Physical Medicine and Rehabilitation School, University of Padova, Padua, Italy.
La Residence & Idrokinesis, Abano Terme, Italy.
Int J Biometeorol. 2023 Jan;67(1):29-36. doi: 10.1007/s00484-022-02381-4. Epub 2022 Oct 8.
Clinical trials have demonstrated traditional spa therapy effects in musculoskeletal disorders (MSDs). This is the first observational study in Italy aimed at evaluating in real-life the short-time effects of spa rehabilitation on pain, mood and quality of life (QoL) among degenerative or post-surgery MSDs patients. Through the involvement of six Italian spa facilities, 160 patients were enrolled; data from 123 patients were finally analysed. Seventy-nine patients (64.3%) accessed the spa for degenerative MSDs, while 44 (35.8%) had a post-surgical condition. All the patients included in the study underwent 12 sessions of water-based exercise (joint exercises, muscle strengthening, gait training, proprioceptive and balance techniques) conducted in thermal or in warm water pools, six sessions per week, for a period of 2 weeks from March 2019 up to October 2019. A group of 45 patients (36.6%) also received traditional thermal therapies, including 12 mud therapy sessions and 12 thermal baths, six times each week, for 2 weeks. Evaluation before and after the treatment included the Numerical Rating Scale (NRS), the Short Form Health Survey (SF-12) and the EuroQol-5D (EQ-5D). The analysis of the scores reported in the questionnaires after the treatment showed a significant improvement in all the scores evaluated. Comparison between patients that performed water-based exercise protocols alone (group A) and patients that in addition to water exercise performed traditional thermal interventions (group B) showed no statistically significant differences in NRSp, NRSa, NRSm, SF-12 PCS, SF-12 MCS and EQ-5D variations; only NRSa value reduction was lower in group B. Sulphate water was found to be associated with a lower reduction of all the scores considered, when compared to the other water types. Patients with degenerative or post-surgery MSDs showed favourable effects on pain, mood and QoL after water exercise training alone or in combination with traditional thermal therapy. Our research provides the first proof that spa rehabilitation can be in real-life conditions an appropriate alternative strategy for post-orthopaedic surgical outcomes recovery. In the future, these results will need to be further investigated.
临床试验已经证明了传统水疗在肌肉骨骼疾病（MSD）中的治疗效果。这是意大利第一项旨在评估水疗康复对退行性或手术后 MSD 患者疼痛、情绪和生活质量（QoL）的短期影响的观察性研究。通过六家意大利水疗设施的参与，共招募了 160 名患者；最终对 123 名患者的数据进行了分析。79 名患者（64.3%）因退行性 MSD 接受水疗，44 名患者（35.8%）为手术后状况。所有纳入研究的患者均接受了 12 次水基运动（关节运动、肌肉强化、步态训练、本体感觉和平衡技术），在热或温水池中进行，每周 6 次，为期 2 周，时间为 2019 年 3 月至 2019 年 10 月。一组 45 名患者（36.6%）还接受了传统的热疗，包括 12 次泥疗和 12 次温泉浴，每周 6 次，为期 2 周。治疗前后的评估包括数字评分量表（NRS）、健康调查简表 12 项（SF-12）和 EuroQol-5D（EQ-5D）。治疗后问卷评分分析显示，所有评估项目的评分均有显著改善。仅接受水基运动方案的患者（A 组）与除水运动外还进行传统热干预的患者（B 组）之间，NRSp、NRSa、NRSm、SF-12 PCS、SF-12 MCS 和 EQ-5D 变化的 NRS 差异无统计学意义；B 组的 NRSa 值降低幅度较低。与其他类型的水相比，硫酸盐水被发现与所有评分的降低幅度较小有关。单独接受水运动训练或结合传统热疗的退行性或手术后 MSD 患者的疼痛、情绪和生活质量均有改善。我们的研究首次证明，水疗康复在现实条件下可能是骨科手术后康复的一种合适的替代策略。未来，还需要进一步研究这些结果。
