OBJECTIVE AND SUBJECTIVE ASSESSMENT IN BALNEOTHERAPY: A SYSTEMATIC REVIEW

E.A. Tsounia¹, K. Chandolias¹, G. Tsatsakos¹, N. Strimpakos^1,2

¹University of Thessaly, Department of Physiotherapy, Lamia, Greece, ²University of Manchester, Division of Musculoskeletal & Dermatological Sciences, UK, United Kingdom

Background: Natural mineral water's healing properties have been appreciated for the human body's health benefits since ancient times. The use of natural mineral waters, gases, and peloids for the treatment and prevention of various diseases is known as balneotherapy. The implementation of a comprehensive subjective and objective assessment of the patients/users of balneotherapy is critical for constructing safe and valid intervention programs as well as for the evaluation of the effectiveness of these programs.

Purpose: The investigation and documentation of the assessment tools used in balneotherapy are the goals of this systematic review.

Methods: From January 2000 to July 2022, a systematic review was conducted in 6 databases (PubMed/Medline, Pedro, Cochrane Database Systematic Review, Scopus, OVID, and Web of Science). Keywords such as "thermal therapy" or "thermal bath" or "thermal springs" or "balneotherapy" or "spa therapy" AND "assessment" or "physiotherapy" or "rehabilitation" or "pain" or "quality of life" were used. Articles were searched and qualitatively assessed by two independent researchers using the STARD and SPAC (Spa Therapy Checklist) tools. The current study was performed in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis standards (PRISMA). The protocol of the systematic review was registered in PROSPERO (International Prospective Register of Systematic Reviews) with registration number: CRD42021240152.

Results: In this systematic review, the results were selected and evaluated by two independent researchers (ET, CK). The total number of studies identified in the databases was 5.278. Twenty-eight (28) studies were selected for quality assessment. The final studies included in the total results were sixteen (16). The included studies were highly heterogeneous in a range of variables such as the water composition, the sample sizes, the assessment tools, and the assessment protocols used. According to the results, in all the included studies the objective assessment was performed with tools and functional tests utilized on dry land. The subjective assessment was conducted using patient-reported outcomes (PROs) mainly related to the general health and quality of life.

Conclusions: Assessment of patients in balneotherapy studies was mainly performed with self-report questionnaires and functional tests or objective tools on dry land environment and not in the water. Provided that in hydrotherapy research, many functional tests are conducted to evaluate patients in both environments (aquatic and dry land) and the results were different between the two environments it is necessary also in balneotherapy studies to design a complete assessment protocol while the patients are in the water.

Implications: In balneotherapy studies, the patients' assessment was performed with objective and subjective assessment tools on dry land and not in an aquatic environment.

Funding acknowledgements: Framework "Smart Tourist". Co-financed by Greece and EU (European Regional Development Fund) NSRF 2014-2020, MIS 5047243.

Keywords:
balneotherapy
spa therapy
assessment

Topics:
Health promotion & wellbeing/healthy ageing/physical activity
Older people

Did this work require ethics approval? No

Reason: This study is a systematic review and was carried out with studies in balneotherapy. All the clinical outcomes did not have any human subjects as samples for the study