RESUMEN
Einleitung: Ziel dieser systematischen Übersicht war die Bewertung der verfügbaren Evidenz zur Wirkung der Kneipp-Therapie. Methoden: MEDLINE, Embase, Web of Science, Cochrane-Library und CAMbase wurden nach relevanten Artikeln, veröffentlicht zwischen 2000 und 2019, durchsucht. Graue Literatur wurde über Google Scholar und andere Tools bezogen. Studien mit jeglicher Art von Studiendesign, die die Effekte der Kneipp-Therapie untersuchten, wurden eingeschlossen. Die Qualitätsbewertung erfolgte mittels EPHPP-QAT. Ergebnisse: 25 Quellen, darunter 14 kontrol-lierte Studien, wurden eingeschlossen. Gemäß EPHPP-QAT wurden 3 Studien "stark", 13 "moderat" und 9 "schwach" bewertet. Neun (64%) der kontrollierten Studien berichteten signifikante Verbesserungen nach Kneipp-Therapie im Gruppenvergleich bei chronisch-venöser Insuffizienz, Hypertonie, leichter Herzinsuffizienz, menopausalen Be-schwerden und Schlafstörungen in verschiedenen Patientenkollektiven sowie verbesserte Immunparameter bei gesunden Probanden. Im Hinblick auf Depression und Angst bei Mammakarzinom-Patientinnen mit klimakterischen Beschwerden, Lebensqualität bei Post-Polio-Syndrom, krankheitsbedingten polyneuropathischen Beschwerden und Inzidenz von Erkältungsepisoden bei Kindern konnten keine signifikanten Gruppenunterschiede festgestellt werden. Elf unkontrollierte Studien berichteten Verbesse-rungen bei allergischen Symptomen, Dyspepsie, Lebens-qualität, Herzratenvariabilität, Infekten, Hypertonie, Wohlbefinden, Schmerz und polyneuropathischen Beschwerden. Diskussion/Schlussfolgerung: Die Kneipp-Therapie scheint bei zahlreichen Beschwerdebildern in verschiedenen Patientenkollektiven positive Effekte zu bewirken. Zukünftige Studien sollten noch stärker auf eine methodisch sorgfältige Studienplanung achten (Kontrollgruppen, Randomisierung, adäquate Fallzahlen, Verblindung), um Verzerrungen entgegenzuwirken. INTRODUCTION: The aim of this systematic review was to evaluate the available evidence on the effect of Kneipp therapy. METHODS: MEDLINE, Embase, Web of Science, Cochrane Library and CAMbase were searched for relevant articles published between 2000 and 2019. Grey literature was obtained through Google Scholar and other tools. Studies with any kind of study design that examined the effects of Kneipp therapy were included. The quality assessment was carried out using EPHPP-QAT. RESULTS: 25 sources, including 14 controlled studies, were included. According to EPHPP-QAT, 3 studies were rated as "strong," 13 as "moderate" and 9 as "weak." Nine (64%) of the controlled studies reported significant improvements after Kneipp therapy in a between-group comparison in chronic venous insufficiency, hypertension, mild heart failure, menopausal complaints, and sleep disorders in different patient collectives as well as improved immune parameters in healthy subjects. Regarding depression and anxiety in breast cancer patients with climacteric complaints, quality of life in post-polio syndrome, disease-related polyneuropathic complaints and incidence of cold episodes in children, no significant group differences were found. Eleven uncontrolled studies reported improvements in allergic symptoms, dyspepsia, quality of life, heart rate variability, infections, hypertension, well-being, pain and polyneuropathic complaints. DISCUSSION/CONCLUSION: Kneipp therapy seems to be beneficial for numerous symptoms in different patient groups. Future studies should pay even more attention to methodologically careful study planning (control groups, randomisation, adequate case numbers, blinding) to counteract bias.
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Hidroterapia , Fitoterapia , Calidad de Vida , HumanosRESUMEN
The classical description of psoriasis does not include any of the subjective symptoms that accompany skin manifestations (pruritus, burning, tingling, pain), which is surprising especially for pruritus, a symptom present in the majority of patients with this disease, in a variable proportion between 60% and more than 90%. For the last two decades, the scientific interest for this symptom has increased. Many studies are evaluating the potential positive effect of various classes of drugs. No therapy is totally free of side effects. Psoriasis is an indication of the thermal treatment. The thermal water from Avène Hydrotherapy Center is known for its anti-inflammatory and immunomodulatory properties, as shown by many scientific studies. In this context, from the year 2016, in the Thermal Center, we studied the prevalence and characteristics of pruritus in patients with psoriasis, who came for a thermal treatment, but also the effect of hydrotherapy. In 2016, a study based on a dedicated questionnaire, administered at the entrance of the thermal station, revealed the presence of pruritus for 92% of patients who responded. In the period 2017-2018, the evaluation of pruritus associated with psoriasis on a numerical scale, in parallel with the evaluation of the severity of the disease by the thermal physician, showed the improvement of the psoriatic pruritus by 42% after the hydrotherapy cure. Recent results suggest that treatment in Avène Hydrotherapy Center might be considered for managing psoriasis accompanied by subjective symptoms, especially pruritus. © 2020 Elsevier Masson SAS. All rights reserved.
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Balneología , Aguas Minerales/uso terapéutico , Prurito/terapia , Psoriasis/complicaciones , Adulto , Anciano , Femenino , Francia , Humanos , Masculino , Persona de Mediana Edad , Prurito/etiología , Índice de Severidad de la EnfermedadRESUMEN
The sequelae of burns often are complicated by inflammatory and hypertrophic scars. Thermal cures can make a noticeable difference in improving these situations, which can be associated with considerable aesthetic damage and altered function. In this setting the benefits of the anti-inflammatory and antipruritic properties of thermal waters are combined with a high-pressure shower technique - the filiform shower - designed to soften and shape the infiltrated and hypertrophied skin areas. It is important to integrate the thermal cure at an early stage in the management of the condition, always considering it as an adjunct to the other therapeutic options available for the management of post-burn scarring. © 2020 Elsevier Masson SAS. All rights reserved.
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Balneología , Quemaduras/terapia , Aguas Minerales/uso terapéutico , Cicatrización de Heridas , Quemaduras/complicaciones , Cicatriz Hipertrófica/etiología , Cicatriz Hipertrófica/prevención & control , Humanos , Prurito/etiología , Prurito/terapiaRESUMEN
Thermalism is one of the oldest medical disciplines with a history of thousands of years and whose benefits are well documented. The therapy is based on a program of daily care for a period of three weeks in a thermal station. Hydrotherapy is particularly suitable in dermatology since the thermal water will be in direct contact with the skin lesions. The main indications are eczema, psoriasis, chronic pruritus, and wound healing disorders with new indications emerging, such as for cancer treatment-related side effects and follow-up care after cancer treatment. Thermalism encompasses much more than hydrotherapy, acquiring over the past few years a distinct place in therapeutic education. The therapy, which for a long time has been seen as an alternative to pharmacological treatments, should be positioned as an adjunct treatment for chronic dermatoses, aiming at reducing in the mid and long term the severity of the disease and drug dependence. © 2020 Elsevier Masson SAS. Tous droits réservés.
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Balneología , Aguas Minerales/uso terapéutico , Enfermedades de la Piel/terapia , Contraindicaciones , Dermatología , Francia , HumanosRESUMEN
Jean-Louis Alibert (1768-1837), Pierre-Alphée Cazenave (1802-1877) and Ferdinand von Hebra (1846-1880) are among the most famous names of the XIXth century dermatology. All were interested in hydrotherapy and mineral waters. Alibert was especially fond of sulfurous waters from the Pyrenees, for treating almost every inflammatory disease, like psoriasis, chronic eczema and even hair diseases or cheloids. He mentioned very often the use of mineral waters in his two masterpieces, Description des Maladies de la peau (1806) and Clinique de l'Hôpital Saint-Louis (1833). In case patients were not able to travel and spend times at thermal stations, he recommended artificial waters made by pharmacists in specialized places in Paris, consisting in water plus minerals, in order to obtain a composition close to natural spring waters. Around 1850, Cazenave also used mineral waters and hydrotherapy, mainly sulfurous waters. In Vienna, von Hebra was more reluctant to the use of mineral water, as he believed that the time spent in baths was more important than the composition of the water itself. Adrien Doyon (1827-1907), who translated Hebra's book in French, strongly disagreed with him, as he had a dermatology private practice in Uriage, in the French Alps. Modern hydrotherapy in dermatology is clearly in relation with this XIXth century tradition. © 2020 Elsevier Masson SAS. All rights reserved.
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Balneología/historia , Dermatología/historia , Aguas Minerales/historia , Enfermedades de la Piel/terapia , Historia del Siglo XIX , Humanos , Enfermedades de la Piel/historiaRESUMEN
Atopic dermatitis (AD) is the most frequent disease treated at the Avène hydrotherapy center. Children represent a large part of the population due to the high prevalence of AD in early childhood. Avène thermal spring water (ATSW) has been known for its therapeutic effects since the middle of the 18th century. It has been greatly studied over the last decades, with a comprehensive fundamental, pharmaco-clinical and clinical approach. Cohort studies using the Scoring Atopic Dermatitis (SCORAD) clinical score and the Dermatology Life Quality Index (DLQI) or the Children's Dermatology Life Quality Index [CDLQI]) quality of life scores, allowed to confirm the clinical results obtained from the previous studies. These results were corroborated by clinical trials conducted in atopic patients outside the Avène hydrotherapy center, allowing to demonstrate the specific effect of the ATSW. Pharmacological and pharmaco-clinical studies evidenced several effects that could explain the healing effect of ATSW: effect on histamine release, anti-inflammatory effects on standardized models, immuno-modulation of some cytokines involved in DA physiopathology (interferon [INF], interleukin 2 and 4 [IL-2, IL-4]), improvement of keratinocyte differentiation, effect on the skin microbioma by promoting the development of a diversified non-pathogenic flora. In addition, an original microorganism, Aquaphilus dolomiae, never described in another medium, has very recently been identified in the ATSW. Aquaphilus dolomiae is responsible for significant pharmacological activities on inflammation, pruritus and enhancement of innate immunity. This set of works confirms the medical significance of the hydrotherapy which should be considered as a complementary care in the sometimes difficult management of AD.
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Balneología , Dermatitis Atópica/terapia , Colonias de Salud , Aguas Minerales , Aerosoles , Calcio/metabolismo , Diferenciación Celular , Niño , Preescolar , Estudios de Cohortes , Terapia Combinada , Dermatitis Atópica/microbiología , Dermatitis Atópica/psicología , Francia , Humanos , Inmunomodulación , Queratinocitos/citología , Queratinocitos/efectos de los fármacos , Aguas Minerales/administración & dosificación , Aguas Minerales/análisis , Aguas Minerales/uso terapéutico , Estudios Multicéntricos como Asunto , Estudios Observacionales como Asunto , Calidad de Vida , Índice de Severidad de la Enfermedad , Piel/microbiología , Resultado del TratamientoRESUMEN
A brief cold water immersion between 2 continuous high-intensity exercise bouts improves the performance of the latter compared with passive recovery in the heat. We investigated if this effect is apparent in normothermic conditions (â¼19 °C), employing an intermittent high-intensity exercise designed to reflect the work performed at the high-intensity domain in team sports. Fifteen young active men completed 2 exhaustive cycling protocols (Ex1 and Ex2: 12 min at 85% ventilatory threshold (VT) and then an intermittent exercise alternating 30-s at 40% peak power (Ppeak) and 30 s at 90% Ppeak to exhaustion) separated by 15 min of (i) passive rest, (ii) 5-min cold-water immersion at 8 °C, and (iii) 10-min cold-water immersion at 8 °C. Core temperature, heart rate, rates of perceived exertion, and oxygen uptake kinetics were not different during Ex1 among conditions. Time to failure during the intermittent exercise was significantly (P < 0.05) longer during Ex2 following the 5- and 10-min cold-water immersions (7.2 ± 3.5 min and 7.3 ± 3.3 min, respectively) compared with passive rest (5.8 ± 3.1 min). Core temperature, heart rate, and rates of perceived exertion were significantly (P < 0.05) lower during most periods of Ex2 after both cold-water immersions compared with passive rest. The time constant of phase II oxygen uptake response during the 85% VT bout of Ex2 was not different among the 3 conditions. A postexercise, 5- to 10-min cold-water immersion increases subsequent intermittent high-intensity exercise compared with passive rest in normothermia due, at least in part, to reductions in core temperature, circulatory strain, and effort perception.