title: [Effects of Kneippism, a standardized complex therapy, on pain, quality of life and use of medicines: cohort study with a one-year follow-up].
abstract: BACKGROUND
  Inpatient as well as outpatient cure in a spa environment with commonly 3- to 4-week duration features a combination of different treatments customized according to the needs of the individual patient. The physiological rationale and the mode of action are widely accepted. However, firm quantitative evidence of the clinical effectiveness is incomplete.
  
  
  OBJECTIVE
  To document the effects of a well standardized complex therapeutic regimen (Kneippism) on pain, quality of life, and drug consumption during therapy and with 1-year follow up.
  
  
  METHODS
  Prospective cohort study with assessments at the beginning, during, and at the end of treatment and with follow-up investigations 3, 6, and 12 months thereafter.
  
  
  METHODS
  Four spa clinics in Bad Wörishofen, Southern Bavaria.
  
  
  METHODS
  363 patients (248 outpatients, mean duration of therapy 23.3 days, and 115 inpatients, mean duration of therapy 27.4 days), one half between 40 and 60 years old above 60 years of age, predominantly suffering from musculoskeletal and/or cardiovascular diseases.
  
  
  METHODS
  Custom-tailored combination of therapies comprising of hydro-, kinesi-, and phytotherapy, dietetics, 'ordnungstherapie', and continued disease-specific standard treatment, if necessary.
  
  
  METHODS
  Pain, patients' self-rating, (IRES questionnaire), medication.
  
  
  RESULTS
  The monitored dimensions of pain improved significantly during treatment and remained at that level essentially for the complete follow up interval. The same was true for various dimensions of reported subjective complaints as well as for drug consumption.
  
  
  CONCLUSIONS
  When estimating the clinical relevance of a complex therapeutic regimen such as a cure of 3- to 4-week duration, the question of the impact of the specific effect of single components is secondary to the question of the overall relevance of that therapeutic concept. The findings of this study point at potential long-term effects of at least 1-year duration.
authors.affiliation: Bad Wörishofen, Klinikum, Friedrich-Schiller-Universität Jena, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Leuchtgens
authors.forename: T
authors.initials: T
authors.lastname: Albus
authors.forename: C
authors.initials: C
authors.lastname: Uhlemann
authors.forename: E
authors.initials: E
authors.lastname: Volger
authors.forename: R B
authors.initials: RB
authors.lastname: Pelka
authors.forename: K L
authors.initials: KL
authors.lastname: Resch
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000503:physiopathology; D015331:Cohort Studies; D000529:Complementary Therapies; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007297:Inpatients; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000503:physiopathology; D010045:Outpatients; D010146:Pain / Q000188:drug therapy; D059408:Pain Management; D010147:Pain Measurement; D011788:Quality of Life; D013997:Time Factors