Evaluation of the immediate and midterm effects of mobilization in hot spa water on static and dynamic balance in elderly subjects.

OBJECTIVES

The purpose of this study was to compare one and four weeks of active mobilization during balneotherapy (B) with mobilization on land (L) in terms of the respective effects on static and dynamic balance in elderly subjects.

METHODS

Twelve elderly volunteers (mean age: 65.6+/-6.3 years) were evaluated for pain (on a visual analogue scale, [VAS]), static balance (as measured by the centre of foot pressure, [COP]) and dynamic balance (the "Timed Up and Go" [TUG] test). Six measurement sessions were performed: three baseline sessions before exercise sessions (PostL, PreB1 and PreB4) and then after a land-based session L and after one and four weeks (B1 and B4) of balneotherapy at 34 degrees C (PostL, PostB1 and PostB4, respectively).

RESULTS

A Friedman analysis of variance (ANOVA) revealed significant differences between the six conditions in terms of the TUG and VAS results (p<0.01 and p<0.05, respectively). The TUG time decreased after the balneotherapy session(s) (p<0.01, PreB1 versus PostB1 and PreB4 versus PostB4). After sessions B1 and B4, a decrease in the VAS score was noted (p<0.05, PreB1 versus PostB1 and PreB4 versus PostB4). In contrast, there were no significant postbalneotherapy changes in any of the postural parameters.

CONCLUSION

Balneotherapy sessions appear to induce a decrease in pain and an increase in dynamic mobility. This might be explained by enhanced proprioceptive input during neuromuscular mobilization in water (i.e. with increased resistance but a lower load).