06-1 Single and double blind randomized controlled studies in the field of balneology (aspects of locomotor diseases) / 日本温泉気候物理医学会雑誌

  The aim of the lecture is to overview the single and doube blind studies related to musculoskeletal diseases. We systematically searched articles in the Pubmed, Scopus, Web of science and PEDro databeses published by blinding method, a total of 28 studies (10 double blind and 18 single blind) were identified. The randomised single or double blind studies clearly present the highest evidence, to avoid the publication bias. In balneotheray, due to technical challenges sometimes it is really diffucult to accomplish the blinding methods.

Health benefits of immersion and therapeutic aquatic exercise in swimming pools and spas in health care, with focus on rheumatologic, orthopaedic and neurological disorders / 日本温泉気候物理医学会雑誌

Introduction: The World Health Organization (WHO) is in the process of updating the "Guidelines for safe recreational water environments, volume 2: swimming pools and similar environments (2006). The update plans to contain a chapter on the health benefits of immersion and therapeutic aquatic exercise in pools and spas. Methods: In order to write a narrative review, searches in PubMed, Embase, Cinahl, Sportdiscus, PEDro and Cochrane central were conducted in May-October 2012.   The group of 8 experts focused on persons with a medical diagnosis as described in the ICD-10 and their resultants effects (as described in the ICF)., but has been restricted to diseases, which have been presented in aquatic research literature sufficiently.   Keywords about the interventions included “Hydrotherapy Or Water exercise Or Aquatic exercise Or Aquatic therapy Or Water rehabilitation Or Aquatic physical therapy Or Aquatic rehabilitation Or Aquatics”, as well as the appropriate keywords for the pathologies.   References were restricted to Level 1-3 evidence papers as defined by the Oxford Centre of Evidence Based Medicine. Results: In summary, across musculoskeletal disorders (low back and neck pain, osteoarthritis, joint replacement, fibromyalgia, rheumatoid arthritis and ankylosing spondylitis), both active and passive interventions have low to high clinical effects on outcome parameters at the various ICF levels and on quality of life. Adverse effects have not been reported.   The evidence across neurological diseases (stroke, Parkinson disease, multiple sclerosis) is limited in comparison to musculoskeletal ones and mainly focuses on balance, gait, functional independence and quality of life. Moderate to high clinical effects have been found for these parameters. Effects on fatigue are conflicting. No adverse effects have been reported. Discussion: This narrative review didn’t allow a comparison with other interventions and only focuses on the health benefits of aquatic interventions themselves. Description of intervention and the applied doses were often insufficient, therefore the exact parameters of the intervention tactics still have to be established. Many studies were underpowered and would need follow-up studies that are more rigorous in order to establish the health benefits with higher effects sizes and statistical significance. Conclusion: The average - level 2 - evidence of therapeutic aquatic exercise and balneotherapy in neuro-musculoskeletal diseases have moderate to high beneficial effects on variables at the levels if function (primarily pain) and activity of the ICF, as well as on quality of life. These benefits seem to comparable across the diseases.

PT2-1 EBM Balneotherapy in Hungary / 日本温泉気候物理医学会雑誌

  Hungary is rich in thermal mineral waters. Here, we present a systematic review and meta-analysis of clinical trials conducted with Hungarian thermal mineral waters, the findings of which have been published by Hungarian authors in English. The 124 studies identified in different databases include 20 clinical trials. Seven of these evaluated the effect of hydro- and balneotherapy on chronic low back pain, four on osteoarthritis of the knee, and two on osteoarthritis of the hand and one ostheoarthrtis of shoulder. One of the remaining seven trials evaluated balneotherapy in chronic inflammatory pelvic diseases, while six studies explored its effect on various laboratory parameters. Out of the 20 studies, 9 met the predefined criteria for meta-analysis.The results confirmed the beneficial effect of balneotherapy on pain with weightbearing and at rest in patients with degenerative joint and spinal diseases. A similar effect has been found in chronic pelvic inflammatory disease. The review also revealed that balneotherapy has some beneficial effects on antioxidant status, and on metabolic and inflammatory parameters.Based on the results, we conclude that balneotherapy with Hungarian thermal-mineral waters is an effective remedy for lower back pain, as well as for knee and hand and shoulder osteoarthritis.

PT2-1EBM Balneotherapy in Hungary / 日本温泉気候物理医学会雑誌

  Hungary is rich in thermal mineral waters. Here, we present a systematic review and meta-analysis of clinical trials conducted with Hungarian thermal mineral waters, the findings of which have been published by Hungarian authors in English. The 124 studies identified in different databases include 20 clinical trials. Seven of these evaluated the effect of hydro- and balneotherapy on chronic low back pain, four on osteoarthritis of the knee, and two on osteoarthritis of the hand and one ostheoarthrtis of shoulder. One of the remaining seven trials evaluated balneotherapy in chronic inflammatory pelvic diseases, while six studies explored its effect on various laboratory parameters. Out of the 20 studies, 9 met the predefined criteria for meta-analysis.The results confirmed the beneficial effect of balneotherapy on pain with weightbearing and at rest in patients with degenerative joint and spinal diseases. A similar effect has been found in chronic pelvic inflammatory disease. The review also revealed that balneotherapy has some beneficial effects on antioxidant status, and on metabolic and inflammatory parameters.Based on the results, we conclude that balneotherapy with Hungarian thermal-mineral waters is an effective remedy for lower back pain, as well as for knee and hand and shoulder osteoarthritis.

Health benefits of immersion and therapeutic aquatic exercise in swimming pools and spas in health care, with focus on rheumatologic, orthopaedic and neurological disorders / 日本温泉気候物理医学会雑誌

<b>Int</b><b>roduction:</b> The World Health Organization (WHO) is in the process of updating the "Guidelines for safe recreational water environments, volume 2: swimming pools and similar environments (2006). The update plans to contain a chapter on the health benefits of immersion and therapeutic aquatic exercise in pools and spas. <BR><b>Methods:</b> In order to write a narrative review, searches in PubMed, Embase, Cinahl, Sportdiscus, PEDro and Cochrane central were conducted in May-October 2012.<BR>  The group of 8 experts focused on persons with a medical diagnosis as described in the ICD-10 and their resultants effects (as described in the ICF)., but has been restricted to diseases, which have been presented in aquatic research literature sufficiently.<BR>  Keywords about the interventions included “Hydrotherapy Or Water exercise Or Aquatic exercise Or Aquatic therapy Or Water rehabilitation Or Aquatic physical therapy Or Aquatic rehabilitation Or Aquatics”, as well as the appropriate keywords for the pathologies.<BR>  References were restricted to Level 1-3 evidence papers as defined by the Oxford Centre of Evidence Based Medicine.<BR><b>Results:</b> In summary, across musculoskeletal disorders (low back and neck pain, osteoarthritis, joint replacement, fibromyalgia, rheumatoid arthritis and ankylosing spondylitis), both active and passive interventions have low to high clinical effects on outcome parameters at the various ICF levels and on quality of life. Adverse effects have not been reported.<BR>  The evidence across neurological diseases (stroke, Parkinson disease, multiple sclerosis) is limited in comparison to musculoskeletal ones and mainly focuses on balance, gait, functional independence and quality of life. Moderate to high clinical effects have been found for these parameters. Effects on fatigue are conflicting. No adverse effects have been reported.<BR><b>Discussion:</b> This narrative review didn’t allow a comparison with other interventions and only focuses on the health benefits of aquatic interventions themselves. Description of intervention and the applied doses were often insufficient, therefore the exact parameters of the intervention tactics still have to be established. Many studies were underpowered and would need follow-up studies that are more rigorous in order to establish the health benefits with higher effects sizes and statistical significance.<BR><b>Conclusion: </b>The average - level 2 - evidence of therapeutic aquatic exercise and balneotherapy in neuro-musculoskeletal diseases have moderate to high beneficial effects on variables at the levels if function (primarily pain) and activity of the ICF, as well as on quality of life. These benefits seem to comparable across the diseases.

06-1Single and double blind randomized controlled studies in thefield of balneology (aspects of locomotor diseases) / 日本温泉気候物理医学会雑誌

  The aim of the lecture is to overview the single and doube blind studies related to musculoskeletal diseases. We systematically searched articles in the Pubmed, Scopus, Web of science and PEDro databeses published by blinding method, a total of 28 studies (10 double blind and 18 single blind) were identified. The randomised single or double blind studies clearly present the highest evidence, to avoid the publication bias. In balneotheray, due to technical challenges sometimes it is really diffucult to accomplish the blinding methods.