experimentation with thirty patients showed that the big thermal bath at Barbotan produces a highly significant increase in ANF secretion, resulting in the diuresis observed after the use of the bath. The antagonist effect of AFN on the renin--angiotensin-aldosterone system was corroborated: we found decreased aldosterone, PRA and creatinine clearance, and increased diuresis and natriuresis. The renal and cardiovascular effects observed after extended immersion in the Barbotan bath (increased diuresis, tachycardia and hypotension, transitory venous vasoplegia and ephemeral vasodilatation of the surface capillaries) are the result of increased ANF secretion. [formula: see text] Supine rest immediately after the bath is essential. This sustains the enhanced ANF and thus reinforces its renal effects, while reducing adverse cardiovascular effects such as the orthostatic hypotension and venous vasoplegia that are normally observed after use of the bath. Moreover, by reducing venular and lymphatic pressure, clinostatism facilitate interstitial to intravascular tissue fluid exchanges and thus helps to drain oedema from the legs. It is striking to note that the hydrotherapy prescribed at Barbotan les Thermes has always included the three most potent factors for ANF release: deep immersion in the big bath, immediate supine rest, and walking. Physiological diuresis has thus been induced empirically as an essential part of the treatment of lower limb phlebopathies.

  • Bathing in a magnesium-rich Dead Sea salt solution improves skin barrier function, enhances skin hydration, and reduces inflammation in atopic dry skin.

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    Abstract Title:

    Bathing in a magnesium-rich Dead Sea salt solution improves skin barrier function, enhances skin hydration, and reduces inflammation in atopic dry skin.

    Abstract Source:

    Int J Dermatol. 2005 Feb;44(2):151-7. PMID: 15689218

    Abstract Author(s):

    Ehrhardt Proksch, Hans-Peter Nissen, Markus Bremgartner, Colin Urquhart

    Article Affiliation:

    Department of Dermatology, University of Kiel, Kiel, Germany. This email address is being protected from spambots. You need JavaScript enabled to view it.

    Abstract:

    Magnesium salts, the prevalent minerals in Dead Sea water, are known to exhibit favorable effects in inflammatory diseases. We examined the efficacy of bathing atopic subjects in a salt rich in magnesium chloride from deep layers of the Dead Sea (Mavena(R) Dermaline Mg(46) Dead Sea salt, Mavena AG, Belp, Switzerland). Volunteers with atopic dry skin submerged one forearm for 15 min in a bath solution containing 5% Dead Sea salt. The second arm was submerged in tap water as control. Before the study and at weeks 1-6, transepidermal water loss (TEWL), skin hydration, skin roughness, and skin redness were determined. We found one subgroup with a normal and one subgroup with an elevated TEWL before the study. Bathing in the Dead Sea salt solution significantly improved skin barrier function compared with the tap water-treated control forearm in the subgroup with elevated basal TEWL. Skin hydration was enhanced on the forearm treated with the Dead Sea salt in each group, which means the treatment moisturized the skin. Skin roughness and redness of the skin as a marker for inflammation were significantly reduced after bathing in the salt solution. This demonstrates that bathing in the salt solution was well tolerated, improved skin barrier function, enhanced stratum corneum hydration, and reduced skin roughness and inflammation. We suggest that the favorable effects of bathing in the Dead Sea salt solution are most likely related to the high magnesium content. Magnesium salts are known to bind water, influence epidermal proliferation and differentiation, and enhance permeability barrier repair.

  • Change in salivary physiological stress markers by spa bathing. 📎

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    Abstract Title:

    Change in salivary physiological stress markers by spa bathing.

    Abstract Source:

    Biomed Res. 2006 Feb;27(1):11-4. PMID: 16543660

    Abstract Author(s):

    Masahiro Toda, Kanehisa Morimoto, Shingo Nagasawa, Kazuyuki Kitamura

    Abstract:

    We assessed the stress relief effect of spa bathing by measuring sensitive salivary stress markers, cortisol and chromogranin A (CgA). From 12 healthy males, saliva samples were collected immediately before and after spa bathing, and 30 min after that. Salivary cortisol and CgA levels were determined by ELISA. Salivary cortisol levels decreased after spa bathing. This tendency was more pronounced in individuals with higher levels of stress. The high-stress group showed lower salivary CgA levels after spa bathing, while the low-stress group higher salivary CgA levels in the same condition. These findings suggest that the spa bathing has a moderate affect on the stress relief.

  • Effects of balneotherapy and spa therapy on quality of life of patients with knee osteoarthritis: a systematic review and meta-analysis.

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    Abstract Title:

    Effects of balneotherapy and spa therapy on quality of life of patients with knee osteoarthritis: a systematic review and meta-analysis.

    Abstract Source:

    Rheumatol Int. 2018 Oct ;38(10):1807-1824. Epub 2018 Jun 12. PMID: 29947999

    Abstract Author(s):

    Michele Antonelli, Davide Donelli, Antonella Fioravanti

    Article Affiliation:

    Michele Antonelli

    Abstract:

    Knee osteoarthritis (OA) is a degenerative disease which is expected to become one of the leading causes of disability by the next years. This work aims to assess if balneotherapy and spa therapy can significantly improve Quality of Life (QoL) of patients with knee OA. Medline via PubMed, Scopus, Web of Science, Cochrane Library, and PEDro were systematically searched for articles about trials involving patients with knee OA and measuring the effects of balneotherapy and spa therapy on study participants' QoL with validated scales. A qualitative and quantitative syntheses were performed. Seventeen studies were considered eligible and included in the systematic review. Fourteen trials reported significant improvements in at least one QoL item after treatment. Ten studies were included in quantitative synthesis. When comparing balneological interventions with standard treatment, results favored the former in terms of long-term overall QoL [ES = - 1.03 (95% CI - 1.66 to - 0.40)]. When comparing balneological interventions with sham interventions, results favored the former in terms of long-term pain improvement [ES = - 0.38 (95% CI - 0.74 to - 0.02)], while no significant difference was found when considering social function [ES = - 0.16 (95% CI - 0.52 to 0.19)]. In conclusion, even though limitations must be considered, evidence shows that BT and spa therapy can significantly improve QoL of patients with knee OA. Moreover, reduction of drug consumption and improvement of algofunctional indexes may be other beneficial effects. Further investigation is needed because of limited available data.

  • Effects of low-dose light-emitting-diode therapy in combination with water bath for atopic dermatitis in NC/Nga mice.

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    Abstract Title:

    Effects of low-dose light-emitting-diode therapy in combination with water bath for atopic dermatitis in NC/Nga mice.

    Abstract Source:

    Photodermatol Photoimmunol Photomed. 2016 Jan ;32(1):34-43. Epub 2015 Nov 6. PMID: 26479265

    Abstract Author(s):

    Chang-Hyun Kim, Kyung Ah Cheong, Won Suk Lim, Hyung-Moo Park, Ai-Young Lee

    Article Affiliation:

    Chang-Hyun Kim

    Abstract:

    BACKGROUND:Light-emitting diode (LED) phototherapy and water bath therapy have beneficial effect on atopic dermatitis (AD)-like skin disease. However, not all current treatments work well and alternative therapies are need. The contribution of combination therapy with low-dose 850 nm LED and water bath was investigated on dermatophagoides farina (Df)-induced dermatitis in NC/Nga mice.

    METHODS:Low-dose LED (10, 15, and 20 J/cm(2) ) irradiation, water bath (36± 1°C) were administered separately and together to the Df-induced NC/Nga mice in acrylic jar once a day for 2 weeks.

    RESULTS:Combined therapy with low-dose LED therapy and water bath therapy significantly ameliorated the development of AD-like skin lesions. These effects were correlated with the suppression of total IgE, NO, histamine, and Th2-mediated immune responses. Furthermore, combination therapy significantly reduced the infiltration of inflammatory cells and the induction of thymic stromal lymphopoietin (TSLP) in the skin lesions. The beneficial therapeutic effects of this combination therapy might regulate by the inhibition of various immunological responses including Th2-mediated immune responses, inflammatory mediators such as IgE, histamine, and NO, as well as inflammatory cells.

    CONCLUSIONS:The combination therapy of LED and water bath might be used as an efficacious, safe, and steroid-free alternative therapeutic strategy for the treatment of AD.

  • Effects of low-dose light-emitting-diode therapy in combination with water bath for atopic dermatitis in NC/Nga mice.

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    Abstract Title:

    Effects of low-dose light-emitting-diode therapy in combination with water bath for atopic dermatitis in NC/Nga mice.

    Abstract Source:

    Photodermatol Photoimmunol Photomed. 2016 Jan ;32(1):34-43. Epub 2015 Nov 6. PMID: 26479265

    Abstract Author(s):

    Chang-Hyun Kim, Kyung Ah Cheong, Won Suk Lim, Hyung-Moo Park, Ai-Young Lee

    Article Affiliation:

    Chang-Hyun Kim

    Abstract:

    BACKGROUND:Light-emitting diode (LED) phototherapy and water bath therapy have beneficial effect on atopic dermatitis (AD)-like skin disease. However, not all current treatments work well and alternative therapies are need. The contribution of combination therapy with low-dose 850 nm LED and water bath was investigated on dermatophagoides farina (Df)-induced dermatitis in NC/Nga mice.

    METHODS:Low-dose LED (10, 15, and 20 J/cm(2) ) irradiation, water bath (36± 1°C) were administered separately and together to the Df-induced NC/Nga mice in acrylic jar once a day for 2 weeks.

    RESULTS:Combined therapy with low-dose LED therapy and water bath therapy significantly ameliorated the development of AD-like skin lesions. These effects were correlated with the suppression of total IgE, NO, histamine, and Th2-mediated immune responses. Furthermore, combination therapy significantly reduced the infiltration of inflammatory cells and the induction of thymic stromal lymphopoietin (TSLP) in the skin lesions. The beneficial therapeutic effects of this combination therapy might regulate by the inhibition of various immunological responses including Th2-mediated immune responses, inflammatory mediators such as IgE, histamine, and NO, as well as inflammatory cells.

    CONCLUSIONS:The combination therapy of LED and water bath might be used as an efficacious, safe, and steroid-free alternative therapeutic strategy for the treatment of AD.

  • Effects of mild-stream bathing on recovery from mental fatigue. 📎

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    Abstract Title:

    Effects of mild-stream bathing on recovery from mental fatigue.

    Abstract Source:

    Med Sci Monit. 2010 Jan;16(1):CR8-14. PMID: 20037494

    Abstract Author(s):

    Kei Mizuno, Masaaki Tanaka, Kanako Tajima, Naoki Okada, Kazumasa Rokushima, Yasuyoshi Watanabe

    Article Affiliation:

    Department of Physiology, Osaka City University Graduate School of Medicine, Osaka, Japan. This email address is being protected from spambots. You need JavaScript enabled to view it.

    Abstract:

    BACKGROUND: Bathing in hot water is very common in Japan; people bathe in order to clean their bodies and to recover from physical and mental fatigue. However, there have been few reports examining the effects of bathing on recovery from mental fatigue. The purpose of this study was to examine the effects of mild-stream bathing on recovery from mental fatigue. MATERIAL/METHODS: During mild-stream bathing, a mild stream continuously passes from the sole to the calf, thigh, waist and back, thus providing a massage function. In a double-blinded, placebo-controlled, crossover experiment, 14 male healthy volunteers were randomized into normal bathing and mild-stream bathing experiments. After a fatigue-inducing mental task for 4 hours, subjects took a normal or mild-stream bath. RESULTS: Heart rate was higher, muscle stiffness in the waist was lower and plasma cortisol levels tended to be lower after mild-stream bathing when compared to normal bathing. In addition, after mild-stream bathing, mental task performance, as assessed by reaction times on an advanced trail making test, was better than that after normal bathing. CONCLUSIONS: The present results suggest that improved working memory processing, diminished waist muscle tone, and attenuated mental stress are induced by mild-stream bathing. Therefore, mild-stream bathing appears to be more effective for alleviating mental fatigue than normal bathing.

  • Effects of Spa therapy on serum leptin and adiponectin levels in patients with knee osteoarthritis.

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    Abstract Title:

    Effects of Spa therapy on serum leptin and adiponectin levels in patients with knee osteoarthritis.

    Abstract Source:

    Am J Ind Med. 2003 Feb;43(2):212-20. PMID: 20237929

    Abstract Author(s):

    Antonella Fioravanti, Luca Cantarini, Maria Romana Bacarelli, Arianna de Lalla, Linda Ceccatelli, Patrizia Blardi

    Article Affiliation:
    Abstract:

    Adipocytokine, including leptin and adiponectin, may play an important role in the pathophysiology of osteoarthritis (OA). Spa therapy is one of the most commonly used non-pharmacological approaches for OA, but its mechanisms of action are not completely known. The aim of the present study was to assess whether spa therapy modified plasma levels of leptin and adiponectin in thirty patients with knee OA treated with a cycle of a combination of daily locally applied mud-packs and bicarbonate-sulphate mineral bath water. Leptin and adiponectin plasma levels were assessed at baseline and after 2 weeks, upon completion of the spa treatment period. The concentrations of leptin and adiponectin were measured by ELISA. At basal time, plasma leptin levels were significantly correlated with body mass index (BMI) and gender, but no significant correlation was found with patient age, duration of disease, radiographic severity of knee OA, VAS score or Lequesne index. There was no correlation between plasma adiponectin level and BMI, gender and age, duration of the disease, radiographic severity of knee OA and VAS score. A significant correlation of plasma adiponectin levels was found only with the Lequesne index. At the end of the mud-bath therapy cycle, serum leptin levels showed a slight but not significant increase, while a significant decrease (P<0.05) in serum adiponectin levels was found. However, leptin and adiponectin concentrations after treatment were not correlated with other clinical parameters. In conclusion, our data show that spa therapy can modify plasma levels of the adipocytokines leptin and adiponectin, important mediators of cartilage metabolism. Whether this effect may play a potential role in OA needs further investigations.

  • Effects of Spa therapy on serum leptin and adiponectin levels in patients with knee osteoarthritis.

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    Abstract Title:

    Effects of Spa therapy on serum leptin and adiponectin levels in patients with knee osteoarthritis.

    Abstract Source:

    Am J Ind Med. 2003 Feb;43(2):212-20. PMID: 20237929

    Abstract Author(s):

    Antonella Fioravanti, Luca Cantarini, Maria Romana Bacarelli, Arianna de Lalla, Linda Ceccatelli, Patrizia Blardi

    Article Affiliation:
    Abstract:

    Adipocytokine, including leptin and adiponectin, may play an important role in the pathophysiology of osteoarthritis (OA). Spa therapy is one of the most commonly used non-pharmacological approaches for OA, but its mechanisms of action are not completely known. The aim of the present study was to assess whether spa therapy modified plasma levels of leptin and adiponectin in thirty patients with knee OA treated with a cycle of a combination of daily locally applied mud-packs and bicarbonate-sulphate mineral bath water. Leptin and adiponectin plasma levels were assessed at baseline and after 2 weeks, upon completion of the spa treatment period. The concentrations of leptin and adiponectin were measured by ELISA. At basal time, plasma leptin levels were significantly correlated with body mass index (BMI) and gender, but no significant correlation was found with patient age, duration of disease, radiographic severity of knee OA, VAS score or Lequesne index. There was no correlation between plasma adiponectin level and BMI, gender and age, duration of the disease, radiographic severity of knee OA and VAS score. A significant correlation of plasma adiponectin levels was found only with the Lequesne index. At the end of the mud-bath therapy cycle, serum leptin levels showed a slight but not significant increase, while a significant decrease (P<0.05) in serum adiponectin levels was found. However, leptin and adiponectin concentrations after treatment were not correlated with other clinical parameters. In conclusion, our data show that spa therapy can modify plasma levels of the adipocytokines leptin and adiponectin, important mediators of cartilage metabolism. Whether this effect may play a potential role in OA needs further investigations.

  • Efficacy of baths with mineral-medicinal water in patients with fibromyalgia: a randomized clinical trial.

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    Abstract Title:

    Efficacy of baths with mineral-medicinal water in patients with fibromyalgia: a randomized clinical trial.

    Abstract Source:

    Int J Biometeorol. 2019 Sep ;63(9):1161-1170. Epub 2019 Jun 3. PMID: 31161236

    Abstract Author(s):

    María Reyes Pérez-Fernández, Natalia Calvo-Ayuso, Cristina Martínez-Reglero, Ángel Salgado-Barreira, José Luis Muiño López-Álvarez

    Article Affiliation:

    María Reyes Pérez-Fernández

    Abstract:

    The layout of this study, designed as a randomized crossover clinical trial, is to evaluate the efficacy of an intervention with mineral-medicinal water from As Burgas (Ourense) in patients suffering from fibromyalgia. This sample was randomly divided into two groups: group A and group B. In phase 1, group A had 14 baths in thermal water for a month and standard pharmacological treatment; group B, standard pharmacological treatment. Washout period is 3 months. In phase 2, group A had standard treatment and group B had 14 baths in thermal water for a month plus standard treatment. The Fibromyalgia Impact Questionnaire (FIQ) was used; this grades the impact of the illness from 1 (minimum) to 10 (maximum), which was measured in both phases. Twenty-five patients were included in each group and the study was concluded with 20 patients in group A and 20 in group B. The intervention group obtained, once the baths finished, a mean score of 60.3 (± 11.8) and the control group of 70.8 (± 13.0) (p < 0.001). Three months later, the intervention group presented a mean score of 64.4 (± 10.6) and the control group of 5.0 (± 11.3) (p < 0.001). We can therefore conclude that the simple baths with mineral-medicinal water from As Burgas can make an improvement on the impact caused by fibromyalgia.

  • Efficacy of Spa Therapy, Mud-Pack Therapy, Balneotherapy, and Mud-Bath Therapy in the Management of Knee Osteoarthritis. A Systematic Review. 📎

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    Abstract Title:

    Efficacy of Spa Therapy, Mud-Pack Therapy, Balneotherapy, and Mud-Bath Therapy in the Management of Knee Osteoarthritis. A Systematic Review.

    Abstract Source:

    Biomed Res Int. 2018 ;2018:1042576. Epub 2018 Jun 25. PMID: 30046586

    Abstract Author(s):

    Antonio Fraioli, Gioacchino Mennuni, Mario Fontana, Silvia Nocchi, Fulvia Ceccarelli, Carlo Perricone, Angelo Serio

    Article Affiliation:

    Antonio Fraioli

    Abstract:

    Background:Osteoarthritis (OA) is the most common musculoskeletal disease in the world. OA is the result of an inflammatory and degenerative process affecting the entire joint. Osteoarthritis, especially involving the knee, has a relevant socioeconomic impact in terms of drugs, hospital admissions, work absences, and temporary or permanent invalidity. Therapy of knee osteoarthritis is based on pharmacological and nonpharmacological measures.

    Methods:We conducted a systematic review of the studies published between 2002 and 2017 on spa therapy, mud-pack therapy, balneotherapy, and mud-bath therapy in the treatment of knee osteoarthritis in order to investigate the evidence of the efficacy of such treatment on pain, functional limitation, drug use, and quality of life. Overall, 35 studies were examined among which 12 were selected and included in the review if they are trial comparative. We have been able to illustrate the main results obtained in the individual studies and to elaborate these results in order to allow as much a unitary presentation as possible and hence an overall judgment.

    Results:Because the studies we reviewed differed markedly from one another in terms of the methods used, we were unable to conduct a quantitative analysis (meta-analysis) of pooled data from the 12 studies. For the purposes of the present review, we reevaluated the results of the different studies using the same statistical method, Student's-test, which is used to compare the means of two frequency distributions. Among all the studies, the most relevant indexes used to measure effectiveness of spa therapy were improved including VAS, Lequesne, and WOMAC Score.

    Conclusions:The mud-pack therapy, balneotherapy, mud-bath therapy, and spa therapy have proved to be effective in the treatment and in the secondary prevention of knee osteoarthritis, by reducing pain, nonsteroidal anti-inflammatory drug consumption, and functional limitation and improving quality of life of affected patients.

  • 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.

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    Abstract Title:

    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.

    Abstract Source:

    Int J Biometeorol. 2018 May ;62(5):833-842. Epub 2017 Dec 7. PMID: 29218448

    Abstract Author(s):

    Fatih Karaarslan, Kagan Ozkuk, Serap Seringec Karabulut, Seldag Bekpinar, Mufit Zeki Karagulle, Nergis Erdogan

    Article Affiliation:

    Fatih Karaarslan

    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 Osaturation, 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. PlasmaADMA 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 increasein 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.

  • Short- and long-term effects of mud-bath treatment on hand osteoarthritis: a randomized clinical trial.

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    Abstract Title:

    Short- and long-term effects of mud-bath treatment on hand osteoarthritis: a randomized clinical trial.

    Abstract Source:

    Int J Biometeorol. 2014 Jan ;58(1):79-86. Epub 2013 Jan 14. PMID: 23314489

    Abstract Author(s):

    Antonella Fioravanti, Sara Tenti, Chiara Giannitti, Nicola Angelo Fortunati, Mauro Galeazzi

    Article Affiliation:

    Antonella Fioravanti

    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 OAlast over time.

  • Short- and long-term effects of mud-bath treatment on hand osteoarthritis: a randomized clinical trial.

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    Abstract Title:

    Short- and long-term effects of mud-bath treatment on hand osteoarthritis: a randomized clinical trial.

    Abstract Source:

    Int J Biometeorol. 2014 Jan ;58(1):79-86. Epub 2013 Jan 14. PMID: 23314489

    Abstract Author(s):

    Antonella Fioravanti, Sara Tenti, Chiara Giannitti, Nicola Angelo Fortunati, Mauro Galeazzi

    Article Affiliation:

    Antonella Fioravanti

    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 OAlast over time.

  • Spa Bathing

  • Spa Bathing

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    Spa Bathing: A spa is a location where mineral-rich spring water (and sometimes seawater) is used to give medicinal baths. Spa towns or spa resorts (including hot springs resorts) typically offer various health treatments, which are also known as balneotherapy. The belief in the curative powers of mineral waters goes back to prehistoric times. Such practices have been popular worldwide, but are especially widespread in Europe and Japan. Day spas are also quite popular, and offer various personal care treatments.

  • Spa therapy for gonarthrosis: a prospective study.

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    Abstract Title:

    Spa therapy for gonarthrosis: a prospective study.

    Abstract Source:

    Rheumatol Int. 1995;15(2):65-8. PMID: 7481482

    Abstract Author(s):

    I Wigler, O Elkayam, D Paran, M Yaron

    Article Affiliation:

    Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv University Sackler Faculty of Medicine, Israel.

    Abstract:

    The objective of this study was to evaluate the effect of spa therapy on clinical parameters of patients with gonarthrosis. Patients with gonarthrosis (n = 33) underwent a 2-week spa therapy using three treatment regimes and a 20-week follow-up as follows: group I (n = 11) had mineral water baths and hot native mineral mud packs, group II (n = 12) had mineral water baths and rinsed mineral-free mud packs and group III (n = 10) had tap water baths and mineral-free mud packs. The patients and the assessing rheumatologist were blinded to the difference in the treatment protocols. A significant improvement in the index of severity of the knee (ISK), as well as night pain scores, was achieved in group I. Improvement in physical findings and a reduction in pain ratings on a visual analogue scale (VAS) did not reach statistical significance. Analgesic consumption was significantly decreased in both groups I and III for up to 12 weeks. Global improvement assessed by patients and physician was observed in all three groups up to 16 weeks but persisted to the end of the follow-up period in group I only. Patients with gonarthrosis seemed to benefit from spa therapy under all three regimes. However, for two parameters (night pain and ISK) the combination of mineral water baths and mud packs (group I) appeared to be superior.

  • Spa therapy for gonarthrosis: a prospective study.

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    Abstract Title:

    Spa therapy for gonarthrosis: a prospective study.

    Abstract Source:

    Rheumatol Int. 1995;15(2):65-8. PMID: 7481482

    Abstract Author(s):

    I Wigler, O Elkayam, D Paran, M Yaron

    Article Affiliation:

    Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv University Sackler Faculty of Medicine, Israel.

    Abstract:

    The objective of this study was to evaluate the effect of spa therapy on clinical parameters of patients with gonarthrosis. Patients with gonarthrosis (n = 33) underwent a 2-week spa therapy using three treatment regimes and a 20-week follow-up as follows: group I (n = 11) had mineral water baths and hot native mineral mud packs, group II (n = 12) had mineral water baths and rinsed mineral-free mud packs and group III (n = 10) had tap water baths and mineral-free mud packs. The patients and the assessing rheumatologist were blinded to the difference in the treatment protocols. A significant improvement in the index of severity of the knee (ISK), as well as night pain scores, was achieved in group I. Improvement in physical findings and a reduction in pain ratings on a visual analogue scale (VAS) did not reach statistical significance. Analgesic consumption was significantly decreased in both groups I and III for up to 12 weeks. Global improvement assessed by patients and physician was observed in all three groups up to 16 weeks but persisted to the end of the follow-up period in group I only. Patients with gonarthrosis seemed to benefit from spa therapy under all three regimes. However, for two parameters (night pain and ISK) the combination of mineral water baths and mud packs (group I) appeared to be superior.

  • Spa therapy in rheumatology. Indications based on the clinical guidelines of the French National Authority for health and the European League Against Rheumatism, and the results of 19 randomized clinical trials

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    Abstract Title:

    [Spa therapy in rheumatology. Indications based on the clinical guidelines of the French National Authority for health and the European League Against Rheumatism, and the results of 19 randomized clinical trials].

    Abstract Source:

    Bull Acad Natl Med. 2009 Jun;193(6):1345-56; discussion 1356-8. PMID: 20120164

    Abstract Author(s):

    Alain Françon, Romain Forestier

    Article Affiliation:

    Centre de recherches rhumatologiques et thermales, 73100 Aix les Bains. This email address is being protected from spambots. You need JavaScript enabled to view it.

    Abstract:

    The objective of this work was to update the rheumatologic indications of spa therapy, based on clinical practice guidelines published by the French National Authority for Health (HAS) and the European League Against Rheumatism (EULAR), and on the results of randomized clinical trials (RCT)

    METHODOLOGY: We first examined the indications for which spa therapy is mentioned and/or recommended in HAS and EULAR guidelines. We then identified RCTs in spa therapy and rheumatology by using the key words spa therapy, balneology, balneotherapy, hydrotherapy, mud therapy and mineral water in the Pubmed, Pascal and Embase databases. Only RCTs including a statistical analysis of between-group outcomes were retained We also examined the possible contribution of RCTs not listed in the bibliography of the guidelines.

    RESULTS: RECOMMENDATIONS: spa therapy is recommended by HAS for chronic lower back pain, rank B and for stabilized rheumatoid arthritis, rank C. In ankylosing spondylitis, EULAR classifies spa therapy along with physiotherapy, rank A. In fibromyalgia, EULAR recommends hot-water balneology, an important component of spa therapy, rank B, based on five RCTs, of which three were carried out in thermal springs. Nineteen RCTs that comprised a statistical comparison of between-group outcomes were identified Sixteen studies indicated a persistent improvement (at least twelve weeks) in pain, analgesic and non-steroidal antiinflammatory drug consumption, functional capacity and/or quality of life, in the following indications: chronic lower back pain, knee osteoarthritis, hand osteoarthritis, fibromyalgia, ankylosing spondylitis andrheumatoidarthritis (PR).

    CONCLUSION: Spa therapy, or hot-water balneology, appears to be indicated for chronic low back pain, stabilized rheumatoid arthritis, ankylosing spondylitis and fibromyalgia. RCT findings suggest that patients with knee and hand osteoarthritis might also benefit.

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