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Pantovic SM, Roganovic MB, Slavic VG, Zvizdojevic JM. Laboratory features of effects of peloidotherapy and aromatherapy in patients with rheumatoid arthritis. Int J Biometeorol 2024; 68:855-860. [PMID: 38311644 DOI: 10.1007/s00484-024-02630-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/06/2024]
Abstract
Peloidotherapy and aromatherapy have been used for years in the treatment of numerous inflammatory conditions, including rheumatoid arthritis (RA). The exact mechanism of their action in RA is unclear. The goal of our research is to determine the effect of peloidotherapy and aromatherapy on inflammation parameters in RA patients. Our study included 20 patients of both sexes, with confirmed diagnosis of RA, older than 18 years. Patients were treated during 28 days with combination of peloidotherapy and aromatherapy. Serum samples for detection of levels of inflammation parameters were taken at two intervals: before the start of therapy and at the end of treatment. The results of our study show that there were no significant changes in the parameters of the complete blood count. Nevertheless, a statistically significant decrease in the serum concentration of two markers of inflammation-interleukin-6 (IL-6) and nitrogen-oxide (NO)-was detected. Correlation analyses results say that there is a synchronized drop in the serum concentrations of CRP and the sedimentation rate, and the serum concentrations of fibrinogen and IL-6 are in the same relationship as well as serum levels of IL-6 and NO. Bearing in mind the importance of IL-6 and NO in the pathogenesis of inflammation in RA, we conclude that the application of our therapeutic protocol can be a significant add-on treatment to classic immunomodulators. Due to the small number of study participants, the lack of a control group, and the short follow-up time of patients, additional research is needed.
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Affiliation(s)
- Snezana M Pantovic
- Faculty of Medicine, University of Montenegro, Krusevac Bb, 81000, Podgorica, Montenegro.
| | | | - Vjeroslava G Slavic
- Faculty of Medicine, University of Montenegro, Krusevac Bb, 81000, Podgorica, Montenegro
- Institute for Physical Medicine, Rehabilitation and Rheumatology "Dr Simo Milosevic", Sava Ilica 5, 85347, Igalo, Herceg Novi, Montenegro
| | - Jelena M Zvizdojevic
- Scientific Research Institution Damar, Crnogorskih Serdara Bb, 81000, Podgorica, Montenegro
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Koru H, Yilmaz H, Yilmaz R, Karpuz S. Comparison of the efficiency of peloidotherapy and extracorporeal shock wave therapies in patients diagnosed with lateral epicondylitis: a prospective, randomized, controlled study. Int J Biometeorol 2024; 68:101-108. [PMID: 37934301 DOI: 10.1007/s00484-023-02574-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/10/2023] [Accepted: 10/27/2023] [Indexed: 11/08/2023]
Abstract
Various treatment methods are used in the management of lateral epicondylitis (LE); however, there is no universally accepted standard treatment approach. The aim of this study is to compare the effects of peloidotherapy and extracorporeal shock wave therapy (ESWT) on pain, functional status, and quality of life in the treatment of LE. The study was designed as a hospital-based, prospective randomized controlled trial. Ninety patients, with a mean age of 47.30±7.95 (range, 18 to 65 years), diagnosed with chronic (3 months) unilateral LE were included in the study. The patients were randomly divided into two groups. The peloidotherapy group received 15 sessions of peloid therapy for 3 weeks, 5 days a week, while the ESWT group received three sessions of ESWT (1.8 bar, 10.0 Hz, 2000 impulses) for 3 weeks, once a week. The patients were evaluated before treatment, at the end of the treatment, and one month after the treatment. The groups were compared in terms of pain, quality of life, functional status, and handgrip strength. At the end of the treatment and one-month follow-up, statistically significant improvements were observed in all parameters. This study is the first randomized trial comparing peloidotherapy to ESWT as an adjunct to exercise therapy in LE. Both ESWT and peloidotherapy, when added to exercise therapy, showed positive short-term effects on pain, quality of life, functional status, and handgrip strength in primary conservative treatment of chronic LE (p<0.001), and no superiority was found between them in terms of efficacy. Peloidotherapy or ESWT may be preferred in the treatment of lateral epicondylitis, depending on the patient's condition. Peloidotherapy appears to be more advantageous due to its lower side effects and painless nature. ClinicalTrials.gov ID: NCT04748406.
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Affiliation(s)
- Hasan Koru
- Department of Physical Medicine and Rehabilitation, Konya Beyhekim Training and Research Hospital, University of Health Sciences, Devlethane Street No:2/A, 42060, Selcuklu, Konya, Turkey.
| | - Halim Yilmaz
- Department of Physical Medicine and Rehabilitation, Konya Beyhekim Training and Research Hospital, University of Health Sciences, Devlethane Street No:2/A, 42060, Selcuklu, Konya, Turkey
| | - Ramazan Yilmaz
- Department of Physical Medicine and Rehabilitation, Konya Beyhekim Training and Research Hospital, University of Health Sciences, Devlethane Street No:2/A, 42060, Selcuklu, Konya, Turkey
| | - Savaş Karpuz
- Department of Physical Medicine and Rehabilitation, Konya Beyhekim Training and Research Hospital, University of Health Sciences, Devlethane Street No:2/A, 42060, Selcuklu, Konya, Turkey
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Adıgüzel T, Arslan B, Gürdal H, Karagülle MZ. Evaluation of the therapeutic and the chemical effects of balneological treatment on clinical and laboratory parameters in knee osteoarthritis: a randomized, controlled, single-blinded trial. Int J Biometeorol 2022; 66:1257-1265. [PMID: 35347399 DOI: 10.1007/s00484-022-02274-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 06/14/2023]
Abstract
The purpose of this study was to investigate the therapeutic and the chemical effects of balneological treatment (peloidotherapy + hydrotherapy), and its effects on serum levels of interleukin-1beta (IL-1β), tumor necrosis factor-alpha (TNF-α), and insulin-like growth factor-1 (IGF-1) in patients with knee osteoarthritis (OA). Sixty-four (64) knee OA patients were randomly divided into study and control groups. Balneological treatment, consisting of hydrotherapy, and peloidotherapy were given to both groups. Unlike the study group, in the control group, the peloid was applied over a stretch film cover, preventing any contact between the skin and peloid. Clinical outcome measures of the study were pain degree, patient's and investigator's global assessment on visual analog scale (VAS-pain, VAS-PGA, VAS-IGA), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (pain, stiffness, and physical function). Patients were evaluated at baseline, post-treatment (after 10th session), and 3 and 6 months after treatment. Blood samples were taken at baseline, post- treatment, and 6 months after treatment for analysis of IL-1β, TNF-α, and IGF-1 serum levels. When compared with the baseline, VAS measurements decreased significantly in almost all evaluation periods in both groups, and no difference was observed between the groups. In the study group, WOMAC scores showed significant improvement in all assessments. In the control group, pain and physical function subscores of WOMAC significantly decreased at post-treatment and 3 months after treatment. In group comparison, pain and stiffness subscores showed a significant difference in favor of the study group at 6 months after treatment. No clinically significant improvement was seen in levels of IL-1β and IGF-1 in both groups during the whole assessment period. Because of TNF-α kit failure, we could not evaluate the measurements. In conclusion, balneological treatment is an effective treatment option to improve the pain and functional capacity of patients with knee OA. The application of peloid by contact with the skin is superior in the long-term period, which means that in addition to the thermal effect, the chemical content of peloid can also contribute to the therapeutic effect.
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Affiliation(s)
- Tuba Adıgüzel
- Department of Medical Ecology and Hydroclimatology, Bolu Abant Izzet Baysal University Physical Medicine and Rehabilitation Hospital, Bolu, Turkey.
| | - Beyza Arslan
- Department of Medical Ecology and Hydroclimatology, Faculty of Medicine, Izmir Katip Çelebi University, Izmir, Turkey
| | - Hatice Gürdal
- Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, Istanbul, Turkey
| | - M Zeki Karagülle
- Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, Istanbul, Turkey
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Güneri FD, Forestier FBE, Forestier RJ, Karabulut SS, Karaarslan F, Karagülle MZ, Karagülle M. Peloidotherapy in rheumatoid arthritis: a pilot randomized clinical trial. Int J Biometeorol 2021; 65:2171-2180. [PMID: 34398311 DOI: 10.1007/s00484-021-02181-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/05/2021] [Indexed: 06/13/2023]
Abstract
To evaluate the additional effect and safety of peloidotherapy to usual care at short- and middle-term in patients with rheumatoid arthritis (RA). RA patients were recruited in the medical ecology and hydroclimatology department of Istanbul Medical Faculty and were randomized into two parallel groups. Peloidotherapy group was treated with heated mudpack (41-42 °C) on painful and active joints (5 days/week, during 2 weeks) + usual care. Control group received usual care alone. Randomization was performed by using a computer-generated table of random numbers and was blinded. The sequence was concealed until interventions were assigned. The investigator was blinded. The assessments were done before and after the intervention, 1 month and 3 months after the completion of treatment. The main criterion was the number of patients with low disease activity (DAS 28 ≤ 3.2) at the end of follow-up. Other judgment criteria were pain (VAS), patient's global assessment (VAS), physician's global assessment (VAS), Health Assessment Questionnaire (HAQ), Disease Activity Score (DAS 28), CRP, and ESR. Fifty-six patients were recruited and analyzed: 29 in peloidotherapy group and 27 in the control group between 11/2011 and 02/2012. At the third month, 9/29 patients were with low disease activity in peloidotherapy group and 4/27 in the control group (p = 0.15). There was a statistically significant improvement in favor of peloidotherapy group for HAQ during all follow-up period (0.25 vs 0.63, p = 0.007 at the end of the treatment, 0.29 vs 0.68 p = 0.007 at the 1st month and 0.30 vs 0.59, p = 0.040 at the 3rd month). Pain (35vs50, p = 0.028), patient's global assessment (37vs53, p = 0.028), physician's global assessment (33vs48, p = 0.030), and DAS28 (3.76vs4.58, p = 0.049) improved significantly more in peloidotherapy group at the 3rd month. There were no between group differences for ESR and CRP. There were no important adverse events. There is no significant improvement for the main criteria so we can't conclude that peloidotherapy has additional effect over usual care. But most of the other judgment criteria improved more in the peloidotherapy group than in the control group and peloidotherapy was well tolerated. A trial with higher statistical power is necessary to if we want to reveal the effects on disease activity and confirm the short and middle term efficiency of this treatment modality on pain and quality of life.
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Affiliation(s)
- Fulya Demircioğlu Güneri
- Department of Medical Ecology and Hydroclimatology, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
| | | | | | - Serap Seringeç Karabulut
- Department of Medical Ecology and Hydroclimatology, Gazi Osmanpaşa Training and Research Hospital, İstanbul, Turkey
| | - Fatih Karaarslan
- Department of Medical Ecology and Hydroclimatology, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Müfit Zeki Karagülle
- Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mine Karagülle
- Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Yücesoy H, Dönmez A, Atmaca-Aydın E, Yentür SP, Saruhan-Direskeneli G, Ankaralı H, Erdoğan N, Karagülle MZ. Effects of balneological outpatient treatment on clinical parameters and serum cytokine levels in patients with chronic low back pain: a single-blind randomized controlled trial. Int J Biometeorol 2021; 65:1367-1376. [PMID: 33712909 DOI: 10.1007/s00484-021-02109-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/27/2021] [Accepted: 03/01/2021] [Indexed: 05/25/2023]
Abstract
This study aimed to investigate the effects of balneological outpatient treatment (hydrotherapy and peloidotherapy) on clinical status and serum cytokine levels in patients with chronic low back pain (CLBP). Seventy-four patients with CLBP who accepted to participate to the study were randomly divided into two groups. The study group was given ten sessions (in 2 weeks) of hydrotherapy, peloidotherapy, and home exercise, while the control group was given only home exercise. All patients were assessed before and at the end of therapy, at the 1st and 3rd months. The primary outcomes were pain intensity on the visual analog scale (VAS) (VAS-pain, VAS-rest, VAS-exercise) and Oswestry Disability Index (ODI). The secondary outcome measures included patient's and physician's global assessment (VAS-PGA), (VAS-DGA), finger-to-floor distance (FFD), modified Schober test, Short Form-36 (SF-36), and the use of analgesic drug. Venous blood samples were drawn from all patients before/1st day and after therapy/12th day to measure serum interleukin (IL)-6 and IL-10 levels. Significant improvement was observed in the study group in VAS-pain, VAS-rest, VAS-exercise, VAS-PGA, VAS-DGA, ODI, and SF-36 parameters after treatment and improvement maintained for 3 months. In the control group, significant improvement was observed in VAS-pain, VAS-exercise, VAS-PGA, VAS-DGA, and ODI scores on the 12th day and continued for 3 months. Decrease in pain, pain during rest and exercise, modified Schober test, VAS-PGA, VAS-DGA, ODI scores, and the increase in SF-36 pain and general health scores showed superiority in favor of the study group in all evaluations. There was a significant increase in IL-10 values from baseline at the end of treatment in the study group. The use of non-steroidal anti-inflammatory drug (NSAID) was significantly lower in the study group compared with the use of NSAID in the control group in the 3rd month. Balneological outpatient treatment improved clinical status in CLBP patients. Although no significant correlation was clearly determined between IL-10 levels and pain score, this effect might be related to the observed increase in the anti-inflammatory cytokine IL-10 levels that was observed only in the study group.
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Affiliation(s)
- H Yücesoy
- Department of Medical Ecology and Hydroclimatology, Antalya Education and Research Hospital, University of Health Sciences, Varlık Mh. Kazım Karabekir Cd., 07100 Muratpaşa, Antalya, Turkey.
| | - A Dönmez
- Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Fatih, Çapa, Istanbul, Turkey
| | - E Atmaca-Aydın
- Department of Medical Ecology and Hydroclimatology, Antalya Education and Research Hospital, University of Health Sciences, Varlık Mh. Kazım Karabekir Cd., 07100 Muratpaşa, Antalya, Turkey
| | - S P Yentür
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Fatih, Çapa, 34093, Istanbul, Turkey
| | - G Saruhan-Direskeneli
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Fatih, Çapa, 34093, Istanbul, Turkey
| | - H Ankaralı
- Department of Biostatistics and Medical Informatics, Istanbul Medeniyet University Medical Faculty, 34093, Kadıköy, Turkey
| | - N Erdoğan
- Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Fatih, Çapa, Istanbul, Turkey
| | - M Z Karagülle
- Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Fatih, Çapa, Istanbul, Turkey
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Maccarone MC, Magro G, Solimene U, Scanu A, Masiero S. From in vitro research to real life studies: an extensive narrative review of the effects of balneotherapy on human immune response. Sport Sci Health 2021; 17:817-835. [PMID: 34035862 PMCID: PMC8136372 DOI: 10.1007/s11332-021-00778-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 05/04/2021] [Indexed: 12/27/2022]
Abstract
Purpose The biologic mechanisms by which balneotherapy (BT) alleviates symptoms of different diseases are still poorly understood. Recently, preclinical models and clinical trials have been developed to study the effects of BT on the immune system. This review summarizes the currently available evidence regarding the effects of spa therapy on the immune response, to confirm the role of BT in the enhancement of immune system and open interesting research fields. Methods PubMed and Google Scholar were searched from 1997 up to June 2020, with search criteria including terms related to BT and immune system. We selected only in vitro research, randomized controlled trials (RCTs) or clinical trials. Results In vitro studies on human and animal samples have demonstrated that thermal waters exert anti-inflammatory and immunomodulatory effects. In particular, H2S donors seem to counteract the inflammatory processes in psoriatic lesions, arthritic fibroblast-like synoviocytes and chondrocytes, and regulate important factors implicated in osteoarthritis pathogenesis and progression. RCTs and clinical trials revealed, after BT, a reduction in circulating levels of pro-inflammatory molecules, such as TNF-α, IL-1β, and C-reactive protein, and an increase in anti-inflammatory molecules such as the IGF-1 growth factor especially in musculoskeletal diseases. Conclusion Further preclinical studies and RCTs could help to exploit BT in real life for preventive and therapeutic treatments.
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Affiliation(s)
- M C Maccarone
- Physical Medicine and Rehabilitation School, University of Padova, Via Giustiniani 3, 35128 Padua, Italy
| | - G Magro
- Physical Medicine and Rehabilitation School, University of Padova, Via Giustiniani 3, 35128 Padua, Italy
| | - U Solimene
- World Federation of Hydrotherapy and Climatotherapy, Milan, Italy
| | - A Scanu
- Reumathology Unit, Department of Medicine - DIMED, University of Padova, Padua, Italy
| | - S Masiero
- Rehabilitation Unit, Department of Neuroscience, University of Padova, Padua, Italy
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Özay P, Karagülle M, Kardeş S, Karagülle MZ. Chemical and mineralogical characteristics of peloids in Turkey. Environ Monit Assess 2020; 192:805. [PMID: 33263866 DOI: 10.1007/s10661-020-08777-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 11/23/2020] [Indexed: 06/12/2023]
Abstract
To investigate the physical, chemical, and mineralogical characteristics of peloids, which are being used traditionally and historically across Turkey, and evaluate their suitability and potential for use in peloidotherapy. Five peloid samples were gathered from their places of origin, namely Gölemezli, Dalyan, Köprüköy, Gökçeada, and Dikili. Mineral analysis and physical and chemical analyses including electrical conductivity, density, cations, anions, trace elements, organic matters, and water retention capacity at 105 °C were performed. The peloids contained a combination of clay minerals (mainly montmorillonite, kaolinite, and muscovite) and non-clay minerals (mainly quartz, calcite, dolomite, and albite) except for Gölemezli peloid, which was dominated by calcite. The other minerals (i.e., chloride-serpentine, sphalerite, pyrite, magnesium calcite, cristobalite) were also found in some peloids. Gölemezli, Dalyan, and Köprüköy peloids had high total organic matters, mainly humic substances. The water retention capacity was high in Dalyan, Köprüköy, and Dikili peloids. All peloids had a pH value slightly greater than 7 (range 7.93-8.69). Dalyan, Köprüköy, and Dikili peloids had a high water retention capacity. Dalyan and Gökçeada peloids had a high electrical conductivity, 22.040 and 9.020 μS/cm, respectively. The density of peloids was ranged between 1.240 (Gölemezli) and 1.450 (Gökçeada) g/cm3. Total mineralization of investigated peloids was greater than 1000 mg/L: Köprüköy, 2754.8 mg/L; Gölemezli, 3092.8 mg/L; Dikili, 4044.6 mg/L; Gökçeada, 6576.6 mg/L; and Dalyan, 11782.9 mg/L, mainly sodium, magnesium, calcium, chloride, sulfate, bicarbonate, and metasilicic acid. The levels of trace elements were low (≤ 2.0 mg/L) in all peloids. The peloids contained various amounts of clay minerals (mainly montmorillonite, kaolinite, and muscovite), non-clay minerals (mainly quartz, calcite, dolomite, and albite), organic matters (mainly humic acid), cations (mainly sodium, magnesium, and calcium), anions (mainly chloride, sulfate, and bicarbonate), and insoluble compounds (mainly metasilicic acid). The physical, chemical, and mineralogical properties of peloids suggest their suitability and potential for use in peloidotherapeutic applications.
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Affiliation(s)
- Pelin Özay
- Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Capa-Fatih, 34093, Istanbul, Turkey
| | - Mine Karagülle
- Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Capa-Fatih, 34093, Istanbul, Turkey.
| | - Sinan Kardeş
- Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Capa-Fatih, 34093, Istanbul, Turkey
| | - Müfit Zeki Karagülle
- Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Capa-Fatih, 34093, Istanbul, Turkey
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Eröksüz R, Erol Forestier FB, Karaaslan F, Forestier R, İşsever H, Erdoğan N, Karagülle MZ, Dönmez A. Comparison of intermittent and consecutive balneological outpatient treatment (hydrotherapy and peloidotherapy) in fibromyalgia syndrome: a randomized, single-blind, pilot study. Int J Biometeorol 2020; 64:513-520. [PMID: 31797039 DOI: 10.1007/s00484-019-01838-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 11/21/2019] [Accepted: 11/21/2019] [Indexed: 05/19/2023]
Abstract
To compare the efficacy of intermittent and consecutive balneological outpatient treatment (hydrotherapy and peloidotherapy) in fibromyalgia syndrome (FMS). A parallel 1:1, single-blind, pilot study was performed. Patients were recruited from musculoskeletal disorders outpatient clinic. Eligible participants were patients aged 18-60, diagnosed as FMS according to ACR 2010 criteria. They were randomly assigned to either consecutive or intermittent treatment groups. Both groups received 20 min of full body immersion in a tap water pool at 38-39 °C and 30 min of mud pack application on the back region at 45 °C. Delivery of the treatment was five times weekly during 2 weeks in consecutive group and two times weekly during 5 weeks in intermittent group. The primary outcomes were pain intensity and the number of patients achieving a minimal clinically important difference (MCID) on Fibromyalgia Impact Questionnaire (FIQ) at the 1st month after the completion of the treatment. Statistical analyses were based on intention to treat method. The assessing physician was blinded. Pain intensity significantly decreased in all post-treatment evaluations of both groups (except after treatment in the intermittent group). There was no significant difference between the groups. MCID for FIQ was achieved in 6 (24%) patients in the consecutive group and 12 (48%) in the intermittent group at the 1st month. There was no statistical difference in the secondary judgment criteria. The consecutive and intermittent deliveries of balneological outpatient treatment (hydrotherapy and peloidotherapy) seem to have similar effects on the clinical status of patients with FMS.
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Affiliation(s)
- Rıza Eröksüz
- Bursa Şevket Yılmaz Training and Research Hospital, Bursa, Turkey
| | - Fatma Begüm Erol Forestier
- Centre de Recherche Rhumatologique et Thermal, 15 Avenue Charles de Gaulle, 73100, Aix Les Bains, France
| | | | - Romain Forestier
- Centre de Recherche Rhumatologique et Thermal, 15 Avenue Charles de Gaulle, 73100, Aix Les Bains, France
| | - Halim İşsever
- Department of Public Health, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Nergis Erdoğan
- Department of Medical Ecology and Hydroclimatology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Müfit Zeki Karagülle
- Department of Medical Ecology and Hydroclimatology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Arif Dönmez
- Department of Medical Ecology and Hydroclimatology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
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Drobnik J, Stebel A. Central European ethnomedical and officinal uses of peat, with special emphasis on the Tołpa peat preparation (TPP): An historical review. J Ethnopharmacol 2020; 246:112248. [PMID: 31550503 DOI: 10.1016/j.jep.2019.112248] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 06/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Medical or hygienic uses of peat mosses dates back to the 18th century. Peat was used externally (as poultices) in the early 19th century. The peat preparation invented by Stanisław Tołpa (Tołpa peat preparation, TPP) was patented in Poland in 1991; its concept had emerged in the 1980s. It raised high therapeutic expectations still being researched in the early 1990s. Profound expectations for peat, a natural product well known in Central European (and Polish) spas (for medicated baths and poultices), earned Tołpa's preparation great renown before any actual benefits (internal actions) were scientifically confirmed. AIM OF THE REVIEW We study the origins of medical interest in peat in Polish science against the background of the historical ethnopharmacy of peat and Sphagnum moss in Central Europe. It is aimed at shedding a new light on the history of TPP, its connections with local ethnopharmacological traditions and inspirations for local medical studies on peat products and peat-derived drugs of the 1980s and early 1900s. MATERIALS AND METHODS The literature on peat baths was found and reviewed including the information and data about the studies of TPP from published though unknown sources as well as from Polish patents, unpublished typescripts, press interviews and reports. RESULTS Tołpa's research team missed the historical data about external and topical actions of Sphagnum peat or its preparations which were published in the 19th- and early 20th-century. This is strange because folk medicine based on peat emanated eastwards from ethnic Austria along the Vistula river and the Carpathians. Tołpa ignored balneotherapeutic (external) applications as well as the action of sphagnan from Sphagnum herb, and rejected this kind of peat as scientifically not promising, based on a single biological test on plants. The concept of an active principle in peat or its preparations evolved, and speculation concerning its nature was not followed by adequate basic research. The active principle was not found. Results concerning plant meristem growth were too readily applied in animal production and finally human medicine. The natural ingredient in TPP production was never defined botanically. Anti-cancer properties ascribed to the TPP on the basis of bio-stimulation tests stirred powerful social emotions. CONCLUSIONS Topical peat cure originated in Austria in about 1820. It evolved as a whole branch of Central European balneotherapy which had been completely scientifically described by the 1950s. At that time an undefined peat extract was once successfully used in ear infections in paediatrics. Stanisław Tołpa's research project to find any internal application of peat ignored the achievements of ethnobiology, balneotherapy, surgery and otorhinolaryngology known at that time. His strenuous and insistent efforts, carried out in isolation, crucially failed pre-clinical and clinical tests in any branch of his therapy. Three commercial drugs were allowed for 3 years before substantial clinical proofs of peat efficacy were achieved. Social impact was high and resulted in the birth of the Polish legend of Tołpa's marvellous drug.
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Affiliation(s)
- Jacek Drobnik
- School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, Department of Pharmaceutical Botany, ul. Ostrogórska 30, 41-200, Sosnowiec, Poland.
| | - Adam Stebel
- School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, Department of Pharmaceutical Botany, ul. Ostrogórska 30, 41-200, Sosnowiec, Poland.
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10
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Yücesoy H, Geçmen İ, Adıgüzel T, Karagülle M, Karagülle MZ. Efficacy of balneological outpatient treatment (hydrotherapy and peloidotherapy) for the management of chronic low back pain: a retrospective study. Int J Biometeorol 2019; 63:351-357. [PMID: 30680627 DOI: 10.1007/s00484-018-01668-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 12/14/2018] [Accepted: 12/24/2018] [Indexed: 05/19/2023]
Abstract
The aim of this study was to evaluate the efficacy of balneological outpatient treatment including hydrotherapy and peloidotherapy on patients with chronic low back pain. In this retrospective observational study, the records (between 2008 and 2016) of patients who have undergone balneological outpatient treatment at the Department of Medical Ecology and Hydroclimatology were analyzed. The patients were examined and assessed by an experienced physician before and after the treatment. Outcome measures were the Pain Visual Analog Scale (VAS), patient's and physician's global assessment (VAS), Health Assessment Questionnaire (HAQ), and the Waddell Disability Index. A total of 139 patients were included in the study. After the treatment, statistically significant improvement in all evaluated outcome measures was found. The detailed analysis showed age, the duration of treatment, and sex did not affect the effectiveness of the treatment. Balneological outpatient treatment may be an effective option for treatment of chronic low back pain patients with the advantages of being integrated into daily routine and not causing any days off by improving pain and increasing the quality of life. Randomized controlled trials are needed to confirm these preliminary results.
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Affiliation(s)
- Hidayet Yücesoy
- Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
- Tıbbi Ekoloji ve Hidroklimatoloji A.B.D. İstanbul Tıp Fakültesi, Fatih, Capa, 34093, İstanbul, Turkey.
| | - İlker Geçmen
- Department of Medical Ecology and Hydroclimatology, Kanuni Sultan Süleyman Education and Research Hospital, Istanbul Health Sciences University, Istanbul, Turkey
| | - Tuba Adıgüzel
- Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
- Tıbbi Ekoloji ve Hidroklimatoloji A.B.D. İstanbul Tıp Fakültesi, Fatih, Capa, 34093, İstanbul, Turkey
| | - Mine Karagülle
- Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
- Tıbbi Ekoloji ve Hidroklimatoloji A.B.D. İstanbul Tıp Fakültesi, Fatih, Capa, 34093, İstanbul, Turkey
| | - Müfit Zeki Karagülle
- Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
- Tıbbi Ekoloji ve Hidroklimatoloji A.B.D. İstanbul Tıp Fakültesi, Fatih, Capa, 34093, İstanbul, Turkey
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11
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Özkuk K, Gürdal H, Karagülle M, Barut Y, Eröksüz R, Karagülle MZ. Balneological outpatient treatment for patients with knee osteoarthritis; an effective non-drug therapy option in daily routine? Int J Biometeorol 2017; 61:719-728. [PMID: 27714506 DOI: 10.1007/s00484-016-1250-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 07/01/2016] [Accepted: 09/17/2016] [Indexed: 06/06/2023]
Abstract
This study aims to compare the effects of balneological treatments applied at consecutive and intermittent sessions without interfering with their daily routine in patients with knee osteoarthritis. This is a randomized, controlled, single-blind clinical trial. Fifty patients diagnosed with knee osteoarthritis were included. The patients were divided into two groups. All patients were given a total of ten sessions of balneological treatment consisting of hydrotherapy and mud pack therapy. Group 1 received consecutive treatment for 2 weeks, while group 2 received intermittent treatment for 5 weeks. Local peloid packs at 45 °C were applied for 20 min, after a tap water (38 °C) bath. Evaluations were conducted before, after treatment, and at 12th week of post-treatment by Pain (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Short Form-36 (SF-36). Both balneological treatment regimens of knee osteoarthritis had statistically significant clinical effects as well as effects on the quality of life. Patients' well-being continued at 3 months, except for joint stiffness (WOMAC), role-emotional (SF-36), and vitality (SF-36) in group 1 and for mental health (SF-36) in both groups. Both patient groups had improved compared to baseline. However, at 3 months after the treatment, the well-being of group 2 was unable to be maintained in terms of role-physical (SF-36) parameter, while the well-being of group 1 was unable to be maintained in terms of pain, WOMAC (pain, physical functions, total), and SF-36 (physical functioning, role-physical, pain, role-emotional, and mental health) variables, compared to data obtained immediately after treatment. Our study suggests that traditional and intermittent balneological therapies have similar efficacy in patients with knee osteoarthritis.
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Affiliation(s)
- Kağan Özkuk
- Department of Medical Ecology and Hydroclimatology, İzzet Baysal Physical Medicine and Rehabilitation Training and Research Hospital, 14020, Bolu, Turkey.
| | - Hatice Gürdal
- Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Mine Karagülle
- Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Yasemin Barut
- Department of Medical Ecology and Hydroclimatology, Büyükçekmece Public Hospital, İstanbul, Turkey
| | - Rıza Eröksüz
- Department of Medical Ecology and Hydroclimatology, Yüksekİhtisas Training and Research Hospital, Bursa, Turkey
| | - Müfit Zeki Karagülle
- Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
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