Objective and subjective assessment in balneotherapy: a systematic review

ABSTRACT

Natural mineral water has been used for its healing properties since ancient times, with balneotherapy being a non-pharmacological method of treating and preventing various diseases. However, it is critical to conduct a comprehensive assessment of patients receiving balneotherapy to construct safe and effective intervention programmes and assess their effectiveness. The purpose of this systematic review was the investigation of the objective and subjective assessment tools used in balneotherapy. The current study was performed from January 2000 to July 2022 in 6 databases in accordance with PRISMA standards. According to the findings, all the included studies relied on objective assessments using tools and functional tests conducted on dry land. Patient-reported outcomes primarily related to general health and quality of life were used for subjective assessments. However, no specific assessment tools for balneotherapy were identified in the review, and no wearable sensors or smart technology were utilised for real-time monitoring to ensure patient safety. This review underlines the importance of a comprehensive assessment protocol in balneotherapy, environing both land and aquatic assessments and integrating smart technology. More research is needed to develop objective and subjective assessment tools to enhance treatment effectiveness and ensure patient safety.

KEYWORDS:

• Balneotherapy
• spa therapy
• assessment

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This project is implemented in the framework of the “SMART TOURIST” Operation [grant number MIS 5047243] which is part of the Action “Strengthening Research and Innovation Infrastructure” and funded by the Operational Program “Competitiveness, Entrepreneurship and Innovation” under the NSRF 2014-2020. The co-financing of Greece and the European Union (European Regional Development Fund).

Notes on contributors

Eleni Argyroula Tsounia

Eleni Argyroula Tsounia is a Ph.D. candidate at the Department of Physiotherapy, University of Thessaly, Greece. The title of she's Ph.D thesis is “Development and implementation of an assessment protocol for patients using thermal springs”. She holds a Master's Degree (2017) in MSc Program in “Advanced Physiotherapy” from Department of Physiotherapy, University of Thessaly and a Bachelor's Degree (2014) in Physiotherapy from the Technological Educational Institute (TEI) of Thessaloniki, Greece. She is a member of the research lab “Health Assessment and Quality of Life” of the Department of Physiotherapy, University of Thessaly, and a researcher on the European-funded Project “Smart-Tourist”. She is also Academic Scholar at the University of Thessaly. Her research interest and expertise concern in hydrotherapy, aquatic therapy, balneotherapy, pediatrics and neurorehabilitation. She has presentations in the Balneotherapy and Hydrotherapy field in national and international conferences and congresses.

Konstantinos Chandolias

Dr Konstantinos Chandolias is a physiotherapist and hydrotherapist with a PhD in hydrotherapy and neurodevelopmental disorders. He is holding 2 masters in ‘Exercise and Health' from the University of Thessaly and in ‘Pediatric Physiotherapy’ from International Hellenic University. He is postdoctoral researcher in the field of hydrotherapy in balneotherapy of the department of physiotherapy, University of Thessaly. His research interests concern the objective assessment in water environment and the functional therapy approach in water. He is a senior Halliwick lecturer, member of The Educational and research committee of IHA and chair of Halliwick Association of Greece. He is teaching Halliwick- hydrotherapy foundation and advanced courses in Greece and all over world.

Markos Sgantzos

Dr. Markos Sgantzos, born in Athens in 1964, is a distinguished medical professional specializing in Physical and Rehabilitation Medicine. He currently holds the position of Consultant Physiatrist at the Department of Neurology, General University Hospital of Larissa. He is also an Associate Professor in the Department of Anatomy at the Faculty of Medicine, University of Thessaly. Since September 2010, he has been imparting his extensive knowledge to fourth-year medical students through the course “Physical Medicine and Rehabilitation.” He has played a pivotal role in shaping the medical landscape, holding the prestigious Senior European Board Certified PRM (SEBPRM) designation and earning a Certificate of Specialty in Physical and Rehabilitation Medicine in Greece since 1996. He serves as a dedicated Delegate for both the Section and Board of UEMS PRM and the European Society of Physical and Rehabilitation Medicine. Additionally, Dr. Sgantzos holds the esteemed position of President of the Hellenic Society of Physical and Rehabilitation Medicine. His commitment to medical education extends beyond the classroom, as he is the President of the examining Committee for the medical specialty of Physical and Rehabilitation Medicine in Greece. He is actively involved in multiple post-graduate programs, demonstrating his dedication to advancing the field of medicine. With a work address at Viopolis New Building in Larissa and contact numbers including [phone] for work and [phone] for his cell phone, Dr. Markos Sgantzos stands as a beacon of expertise and leadership in the realm of Physical and Rehabilitation Medicine

Garyfallia Pepera

Dr Garyfallia Pepera is an Assistant Professor in Cardiovascular Physiotherapy, in Physiotherapy Department at the University of Thessaly. She earned a bachelor's degree (2003) in Physiotherapy from University of Thessaly in Greece. She holds a PhD (Doctor of Philosophy, 2011) in Cardiac Rehabilitation from University of Essex in United Kingdom and an M.Sc. (Master of Science) (2005) in Medicine and Science in Sport and Exercise (Therapy) from Glasgow University, Strathclyde University & Glasgow Caledonian University in United Kingdom. She is a Deputy Director of Clinical Exercise Physiology and Rehabilitation Laboratory in Physiotherapy Department at the University of Thessaly. Her research interests are cardiac rehabilitation, telerehabilitation, the implementation of physical activity programs and cardiovascular assessment programs in cardiac patients, diabetic patients, children, adolescents, and older people. https://orcid.org/my-orcid?orcid=0000-0001-8012-0325

Eleni Kapreli

Prof. Eleni Kapreli is a Professor in Physiotherapy Department, University of Thessaly. She has an MSc (1996) from University of Nottingham, UK and a PhD (2006) from National and Kapodistrian University of Athens and research interest on the underlying mechanisms of dysfunction development in chronic neuro-musculoskeletal patients as well as in prevention and rehabilitation of sports injuries. She has attended numerous specialized postgraduate courses and seminars. She has participated in more than 25 national and international conferences as an invited speaker and also, she has oral presentations and posters in more than 40 international and 70 national conferences and congresses. Furthermore, she has received a number of awards for best conference presentations. She has more than 70 peer reviewed scientific publications with more than 3000 citations and 25 h-index (https://www.researchgate.net/profile/Eleni-Kapreli-2). She has been coordinator/member of scientific team in several research projects and she has received Marie Curie Fellowship by European Commission. She is currently the Director of Clinical Exercise Physiology and Rehabilitation Laboratory, University of Thessaly, Director of MSc Advanced Physiotherapy in University of Thessaly, Director of Lifelong Learning courses, and member of Scientific committee of Sports Physiotherapy accreditation of Pahnellenic Association of Physiotherapsts.

Nikolaos Strimpakos

Prof. Nikolaos Strimpakos is a Professor in the Department of Physiotherapy, University of Thessaly, Greece. He holds an MSc and PhD in Rehabilitation from University of Manchester, UK and has BSc in both Physiotherapy and Sports Science. He has been Vice-Rector of Academic Affairs in the TEI of Sterea Ellada, Director of the Centre for Technological Research of Central Greece and Head of MSc Program in Advanced Physiotherapy. Currently, he is Director of Research Institute of Rehabilitation and Wellbeing, Director of Health Assessment and Quality of Life Lab, Vice-Head of Physiotherapy Department and member of Quality Assurance Unit of University of Thessaly. He is also member of Education and Research Working Group of European Region of WCPT and National Delegate of European Society for Shoulder and Elbow Rehabilitation (EUSSER). He has written more than 60 peer-review articles in international Journals having up to now more than 3100 citations. His research interest and expertise concern the musculoskeletal rehabilitation, development of objective and subjective outcome measures, exercise in chronic diseases, hydrotherapy and has been principal investigator or member of research teams in projects with more than 2.000.000 euros.