A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology
Tóm tắt
Health Resort Medicine, Balneology, Medical Hydrology and Climatology are not fully recognised as independent medical specialties at a global international level. Analysing the reasons, we can identify both external (from outside the field) and internal (from inside the field) factors. External arguments include, e.g. the lack of scientific evidence, the fact that Balneotherapy and Climatotherapy is not used in all countries, and the fact that Health Resort Medicine, Balneology, Medical Hydrology and Climatology focus only on single methods and do not have a comprehensive concept. Implicit barriers are the lack of international accepted terms in the field, the restriction of being allowed to practice the activities only in specific settings, and the trend to use Balneotherapy mainly for wellness concepts. Especially the implicit barriers should be subject to intense discussions among scientists and specialists. This paper suggests one option to tackle the problem of implicit barriers by making a proposal for a structure and description of the medical field, and to provide some commonly acceptable descriptions of content and terminology. The medical area can be defined as “medicine in health resorts” (or “health resort medicine”). Health resort medicine includes “all medical activities originated and derived in health resorts based on scientific evidence aiming at health promotion, prevention, therapy and rehabilitation”. Core elements of health resort interventions in health resorts are balneotherapy, hydrotherapy, and climatotherapy. Health resort medicine can be used for health promotion, prevention, treatment, and rehabilitation. The use of natural mineral waters, gases and peloids in many countries is called balneotherapy, but other (equivalent) terms exist. Substances used for balneotherapy are medical mineral waters, medical peloids, and natural gases (bathing, drinking, inhalation, etc.). The use of plain water (tap water) for therapy is called hydrotherapy, and the use of climatic factors for therapy is called climatotherapy. Reflecting the effects of health resort medicine, it is important to take other environmental factors into account. These can be classified within the framework of the ICF (International Classification of Functioning, Disability and Health). Examples include receiving health care by specialised doctors, being well educated (ICF-domain: e355), having an environment supporting social contacts (family, peer groups) (cf. ICF-domains: d740, d760), facilities for recreation, cultural activities, leisure and sports (cf. ICF-domain: d920), access to a health-promoting atmosphere and an environment close to nature (cf. ICF-domain: e210). The scientific field dealing with health resort medicine is called health resort sciences. It includes the medical sciences, psychology, social sciences, technical sciences, chemistry, physics, geography, jurisprudence, etc. Finally, this paper proposes a systematic international discussion of descriptions in the field of Health Resort Medicine, Balneology, Medical Hydrology and Climatology, and discusses short descriptive terms with the goal of achieving internationally accepted distinct terms. This task should be done via a structured consensus process and is of major importance for the publication of scientific results as well as for systematic reviews and meta-analyses.
Tài liệu tham khảo
citation_journal_title=Rheumatol Int; citation_title=Effects of balneotherapy on serum IL-1, PGE2 and LTB4 levels in fibromyalgia patients; citation_author=F Ardic, M Ozgen, H Aybek, S Rota, D Cubukcu, A Gokgoz; citation_volume=27; citation_publication_date=2007; citation_pages=441-446; citation_doi=10.1007/s00296-006-0237-x; citation_id=CR1
citation_journal_title=An R Acad Nac Med Madrid; citation_title=Spa therapy in depresive status and undercover depressions; citation_author=M Armijo Valenzuela; citation_volume=123; citation_publication_date=2006; citation_pages=673-684; citation_id=CR2
citation_journal_title=Acta Derm Venereol; citation_title=Heliotherapy in atopic dermatitis: a prospective study on climatotherapy using the SCORAD index; citation_author=P Autio, P Komulainen, HM Larni; citation_volume=82; citation_publication_date=2002; citation_pages=436-440; citation_doi=10.1080/000155502762064575; citation_id=CR3
citation_journal_title=Clin Rheumatol; citation_title=The effect of the thermal mineral water of Nagybaracska on patients with knee joint osteoarthritis—a double blind study; citation_author=GP Balint, WW Buchanan, A Adam, I Ratko, L Poor, PV Balint, E Somos, I Tefner, T Bender; citation_volume=26; citation_publication_date=2007; citation_pages=890-894; citation_doi=10.1007/s10067-006-0420-1; citation_id=CR4
citation_journal_title=Cochrane Database Syst Rev; citation_title=Aquatic exercise for the treatment of knee and hip osteoarthritis; citation_author=EM Bartels, H Lund, KB Hagen, H Dagfinrud, R Christensen, B Danneskiold-Samsoe; citation_volume=4; citation_publication_date=2007; citation_pages=CD005523; citation_id=CR5
citation_journal_title=J Prev Med Hyg; citation_title=Evaluation of outcomes in SPA-treated osteoarthrosic patients; citation_author=S Bellometti, C Gallotti, G Pacileo, A Rota, MT Tenconi; citation_volume=48; citation_publication_date=2007; citation_pages=1-4; citation_id=CR6
citation_journal_title=Rheum Int; citation_title=Hydrotherapy, balneotherapy, and spa treatment in pain management; citation_author=T Bender, Z Karagülle, GP Bálint, Chr Gutenbrunner, PV Bálint, S Sukenik; citation_volume=25; citation_publication_date=2005; citation_pages=220-224; citation_doi=10.1007/s00296-004-0487-4; citation_id=CR7
citation_journal_title=Arch Med Res; citation_title=Effect of balneotherapy on the antioxidant system—a controlled pilot study; citation_author=T Bender, J Bariska, R Vaghy, R Gomez, I Kovacs; citation_volume=38; citation_publication_date=2007; citation_pages=86-89; citation_doi=10.1016/j.arcmed.2006.08.007; citation_id=CR8
citation_journal_title=Respiration; citation_title=Antioxidant effect of sulphurous thermal water on human neutrophil bursts: chemiluminescence evaluation; citation_author=PC Braga, G Sambataro, M Dal Sasso, M Culici, M Alfieri, G Nappi; citation_volume=75; citation_publication_date=2008; citation_pages=193-201; citation_doi=10.1159/000107976; citation_id=CR9
citation_journal_title=Mov Disord; citation_title=Clinical and economic analysis of spa therapy in Parkinson's disease; citation_author=C Brefel-Courbon, K Desboeuf, C Thalamas, M Galitzky, JM Senard, O Rascol, JL Montastruc; citation_volume=18; citation_publication_date=2003; citation_pages=578-584; citation_doi=10.1002/mds.10404; citation_id=CR10
citation_journal_title=J Altern Complement Med; citation_title=A pragmatic randomized controlled trial on the effectiveness of highly concentrated saline spa water baths followed by UVB compared to UVB only in moderate to severe psoriasis; citation_author=T Brockow, R Schiener, A Franke, KL Resch, RU Peter; citation_volume=13; citation_publication_date=2007; citation_pages=725-732; citation_doi=10.1089/acm.2007.7099; citation_id=CR11
citation_journal_title=J Eur Acad Dermatol Venereol; citation_title=A pragmatic randomized controlled trial on the effectiveness of low concentrated saline spa water baths followed by ultraviolet B (UVB) compared to UVB only in moderate to severe psoriasis; citation_author=T Brockow, R Schiener, A Franke, KL Resch, RU Peter; citation_volume=21; citation_publication_date=2007; citation_pages=1027-1037; citation_doi=10.1111/j.1468-3083.2007.02152.x; citation_id=CR12
citation_journal_title=J Altern Complement Med; citation_title=A pragmatic randomized controlled trial on the effectiveness of highly concentrated saline spa water baths followed by UVB compared to UVB only in moderate to severe psoriasis; citation_author=T Brockow, R Schiener, A Franke, KL Resch, RU Peter; citation_volume=13; citation_publication_date=2007; citation_pages=725-732; citation_doi=10.1089/acm.2007.7099; citation_id=CR13
citation_journal_title=Rheumatol Int; citation_title=Balneotherapy for fibromyalgia at the Dead Sea; citation_author=D Buskila, M Abu-Shakra, L Neumann, L Odes, E Shneider, D Flusser, S Sukenik; citation_volume=20; citation_publication_date=2001; citation_pages=105-108; citation_doi=10.1007/s002960000085; citation_id=CR14
citation_journal_title=Rheumatol Int; citation_title=Therapeutic effect of spa therapy and short wave therapy in knee osteoarthritis: a randomized, single blind, controlled trial; citation_author=L Cantarini, G Leo, C Giannitti, G Cevenini, P Barberini, A Fioravanti; citation_volume=27; citation_publication_date=2007; citation_pages=523-529; citation_doi=10.1007/s00296-006-0266-5; citation_id=CR15
citation_journal_title=J Vasc Surg; citation_title=Randomized trial of balneotherapy associated with patient education in patients with advanced chronic venous insufficiency; citation_author=PH Carpentier, B Satger; citation_volume=49; citation_publication_date=2009; citation_pages=163-170; citation_doi=10.1016/j.jvs.2008.07.075; citation_id=CR16
citation_journal_title=Int Angiol; citation_title=Changes in the use of health resources by patients with chronic phlebopathies after thermal hydrotherapy. Report from the Naiade project, a nation-wide survey on thermal therapies in Italy; citation_author=S Coccheri, G Nappi, M Valenti, F Orio, E Altobelli, S Luca; citation_volume=21; citation_publication_date=2002; citation_pages=196-200; citation_id=CR17
citation_journal_title=Isr Med Assoc J; citation_title=Spa therapy for ankylosing spondylltis at the Dead Sea; citation_author=S Codish, S Dobrovinsky, M Abu Shakra, D Flusser, S Sukenik; citation_volume=7; citation_publication_date=2005; citation_pages=443-446; citation_id=CR18
citation_journal_title=J Derm Treat; citation_title=Effectiveness of climatotherapy at the Dead Sea for psoriasis vulgaris: a community-oriented study introducing the ‘Beer Sheva Psoriasis Severity Score’; citation_author=AD Cohen, D Van-Dijk, L Naggan, DA Vardy; citation_volume=16; citation_publication_date=2005; citation_pages=308-313; citation_doi=10.1080/09546630500375841; citation_id=CR19
citation_journal_title=Acta Derm Venereol; citation_title=Outcome of “short-term” Dead Sea climatotherapy for psoriasis; citation_author=AD Cohen, J Shapiro, D Michael, E Hodak, D Van-Dijk, L Naggan, DA Vardy; citation_volume=88; citation_publication_date=2008; citation_pages=90-91; citation_doi=10.2340/00015555-0340; citation_id=CR20
citation_journal_title=Clin Ter; citation_title=Psoriasis and mud bath therapy: clinical-experimental study (in Italian); citation_author=M Costantino, E Lampa; citation_volume=156; citation_publication_date=2005; citation_pages=145-149; citation_id=CR21
citation_journal_title=Acta Otorhinolaryngol Ital; citation_title=Effectiveness of sulphur spa therapy with politzer in the treatment of rhinogenic deafness; citation_author=M Costantino, E Lampa, G Nappi; citation_volume=26; citation_publication_date=2006; citation_pages=7-13; citation_id=CR22
citation_journal_title=Med Pregl; citation_title=The effects of balneotherapy on knee osteoarthritis (Serbian); citation_author=M Cutovic, S Jovic, L Konstantinovic, M Lazovic, T Jovanovic, V Vesovic; citation_volume=59; citation_issue=Suppl 1; citation_publication_date=2006; citation_pages=47-50; citation_id=CR23
citation_journal_title=Rheumatol Int; citation_title=Thalassotherapy for fibromyalgia: a randomized controlled trial comparing aquatic exercises in sea water and water pool; citation_author=SC Andrade, RF Carvalho, AS Soares, RP Abreu Freitas, LM Medeiros Guerra, MJ Vilar; citation_volume=29; citation_publication_date=2008; citation_pages=147-152; citation_doi=10.1007/s00296-008-0644-2; citation_id=CR24
citation_journal_title=Aust J Physiother; citation_title=Effects of a water-based program on women 65 years and over: a randomised controlled trial; citation_author=K Devereux, D Robertson, NK Briffa; citation_volume=51; citation_publication_date=2005; citation_pages=102-108; citation_id=CR25
citation_journal_title=Rheumatol Int; citation_title=Spa therapy in fibromyalgia: a randomised controlled clinic study; citation_author=A Dönmez, MZ Karagülle, N Tercan, M Dinler, H Issever, M Karagülle, M Turan; citation_volume=26; citation_publication_date=2005; citation_pages=168-172; citation_doi=10.1007/s00296-005-0623-9; citation_id=CR26
Epps H, Ginnelly L, Utley M, Southwood T, Gallivan S, Sculpher M, Woo P (2005) Is hydrotherapy cost-effective? A randomised controlled trial of combined hydrotherapy programmes compared with physiotherapy land techniques in children with juvenile idiopathic arthritis. Health Technol Assess (Winchester, England) 9:iii–iv, ix–x, 1–59
citation_journal_title=Jt Bone Spine: Revue du Rhumatisme; citation_title=The efficacy of balneotherapy and mud-pack therapy in patients with knee osteoarthritis; citation_author=D Evcik, V Kavuncu, A Yeter, I Yigit; citation_volume=74; citation_publication_date=2007; citation_pages=60-65; citation_doi=10.1016/j.jbspin.2006.03.009; citation_id=CR28
citation_journal_title=BMC Musculoskelet Disord; citation_title=A pragmatic randomised controlled trial of hydrotherapy and land exercises on overall well being and quality of life in rheumatoid arthritis; citation_author=L Eversden, F Maggs, P Nightingale, P Jobanputra; citation_volume=8; citation_publication_date=2007; citation_pages=23; citation_doi=10.1186/1471-2474-8-23; citation_id=CR29
citation_journal_title=Phys Med Rehab Kuror; citation_title=Untersuchungen über die Wirkungen von CO2-Gasbädern von unterschiedlicher Temperatur und Feuchte auf Hautdurchblutung und transkutan gemessenen Sauerstoffpartialdruck; citation_author=M Fink, C Heisler, F Candir, A Gehrke, Chr Gutenbrunner; citation_volume=11; citation_publication_date=2001; citation_pages=23-27; citation_doi=10.1055/s-2001-11039; citation_id=CR30
citation_journal_title=Minerva Med; citation_title=Evaluation of the efficacy and tolerance of radioactive fangotherapy in gonarthrosis. Comparative study versus short wave therapy; citation_author=A Fioravanti, S Bisogno, F Nerucci, MR Cicero, S Locunsolo, R Marcolongo; citation_volume=91; citation_publication_date=2000; citation_pages=291-298; citation_id=CR31
citation_journal_title=Panminerva Med; citation_title=Clinical efficacy and cost-effectiveness evidence of spa therapy in osteoarthritis. The results of “Naiade” Italian Project; citation_author=A Fioravanti, M Valenti, E Altobelli, F Orio, G Nappi, A Crisanti, L Cantarini, R Marcolongo; citation_volume=45; citation_publication_date=2003; citation_pages=211-217; citation_id=CR32
citation_journal_title=Joint Bone Spine: Revue du Rhumatisme; citation_title=Magnitude and duration of the effects of two spa therapy courses on knee and hip osteoarthritis: an open prospective study in 51 consecutive patients; citation_author=R Forestier; citation_volume=67; citation_publication_date=2000; citation_pages=296-304; citation_id=CR33
citation_journal_title=Joint Bone Spine: Revue du Rhumatisme; citation_title=Crenobalneotherapy for limb osteoarthritis: systematic literature review and methodological analysis; citation_author=R Forestier, A Francon; citation_volume=75; citation_publication_date=2008; citation_pages=138-148; citation_doi=10.1016/j.jbspin.2007.06.009; citation_id=CR34
citation_journal_title=Rheumatology; citation_title=Long-term efficacy of radon spa therapy in rheumatoid arthritis—a randomized, sham-controlled study and follow-up; citation_author=A Franke, L Reiner, HG Pratzel, T Franke, KL Resch; citation_volume=39; citation_publication_date=2000; citation_pages=894-902; citation_doi=10.1093/rheumatology/39.8.894; citation_id=CR35
citation_journal_title=Rheumatol Int; citation_title=Long-term benefit of radon spa therapy in the rehabilitation of rheumatoid arthritis: a randomised, double-blinded trial; citation_author=A Franke, L Reiner, KL Resch; citation_volume=27; citation_publication_date=2007; citation_pages=703-713; citation_doi=10.1007/s00296-006-0293-2; citation_id=CR36
citation_journal_title=Rheumatol Int; citation_title=Long-term benefit of radon spa therapy in the rehabilitation of rheumatoid arthritis: a randomised, double-blinded trial; citation_author=A Franke, L Reiner, KL Resch; citation_volume=27; citation_publication_date=2007; citation_pages=703-713; citation_doi=10.1007/s00296-006-0293-2; citation_id=CR37
citation_journal_title=Arthritis Rheum; citation_title=Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai Chi classes; citation_author=M Fransen, L Nairn, J Winstanley, P Lam, J Edmonds; citation_volume=57; citation_publication_date=2007; citation_pages=407-414; citation_doi=10.1002/art.22621; citation_id=CR38
citation_journal_title=Isr Med Assoc J; citation_title=Balneotherapy in elderly patients: effect on pain from degenerative knee and spine conditions and on quality of life; citation_author=J Gaal, J Varga, Z Szekanecz, J Kurko, A Ficzere, E Bodolay, T Bender; citation_volume=10; citation_publication_date=2008; citation_pages=365-369; citation_id=CR39
citation_journal_title=Arch Dermatol; citation_title=Balneophototherapy for psoriasis using saltwater baths and UV-B irradiation, revisited; citation_author=T Gambichler; citation_volume=143; citation_publication_date=2007; citation_pages=647-649; citation_doi=10.1001/archderm.143.5.647; citation_id=CR40
citation_journal_title=Joint Bone Spine: Revue du Rhumatisme; citation_title=Effect on osteoarthritis of spa therapy at Bourbonne-les-Bains; citation_author=F Guillemin, JM Virion, P Escudier, N Talance, G Weryha; citation_volume=68; citation_publication_date=2001; citation_pages=499-503; citation_doi=10.1016/S1297-319X(01)00314-1; citation_id=CR41
citation_journal_title=Z Allg Med; citation_title=Trinkkuren bei orthostatischen Kreislaufregulationsstörungen—Untersuchungen mit einem Natrium-Hydrogencarbonat-Chlorid-Wasser; citation_author=G Gundermann, Chr Gutenbrunner, B Stütgen, G Hildebrandt; citation_volume=74; citation_publication_date=1998; citation_pages=615-620; citation_id=CR42
citation_journal_title=Arthritis Rheum; citation_title=Exercise in waist-high warm water decreases pain and improves health-related quality of life and strength in the lower extremities in women with fibromyalgia; citation_author=N Gusi, P Tomas-Carus, A Hakkinen, K Hakkinen, A Ortega-Alonso; citation_volume=55; citation_publication_date=2006; citation_pages=66-73; citation_doi=10.1002/art.21718; citation_id=CR43
citation_journal_title=Phys Med Rehab Kuror; citation_title=Prospektive kontrollierte Studie über die Langzeitwirksamkeit stationärer Heilverfahren auf das kardiovaskuläre Risikoprofil; citation_author=Chr Gutenbruner, C Schreiber, K Beck, N Walter, I Ehlebracht-König, E v Pezold, A Gehrke, K Kniesch, B Thon, F Candir; citation_volume=12; citation_publication_date=2002; citation_pages=272-283; citation_doi=10.1055/s-2002-35159; citation_id=CR44
citation_journal_title=Wien Klin Wochenschr; citation_title=Hat die Balneologie und Medizinische Klimatologie in der Therapie chronischer Erkrankungen mehr als nur historische Bedeutung?; citation_author=CHR Gutenbrunner; citation_volume=118; citation_publication_date=2006; citation_pages=251-252; citation_doi=10.1007/s00508-006-0604-3; citation_id=CR45
citation_journal_title=Z Allg Med; citation_title=Kontrollierte Studie über die abführende Wirkung eines sulfathaltigen Heilwassers; citation_author=Chr Gutenbrunner, G Gundermann; citation_volume=74; citation_publication_date=1998; citation_pages=648-651; citation_id=CR46
citation_title=Handbuch der Balneologie und medizinischen Klimatologie; citation_publication_date=1998; citation_id=CR47; citation_author=Chr Gutenbrunner; citation_author=G Hildebrandt; citation_publisher=Springer
citation_journal_title=Phys Med Rehab Kuror; citation_title=Begriffsdefinitionen Medizinische Balneologie – Medizinische Klimatologie – Kurortmedizin; citation_author=Chr Gutenbrunner, A Schuh; citation_volume=12; citation_publication_date=2002; citation_pages=M13-M14; citation_id=CR48
citation_journal_title=Phys Med Rehab Kuror; citation_title=Vergleichende klinische Untersuchung über die Wirkung von kurörtlichen Trinkkuren mit einem Hydrogencarbonat-Heilwasser bei Patienten mit Hyperuricämie; citation_author=Chr Gutenbrunner, G Gunderman, R Wendt, D Grebe, A Gehrke; citation_volume=7; citation_publication_date=1997; citation_pages=257-259; citation_doi=10.1055/s-2008-1061884; citation_id=CR49
citation_journal_title=Phys Med Rehabilmed Kurortmed; citation_title=Beeinflussung der Schmerzempfindlichkeit gesunder Versuchspersonen durch natürliche Schwefelbäder; citation_author=Chr Gutenbrunner, K Kopetzki, M Neues-Lahusen, A Gehrke; citation_volume=9; citation_publication_date=1999; citation_pages=20-24; citation_doi=10.1055/s-2008-1061776; citation_id=CR50
citation_journal_title=Akt Rheumatol; citation_title=Wirkungen natürlicher thermoindifferenter Schwefelbäder auf Hautdurchblutung und Schmerzempfindlichkeit bei Gesunden und Patienten mit chronischer Polyarthritis; citation_author=Chr Gutenbrunner, K Kopetzki, M Neues-Lahusen, A Gehrke; citation_volume=24; citation_publication_date=1999; citation_pages=117-123; citation_doi=10.1055/s-2008-1043558; citation_id=CR51
citation_journal_title=J J A Phys M Baln Clim; citation_title=Controlled study on analgetic effects of sulphur baths and cold chamber expositions on patients suffering from fibromyalgia; citation_author=Chr Gutenbrunner, G Englert, M Neues-Lahusen, A Gehrke; citation_volume=64; citation_publication_date=2001b; citation_pages=129-140; citation_id=CR52
citation_journal_title=Chronobiol Int; citation_title=Circadian variations in the responsiveness of human gallbladder to sulfated mineral water; citation_author=Chr Gutenbrunner, A El-Cherid, A Gehrke, M Fink; citation_volume=18; citation_publication_date=2001a; citation_pages=1029-1039; citation_doi=10.1081/CBI-100107976; citation_id=CR53
citation_journal_title=J Rehabil Med; citation_title=White book on physical and rehabilitation medicine in Europe; citation_author=C Gutenbrunner, AB Ward, MA Chamberlain; citation_volume=45; citation_issue=Suppl. 1; citation_publication_date=2007; citation_pages=1-48; citation_id=CR54
citation_journal_title=Arch Phys Med Rehabil; citation_title=Does aquatic exercise relieve pain in adults with neurologic or musculoskeletal disease? A systematic review and meta-analysis of randomized controlled trials; citation_author=J Hall, A Swinkels, J Briddon, CS McCabe; citation_volume=89; citation_publication_date=2008; citation_pages=873-883; citation_doi=10.1016/j.apmr.2007.09.054; citation_id=CR55
citation_journal_title=Int J Dermatol; citation_title=The percentage of patients achieving PASI 75 after 1 month and remission time after climatotherapy at the Dead Sea; citation_author=M Harari, L Novack, J Barth, M David, M Friger, SW Moses; citation_volume=46; citation_publication_date=2007; citation_pages=1087-1091; citation_doi=10.1111/j.1365-4632.2007.03278.x; citation_id=CR56
Hernansanz AC (2001) Glosario de Hidrología Médica. Universidad Europea—CEES Ediciones. Serie “Manuales Universitarios” No 6, Madrid
citation_journal_title=J Am Acad Dermatol; citation_title=Climatotherapy at the Dead Sea is a remittive therapy for psoriasis: combined effects on epidermal and immunologic activation; citation_author=E Hodak, AB Gottlieb, T Segal, Y Politi, L Maron, J Sulkes, M David; citation_volume=49; citation_publication_date=2003; citation_pages=451-457; citation_doi=10.1067/S0190-9622(03)00916-2; citation_id=CR58
citation_journal_title=Minerva Cardioangiol; citation_title=Experimental-clinical study on the effects of hydromassage with Thermae Oasis's salsobromoiodine water in chronic venous stasis disease of the lower extremities; citation_author=E Ippolito, S Luca, S Sommaruga, V Grassellino, G Nappi; citation_volume=56; citation_publication_date=2008; citation_pages=401-408; citation_id=CR59
citation_journal_title=Endocr Regul; citation_title=Health resort treatment improved the neurosteroid profile in thyroidectomized women; citation_author=D Jandova, M Bicikova, M Hill, R Hampl; citation_volume=42; citation_publication_date=2008; citation_pages=17-22; citation_id=CR60
citation_journal_title=Forsch Komplementärmed Klass Naturheilkd; citation_title=Balneotherapy and spa therapy of rheumatic diseases in Turkey: a systematic review; citation_author=MZ Karagülle, M Karagülle; citation_volume=11; citation_publication_date=2004; citation_pages=33-41; citation_doi=10.1159/000077194; citation_id=CR61
citation_journal_title=World J Urol; citation_title=Clinical study on the effect of mineral waters containing bicarbonate on the risk of urinary stone formation in patients with multiple episodes of CaOx-urolithiasis; citation_author=O Karagülle, U Smorag, F Candir, G Gunderman, U Jonas, AJ Becker, A Gehrke, C Gutenbrunner; citation_volume=25; citation_publication_date=2007; citation_pages=315-323; citation_doi=10.1007/s00345-007-0144-0; citation_id=CR62
citation_journal_title=Clin Rheumatol; citation_title=A 10-day course of SPA therapy is beneficial for people with severe knee osteoarthritis. A 24-week randomised, controlled pilot study; citation_author=M Karagülle, MZ Karagülle, O Karagülle, A Dönmez, M Turan; citation_volume=26; citation_publication_date=2007; citation_pages=2063-2071; citation_doi=10.1007/s10067-007-0618-x; citation_id=CR63
citation_journal_title=Clin Dermatol; citation_title=Climatotherapy of psoriasis; citation_author=J Kazandjieva, I Grozdev, R Darlenski, N Tsankov; citation_volume=26; citation_publication_date=2008; citation_pages=477-485; citation_doi=10.1016/j.clindermatol.2008.05.001; citation_id=CR64
citation_journal_title=Clin Dermatol; citation_title=Climatotherapy of psoriasis; citation_author=J Kazandjieva, I Grozdev, R Darlenski, N Tsankov; citation_volume=26; citation_publication_date=2008; citation_pages=477-485; citation_doi=10.1016/j.clindermatol.2008.05.001; citation_id=CR65
citation_title=Glossar des Europäischen Heilbäderverbandese (Glossary of the European Spas Association; citation_publication_date=2005; citation_id=CR66; citation_author=C Kirschner; citation_publisher=Notamed
Klick J, Stratmann T (2008) Do spa visits improve health: evidence from German micro data. East Econ J EEA 0094-5056/08
citation_journal_title=Bull Exp Biol Med; citation_title=Genetic determinants of the efficiency of climatotherapy in patients with chronic heart failure; citation_author=DV Kovlen, AY Tishakov, OS Glotov, MV Moskalenko, GS Demin, AN Bitsadze, AV Chernyshev, NI Bratova, TE Ivashchenko, AG Obrezan, GN Ponomarenko; citation_volume=143; citation_publication_date=2007; citation_pages=26-31; citation_doi=10.1007/s10517-007-0008-z; citation_id=CR68
citation_journal_title=Acta Derm Venereol; citation_title=Climatotherapy at the Dead Sea stimulates vitamin D3 metabolism; citation_author=K Kragballe, WW Avrach, Y Politi, M Landau, S Brenner; citation_volume=76; citation_publication_date=1996; citation_pages=324-325; citation_id=CR69
citation_journal_title=Arch Dermatol; citation_title=Saline spa water or combined water and UV-B for psoriasis vs conventional UV-B: lessons from the Salies de Bearn randomized study; citation_author=C Leaute-Labreze, F Saillour, G Chene, C Cazenave, ML Luxey-Bellocq, C Sanciaume, JF Toussaint, A Taieb; citation_volume=137; citation_publication_date=2001; citation_pages=1035-1039; citation_id=CR70
citation_journal_title=J Rehabil Med; citation_title=A randomized controlled trial of aquatic and land-based exercise in patients with knee osteoarthritis; citation_author=H Lund, U Weile, R Christensen, B Rostock, A Downey, EM Bartels, B Danneskiold-Samsoe, H Bliddal; citation_volume=40; citation_publication_date=2008; citation_pages=137-144; citation_doi=10.2340/16501977-0134; citation_id=CR71
citation_journal_title=Vasa; citation_title=Clinical, functional and quality of life changes after balneokinesis with sulphurous water in patients with varicose veins; citation_author=S Mancini, A Piccinetti, G Nappi, S Mancini, A Caniato, S Coccheri; citation_volume=32; citation_publication_date=2003; citation_pages=26-30; citation_doi=10.1024/0301-1526.32.1.26; citation_id=CR72
citation_journal_title=Dermatol Ther; citation_title=Balneotherapy in dermatology; citation_author=H Matz, E Orion, R Wolf; citation_volume=16; citation_publication_date=2003; citation_pages=132-140; citation_doi=10.1046/j.1529-8019.2003.01622.x; citation_id=CR73
citation_journal_title=Clin Rheumatol; citation_title=The effect of balneotherapy at the Dead Sea on the quality of life of patients with fibromyalgia syndrome; citation_author=L Neumann, S Sukenik, A Bolotin, M Abu-Shakra, M Amir, D Flusser, D Buskila; citation_volume=20; citation_publication_date=2001; citation_pages=15-19; citation_doi=10.1007/s100670170097; citation_id=CR74
citation_journal_title=Br J Dermatol; citation_title=Increased levels of enkephalin following natural sunlight (combined with salt water bathing at the Dead Sea) and ultraviolet A irradiation; citation_author=JB Nissen, WW Avrach, ES Hansen, K Stengaard-Pedersen, K Kragballe; citation_volume=139; citation_publication_date=1998; citation_pages=1012-1019; citation_doi=10.1046/j.1365-2133.1998.02557.x; citation_id=CR75
citation_journal_title=J Altern Complement Med; citation_title=Does mud pack treatment have any chemical effect? A randomized controlled clinical study; citation_author=E Odabasi, M Turan, H Erdem, F Tekbas; citation_volume=14; citation_publication_date=2008; citation_pages=559-565; citation_doi=10.1089/acm.2008.0003; citation_id=CR76
citation_journal_title=J Hum Hypertens; citation_title=Blood pressure changes at the Dead Sea (a low altitude area); citation_author=E Paran, L Neuman, S Sukenik; citation_volume=12; citation_publication_date=1998; citation_pages=551-555; citation_doi=10.1038/sj.jhh.1000663; citation_id=CR77
citation_journal_title=Clin Ter; citation_title=Spa and climate therapy in chronic obstructive pulmonary diseases; citation_author=L Petraccia, SG Masciullo, M Grassi, A Pace, MC Lucchetta, VI Valenzi, P Avino, A Fraioli; citation_volume=156; citation_publication_date=2005; citation_pages=23-31; citation_id=CR78
citation_journal_title=Rheumatology; citation_title=Spa therapy and balneotherapy for treating low back pain: meta-analysis of randomized trials; citation_author=MH Pittler, MZ Karagülle, M Karagülle, E Ernst; citation_volume=45; citation_publication_date=2006; citation_pages=880-884; citation_doi=10.1093/rheumatology/kel018; citation_id=CR79
citation_journal_title=Santé Publique; citation_title=Evaluation of the effectiveness of crenotherapy in treating generalized anxiety disorder; citation_author=R Salamon, G Christine, JP Olié, O Dubois; citation_volume=20; citation_publication_date=2008; citation_pages=105-112; citation_doi=10.3917/spub.082.0105; citation_id=CR80
citation_journal_title=Experientia; citation_title=Climatotherapy; citation_author=A Schuh; citation_volume=49; citation_publication_date=1993; citation_pages=947-956; citation_doi=10.1007/BF02125641; citation_id=CR81
citation_journal_title=Wien Klin Wochenschr; citation_title=Effect of combined spa-exercise therapy on circulating TGF-beta1 levels in patients with ankylosing spondylitis; citation_author=M Shehata, JD Schwarzmeier, M Hilgarth, D Demirtas, D Richter, R Hubmann, P Boeck, G Leiner, A Falkenbach; citation_volume=118; citation_publication_date=2006; citation_pages=266-272; citation_doi=10.1007/s00508-006-0560-y; citation_id=CR82
citation_journal_title=Phys Ther; citation_title=Hydrotherapy versus conventional land-based exercise for the management of patients with osteoarthritis of the knee: a randomized clinical trial; citation_author=LE Silva, V Valim, AP Pessanha, LM Oliveira, S Myamoto, A Jones, J Natour; citation_volume=88; citation_publication_date=2008; citation_pages=12-21; citation_id=CR83
citation_journal_title=Forsch Komplementärmed Klass Naturheilkd; citation_title=The change of well-being associated with spa therapy; citation_author=G Strauss-Blasche, C Ekmekcioglu, N Klammer, W Marktl; citation_volume=7; citation_publication_date=2000; citation_pages=269-274; citation_doi=10.1159/000057174; citation_id=CR84
citation_journal_title=Forsch Komplementärmed Klass Naturheilkd; citation_title=The change of well-being associated with spa therapy; citation_author=G Strauss-Blasche, C Ekmekcioglu, N Klammer, W Marktl; citation_volume=7; citation_publication_date=2000; citation_pages=269-274; citation_doi=10.1159/000057174; citation_id=CR85
citation_journal_title=J Rehabil Med; citation_title=Developing “Human Functioning and Rehabilitation Research” from the comprehensive perspective; citation_author=G Stucki, JD Reinhardt, G Grimby, J Melvin; citation_volume=39; citation_publication_date=2007; citation_pages=665-671; citation_doi=10.2340/16501977-0136; citation_id=CR86
citation_journal_title=Int J Dermatol; citation_title=Balneotherapy for rheumatic diseases at the Dead Sea; citation_author=S Sukenik; citation_volume=37; citation_publication_date=1998; citation_pages=717-718; citation_doi=10.1046/j.1365-4362.1998.00554.x; citation_id=CR87
citation_journal_title=Clin Exp Rheumatol; citation_title=Dead Sea bath salts for the treatment of rheumatoid arthritis; citation_author=S Sukenik, L Neumann, D Buskila, A Kleiner-Baumgarten, S Zimlichman, J Horowitz; citation_volume=8; citation_publication_date=1990; citation_pages=353-357; citation_id=CR88
citation_journal_title=Ann Rheum Dis; citation_title=Sulphur bath and mud pack treatment for rheumatoid arthritis at the Dead Sea area; citation_author=S Sukenik, D Buskila, L Neumann, A Kleiner-Baumgarten, S Zimlichman, J Horowitz; citation_volume=49; citation_publication_date=1990; citation_pages=99-102; citation_doi=10.1136/ard.49.2.99; citation_id=CR89
citation_journal_title=J Rheumatol; citation_title=Treatment of psoriatic arthritis at the Dead Sea; citation_author=S Sukenik, H Giryes, S Halevy, L Neumann, D Flusser, D Buskila; citation_volume=21; citation_publication_date=1994; citation_pages=1305-1309; citation_id=CR90
citation_journal_title=Isr J Med Sci; citation_title=Balneotherapy for rheumatoid arthritis at the Dead Sea; citation_author=S Sukenik, L Neumann, D Flusser, A Kleiner-Baumgarten, D Buskila; citation_volume=31; citation_publication_date=1995; citation_pages=210-214; citation_id=CR91
citation_journal_title=Yonsei Med J; citation_title=Quality of life of psoriasis patients before and after balneo- or balneophototherapy; citation_author=S Tabolli, A Calza, C Pietro, F Sampogna, D Abeni; citation_volume=50; citation_publication_date=2009; citation_pages=215-221; citation_doi=10.3349/ymj.2009.50.2.215; citation_id=CR92
citation_journal_title=Arerugi; citation_title=Psychological investigation on spa therapy in patients with bronchial asthma; citation_author=Y Tanizaki, K Saitou, S Tada, M Harada; citation_volume=46; citation_publication_date=1997; citation_pages=511-519; citation_id=CR93
citation_journal_title=Med Sci Sports Exerc; citation_title=Aquatic training and detraining on fitness and quality of life in fibromyalgia; citation_author=P Tomas-Carus, A Hakkinen, N Gusi, A Leal, K Hakkinen, A Ortega-Alonso; citation_volume=39; citation_publication_date=2007; citation_pages=1044-1050; citation_doi=10.1249/01.mss.0b0138059aec4; citation_id=CR94
citation_journal_title=J Rehabil Med; citation_title=Eight months of physical training in warm water improves physical and mental health in women with fibromyalgia: a randomized controlled trial; citation_author=P Tomas-Carus, N Gusi, A Hakkinen, K Hakkinen, A Leal, A Ortega-Alonso; citation_volume=40; citation_publication_date=2008; citation_pages=248-252; citation_doi=10.2340/16501977-0168; citation_id=CR95
citation_journal_title=Clin Dermatol; citation_title=High mountain climatotherapy; citation_author=NK Tsankov; citation_volume=16; citation_publication_date=1998; citation_pages=699-707; citation_doi=10.1016/S0738-081X(98)00071-6; citation_id=CR96
citation_journal_title=Radiat Prot Dosim; citation_title=Radiological significance of beach sand used for climatotherapy from Safaga, Egypt; citation_author=MA Uosif, A El-Taher, AG Abbady; citation_volume=131; citation_publication_date=2008; citation_pages=331-339; citation_doi=10.1093/rpd/ncn175; citation_id=CR97
citation_journal_title=Eur J Appl Physiol; citation_title=Effect of hydrotherapy on the signs and symptoms of delayed onset muscle soreness; citation_author=J Vaile, S Halson, N Gill, B Dawson; citation_volume=102; citation_publication_date=2008; citation_pages=447-455; citation_doi=10.1007/s00421-007-0605-6; citation_id=CR98
citation_journal_title=Arth Rheum; citation_title=Combined spa-exercise therapy is effective in patients with ankylosing spondylitis: a randomized controlled trial; citation_author=A Tubergen, R Landewe, D Heijde, A Hidding, N Wolter, M Asscher, A Falkenbach, E Genth, HG The, S Linden; citation_volume=45; citation_publication_date=2001; citation_pages=430-438; citation_doi=10.1002/1529-0131(200110)45:5<430::AID-ART362>3.0.CO;2-F; citation_id=CR99
citation_journal_title=Arthritis Rheum; citation_title=Cost effectiveness of combined spa-exercise therapy in ankylosing spondylitis: a randomized controlled trial; citation_author=A Tubergen, A Boonen, R Landewe, M Rutten-Van Molken, D Heijde, A Hidding, S Linden; citation_volume=47; citation_publication_date=2002; citation_pages=459-467; citation_doi=10.1002/art.10658; citation_id=CR100
citation_journal_title=Cochrane Database Syst Rev; citation_title=Balneotherapy for osteoarthritis; citation_author=AP Verhagen, SM Bierma-Zeinstra, M Boers, JR Cardoso, J Lambeck, RA Bie, HC Vet; citation_volume=4; citation_publication_date=2007; citation_pages=CD006864; citation_id=CR101
citation_journal_title=Altern Complement Ther; citation_title=Spa Therapy for Bronchial Asthma: Studies at the Misasa Medical Center; citation_author=K Vu, F Mitsunobu; citation_volume=10; citation_publication_date=2004; citation_pages=144-150; citation_doi=10.1089/1076280041138243; citation_id=CR102
citation_journal_title=Altern Complement Ther; citation_title=Spa therapy for chronic obstructive pulmonary disease: studies at the Misasa Medical Center; citation_author=K Vu, F Mitsunobu; citation_volume=11; citation_publication_date=2005; citation_pages=89-93; citation_doi=10.1089/act.2005.11.89; citation_id=CR103
citation_journal_title=Isr Med Assoc J; citation_title=Climatotherapy: there is life in the Dead Sea; citation_author=R Wolf, E Orion, H Matz; citation_volume=5; citation_publication_date=2003; citation_pages=124-125; citation_id=CR104
citation_journal_title=Isr Med Assoc J; citation_title=Climatotherapy: there is life in the Dead Sea; citation_author=R Wolf, E Orion, H Matz; citation_volume=5; citation_publication_date=2003; citation_pages=124-125; citation_id=CR105
citation_journal_title=Rheumatology; citation_title=Cost-effectiveness of Spa treatment for fibromyalgia: general health improvement is not for free; citation_author=TR Zijlstra, LM Braakman-Jansen, E Taal, JJ Rasker, MA Laar; citation_volume=46; citation_publication_date=2007; citation_pages=1454-1459; citation_doi=10.1093/rheumatology/kem157; citation_id=CR106