Skip to main content

Advertisement

Log in

Health resort medicine in non-musculoskeletal disorders: is there evidence of its effectiveness?

  • Review Paper
  • Published:
International Journal of Biometeorology Aims and scope Submit manuscript

Abstract

Health resort medicine (HRM; in German: Kurortmedizin) is a field of medicine with long-lasting tradition in several European countries. A number of systematic reviews have shown the effectiveness of HRM in musculoskeletal conditions. Reviews focusing on the effectiveness of HRM in non-musculoskeletal disorders are rare. This systematic review aims to provide an overview about all types of health resort treatments applied in non-musculoskeletal conditions, to summarize evidence for its effectiveness and to assess the quality of published studies. MEDLINE, Web of Knowledge and Embase were searched for articles published between January 2002 and December 2013. We used a broad search strategy in order to find studies investigating the effects of HRM in non-musculoskeletal disorders. Two authors independently extracted data and assessed quality using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies (EPHPP-QAT). Forty-one studies (19 of them with control group) from eight countries examining the efficacy of various forms of spa treatment for 12 disease groups were included. The studies are markedly heterogeneous regarding study design, population and treatment. HRM treatment is associated with clinical improvement in diseases of the skin, respiratory, circulatory, digestive and nervous system among others. However, small samples, the lack of control groups and an insufficient follow-up often limit the generated evidence. The scientific literature of the last decade has shown that a number of non-musculoskeletal disorders are treated with different kinds of HRM. The challenge for the future will be to carry out thoroughly designed studies in larger patient populations to corroborate the impact of HRM treatment on non-musculoskeletal disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Anti M, Lippi ME, Santarelli L, Gabrielli M, Gasbarrini A, Gasbarrini G (2004) Effects of mineral-water supplementation on gastric emptying of solids in patients with functional dyspepsia assessed with the C-13-octanoic-acid breath test. Hepatogastroenterology 51:1856–1859

    Google Scholar 

  • Armijo-Olivo S, Stiles CR, Hagen NA, Biondo PD, Cummings GG (2012) Assessment of study quality for systematic reviews: a comparison of the Cochrane Collaboration Risk of Bias Tool and the Effective Public Health Practice Project Quality Assessment Tool: methodological research. J Eval Clin Pract 18:12–18. doi:10.1111/j.1365-2753.2010.01516.x

    Article  Google Scholar 

  • Bertoni M et al (2002) Effects of a bicarbonate-alkaline mineral water on gastric functions and functional dyspepsia: a preclinical and clinical study. Pharmacol Res 46:525–531. doi:10.1016/S1043-6618(02)00232-3

    Article  Google Scholar 

  • Blasche G, Leibetseder V, Marktl W (2010) Association of spa therapy with improvement of psychological symptoms of occupational burnout: a pilot study. Forsch Komplementmed 17:132–136. doi:10.1159/000315301

    Article  Google Scholar 

  • Bodemer C et al (2011) Short- and medium-term efficacy of specific hydrotherapy in inherited ichthyosis. Br J Dermatol 165:1087–1094. doi:10.1111/j.1365-2133.2011.10510.x

    Article  CAS  Google Scholar 

  • Brefel-Courbon C, Desboeuf K, Thalamas C, Galitzky M, Senard JM, Rascol O, Montastruc JL (2003) Clinical and economic analysis of spa therapy in Parkinson’s disease. Mov Disord 18:578–584. doi:10.1002/Mds.10404

    Article  Google Scholar 

  • Carpentier PH, Satger B (2009) Randomized trial of balneotherapy associated with patient education in patients with advanced chronic venous insufficiency. J Vasc Surg 49:163–170. doi:10.1016/j.jvs.2008.07.075

    Article  Google Scholar 

  • Casas C, Ribet V, Alvarez-Georges S, Sibaud V, Guerrero D, Schmitt AM, Redoules D (2011) Modulation of Interleukin-8 and staphylococcal flora by Avene hydrotherapy in patients suffering from chronic inflammatory dermatoses. J Eur Acad Dermatol 25:19–23. doi:10.1111/j.1468-3083.2010.03898.x

    Article  Google Scholar 

  • Cider A, Schaufelberger M, Sunnerhagen KS, Andersson B (2003) Hydrotherapy—a new approach to improve function in the older patient with chronic heart failure. Eur J Heart Fail 5:527–535

    Article  Google Scholar 

  • Costantino M (2008a) Long-term effectiveness of mud-bath therapy in psoriasis vulgaris. Ig Mod 130:87–96

    Google Scholar 

  • Costantino M (2008b) The rhinogenic deafness and SPA therapy: clinical-experimental study. Clin Ter 159:311–315

    CAS  Google Scholar 

  • Costantino M, Lampa E (2005) Psoriasis and mud bath therapy: clinical-experimental study. Clin Ter 156:145–149

    CAS  Google Scholar 

  • Costantino M, Lampa E, Nappi G (2006) Effectiveness of sulphur spa therapy with politzer in the treatment of rhinogenic deafness. Acta otorhinolaryngologica Italica: organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale 26:7–13

  • Delfino M, Russo N, Migliaccio G, Carraturo N (2003) Experimental study on efficacy of thermal muds of Ischia Island combined with balneotherapy in the treatment of psoriasis vulgaris with plaques. Clin Ter 154:167–171

    CAS  Google Scholar 

  • Dreier M, Borutta B, Stahmeyer J, Krauth C, Walter U (2010) Vergleich von Bewertungsinstrumenten für die Studienqualität von Primär- und Sekundärstudien zur Verwendung für HTA-Berichte im deutschsprachigen Raum vol Bd. 102. Deutsches Institut für Medizinische Dokumentation und Information (DIMDI), Köln

    Google Scholar 

  • DRV (2012) Rentenversicherung in Zeitreihen. Deutsche Rentenversicherung Bund, Berlin

    Google Scholar 

  • Dubois O et al (2010) Balneotherapy versus paroxetine in the treatment of generalized anxiety disorder. Complement Ther Med 18:1–7. doi:10.1016/j.ctim.2009.11.003

    Article  Google Scholar 

  • Falagas ME, Zarkadoulia E, Rafailidis PI (2009) The therapeutic effect of balneotherapy: evaluation of the evidence from randomised controlled trials. Int J Clin Pract 63:1068–1084

    Article  CAS  Google Scholar 

  • Falkenbach A, Kovacs J, Franke A, Jorgens K, Ammer K (2005) Radon therapy for the treatment of rheumatic diseases—review and meta-analysis of controlled clinical trials. Rheumatol Int 25:205–210

    Article  CAS  Google Scholar 

  • Farina S, Gisondi P, Zanoni M, Pace M, Rizzoli L, Baldo E, Girolomoni G (2011) Balneotherapy for atopic dermatitis in children at Comano spa in Trentino, Italy. J Dermatol Treat 22:366–371. doi:10.3109/09546634.2010.512950

    Article  Google Scholar 

  • Fink M, Kalpakcioglu B, Bernateck M, Gutenbrunner C (2011) Gibt es Evidenz in der Balneotherapie rheumatologischer Erkrankungen? Akt Rheumatol 36:157–164. doi:10.1055/s-0031-1271627

    Article  Google Scholar 

  • Forestier R, Francon A (2008) Crenobalneotherapy for limb osteoarthritis: systematic literature review and methodological analysis. Joint Bone Spine Rev Rhum 75:138–148

    Article  Google Scholar 

  • Frost GJ (2004) The spa as a model of an optimal healing environment. J Altern Complement Med 10:S85–S92

    Article  Google Scholar 

  • Gasbarrini G, Candelli M, Graziosetto R, Coccheri S, Di Iorio F, Nappi G (2006) Evaluation of thermal water in patients with functional dyspepsia and irritable bowel syndrome accompanying constipation. World J Gastroenterol 12:2556–2562

    Google Scholar 

  • Geytenbeek J (2002) Evidence for effective hydrotherapy. Physiotherapy 88:514–529

    Article  Google Scholar 

  • Gin H et al (2013) Observation of the long-term effects of lifestyle intervention during balneotherapy in metabolic syndrome. Therapie 68:163–167. doi:10.2515/therapie/2013025

    Article  Google Scholar 

  • Goedsche K, Forster M, Kroegel C, Uhlemann C (2007) Serielle Kaltwasserreize (Kneipp’scher Oberguss) bei Patienten mit Chronisch Obstruktiver Bronchitis (COPD). Forsch Komplementmed 14:158–166. doi:10.1159/000101948

    Article  Google Scholar 

  • Guarnieri G, Ferrazzoni S, Scarpa MC, Lalli A, Maestrelli P (2010) Effects of inhalation of thermal water on exhaled breath condensate in chronic obstructive pulmonary disease. Respiration 79:216–221. doi:10.1159/000227801

    Article  Google Scholar 

  • Gutenbrunner C, Bender T, Cantista P, Karagulle Z (2010) A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology. Int J Biometeorol 54:495–507

    Article  Google Scholar 

  • Hanh T, Serog P, Fauconnier J, Batailler P, Mercier F, Roques CF, Blin P (2012) One-year effectiveness of a 3-week balneotherapy program for the treatment of overweight or obesity. Evidence-based Complementary and Alternative Medicine: eCAM 2012:150839 doi:10.1155/2012/150839

  • Jacob EM, Volger E (2009) Blood pressure lowering by hydrotherapy: a randomised, controlled trail in mild to moderate hypertension. Phys Med Rehab Kuror 19:162–168. doi:10.1055/s-0029-1202769

    Article  Google Scholar 

  • Jandova D, Bicikova M, Hill M, Hampl R (2008) Health resort treatment improved the neurosteroid profile in thyroidectomized women. Endocr Regul 42:17–22

    CAS  Google Scholar 

  • Kamioka H et al (2010) Effectiveness of aquatic exercise and balneotherapy: a summary of systematic reviews based on randomized controlled trials of water immersion therapies. J Epidemiol 20:2–12

    Article  Google Scholar 

  • Kamioka H et al (2013) A checklist to assess the quality of reports on spa therapy and balneotherapy trials was developed using the Delphi consensus method: the SPAC checklist. Complement Ther Med 21:324–332. doi:10.1016/j.ctim.2013.05.002

    Article  Google Scholar 

  • Lang S, Kleijnen J (2010) Quality assessment tools for observational studies: lack of consensus. Int J Evid Based Healthc 8:247. doi:10.1111/j.1744-1609.2010.00195.x

    Article  Google Scholar 

  • Langhorst J, Musial F, Klose P, Hauser W (2009) Efficacy of hydrotherapy in fibromyalgia syndrome—a meta-analysis of randomized controlled clinical trials. Rheumatology 48:1155–1159

    Article  Google Scholar 

  • Mancini S, Piccinetti A, Nappi G, Mancini S, Caniato A, Coccheri S (2003) Clinical, functional and quality of life changes after balneokinesis with sulphurous water in patients with varicose veins. Vasa-J Vasc Dis 32:26–30. doi:10.1024/0301-1526.32.1.26

    Google Scholar 

  • McVeigh JG, McGaughey H, Hall M, Kane P (2008) The effectiveness of hydrotherapy in the management of fibromyalgia syndrome: a systematic review. Rheumatol Int 29:119–130

    Article  Google Scholar 

  • Merial-Kieny C, Mengual X, Guerrero D, Sibaud V (2011) Clinical efficacy of Avene hydrotherapy measured in a large cohort of more than 10,000 atopic or psoriatic patients. J Eur Acad Dermatol 25:30–34. doi:10.1111/j.1468-3083.2010.03900.x

    Article  Google Scholar 

  • Michalsen A, Ludtke R, Buhring M, Spahn G, Langhorst J, Dobos GJ (2003) Thermal hydrotherapy improves quality of life and hemodynamic function in patients with chronic heart failure. Am Heart J 146:728–733. doi:10.1016/S0002-8703(03)00314-4

    Article  Google Scholar 

  • Mitsunobu F et al (2003) Elevation of antioxidant enzymes in the clinical effects of radon and thermal therapy for bronchial asthma. J Radiat Res 44:95–99. doi:10.1269/Jrr.44.95

    Article  CAS  Google Scholar 

  • Moher D et al (1996) Completeness of reporting of trials published in languages other than English: implications for conduct and reporting of systematic reviews. Lancet 347:363–366

    Article  CAS  Google Scholar 

  • Municino A et al (2006) Hydrotherapy in advanced heart failure: the cardio-HKT pilot study Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace/Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Universita di Napoli, Secondo ateneo 66:247–254

  • Nasermoaddeli A, Kagamimori S (2005) Balneotherapy in medicine: a review. Environ Health Prev Med 10:171–179. doi:10.1007/BF02897707

    Article  Google Scholar 

  • NCCMT (2008) Quality Assessment Tool for Quantitative Studies (Update 13 April, 2010) vol Retrieved from http://www.nccmt.ca/registry/view/eng/14.html. National Collaborating Centre for Methods and Tools, McMaster University, Hamilton

    Google Scholar 

  • Olah M, Koncz A, Feher J, Kalmanczhey J, Olah C, Nagy G, Bender T (2011) The effect of balneotherapy on antioxidant, inflammatory, and metabolic indices in patients with cardiovascular risk factors (hypertension and obesity)—a randomised, controlled, follow-up study. Contemp Clin Trials 32:793–801. doi:10.1016/j.cct.2011.06.003

    Article  Google Scholar 

  • Pagourelias ED, Zorou PG, Tsaligopoulos M, Athyros VG, Karagiannis A, Efthimiadis GK (2011) Carbon dioxide balneotherapy and cardiovascular disease. Int J Biometeorol 55:657–663. doi:10.1007/s00484-010-0380-7

    Article  Google Scholar 

  • Passali D et al (2013) Spa therapy of upper respiratory tract inflammations European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies 270:565–570. doi:10.1007/s00405-012-2024-5

  • Pellegrini M et al (2005) Effect of inhalation of thermal water on airway inflammation in chronic obstructive pulmonary disease. Respir Med 99:748–754. doi:10.1016/j.rmed.2004.11.001

    Article  Google Scholar 

  • Pham B, Klassen TP, Lawson ML, Moher D (2005) Language of publication restrictions in systematic reviews gave different results depending on whether the intervention was conventional or complementary. J Clin Epidemiol 58:769–776

    Article  Google Scholar 

  • Pittler MH, Karagulle MZ, Karagulle M, Ernst E (2006) Spa therapy and balneotherapy for treating low back pain: meta-analysis of randomized trials. Rheumatology 45:880–884

    Article  CAS  Google Scholar 

  • Rylander R, Arnaud MJ (2004) Mineral water intake reduces blood pressure among subjects with low urinary magnesium and calcium levels. BMC Public Health 4:56. doi:10.1186/1471-2458-4-56

    Article  Google Scholar 

  • Salami A, Dellepiane M, Strinati F, Guastini L, Mora R (2010) Sulphurous thermal water inhalations in the treatment of chronic rhinosinusitis. Rhinology 48:71–76. doi:10.4193/Rhin09.065

    Google Scholar 

  • Schwarz J, Morstadt E (2010) The effects of medicinal mineral waters with high iron content on the iron status of the human body—a randomized controlled trial. Phys Med Rehab Kuror 20:274–279. doi:10.1055/s-0030-1261928

    Article  Google Scholar 

  • Staffieri A, Abramo A (2007) Sulphurous-arsenical-ferruginous (thermal) water inhalations reduce nasal respiratory resistance and improve mucociliary clearance in patients with chronic sinonasal disease: preliminary outcomes. Acta Oto-Laryngol 127:613–617. doi:10.1080/00016480600951525

    Article  CAS  Google Scholar 

  • StBA (2011) Gesundheitsberichterstattung des Bundes-Abgeschlossene stationäre Leistungen zur medizinischen Rehabilitation und sonstige Leistungen zur Teilhabe für Erwachsene in der Gesetzlichen Rentenversicherung. Statistisches Bundesamt & Robert Koch Institut, Bonn

    Google Scholar 

  • Strauss-Blasche G, Gnad E, Ekmekcioglu C, Hladschik B, Marktl W (2005) Combined inpatient rehabilitation and spa therapy for breast cancer patients: effects on quality of life and CA 15-3. Cancer Nurs 28:390–398

    Article  Google Scholar 

  • Taieb C, Sibaud V, Merial-Kieny C (2011) Impact of Avene hydrotherapy on the quality of life of atopic and psoriatic patients. J Eur Acad Dermatol 25:24–29. doi:10.1111/j.1468-3083.2010.03899.x

    Article  Google Scholar 

  • Takata K, Ashida A, Hosaki Y, Iwagaki N, Kikuchi H, Mitsunobu F (2008) Effect of spa therapy on the six-minute walk test in patients with chronic obstructive pulmonary disease. J Jpn Soc Balneology Climatol Phys Med 71:241–249

    Google Scholar 

  • Thomas BH, Ciliska D, Dobbins M, Micucci S (2004) A process for systematically reviewing the literature: providing the research evidence for public health nursing interventions. Worldviews on evidence-based nursing/Sigma Theta Tau International, Honor Society of Nursing 1:176–84. doi:10.1111/j.1524-475X.2004.04006.x

  • Tsoureli-Nikita E, Menchini G, Ghersetich I, Hercogova J (2002) Alternative treatment of psoriasis with balneotherapy using Leopoldine spa water. J Eur Acad Dermatol 16:260–262. doi:10.1046/j.1468-3083.2002.00452.x

    Article  CAS  Google Scholar 

  • Uehleke B, Woehling H (2008) A prospective “Study by Correspondence” on the effects of Kneipp Hydrotherapy in patients with complaints due to peripheral neuropathy. Schweiz Z Ganzheits Med 20:287–291

    Article  Google Scholar 

  • Vareka I, Stejskal D, Varekova R, Burianova K, Hnatek J (2009) Changes in clusterin serum concentration levels in oncologic patients during the course of spa therapy - a pilot study. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 153:117–120

  • Verhagen AP, Bierma-Zeinstra SMA, Cardoso JR, de Bie RA, Boers M, de Vet HCW (2003) Balneotherapy for rheumatoid arthritis. Cochrane Database Syst Rev CD000518

  • Verhagen AP, Bierma-Zeinstra SMA, Boers M, Cardoso JR, Lambeck J, de Bie RA, de Vet HCW (2007) Balneotherapy for osteoarthritis. Cochrane Database Syst Rev CD006864

  • Verhagen A, Bierma-Zeinstra S, Lambeck J, Cardoso JR, de Bie R, Boers M, de Vet HCW (2008) Balneotherapy for osteoarthritis. A cochrane review. J Rheumatol 35:1118–1123

    Google Scholar 

  • Zambo L, Dekany M, Bender T (2008) The efficacy of alum-containing ferrous thermal water in the management of chronic inflammatory gynaecological disorders—a randomized controlled study. Eur J Obstet Gynecol Reprod Biol 140:252–257. doi:10.1016/j.ejogrb.2008.03.015

    Article  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare no conflicts of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Marita Stier-Jarmer.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stier-Jarmer, M., Kus, S., Frisch, D. et al. Health resort medicine in non-musculoskeletal disorders: is there evidence of its effectiveness?. Int J Biometeorol 59, 1523–1544 (2015). https://doi.org/10.1007/s00484-015-0953-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00484-015-0953-6

Keywords

Navigation