title: The effect of combined therapy (spa and physical therapy) on pain in various chronic diseases.
abstract: OBJECTIVE
  Spa therapy is commonly used in the treatment of daily chronic diseases practice, but its benefits are still the subjects of discussion. This study investigates possible effects of a combined spa and physical therapy program on pain and hemodynamic responses in various chronic diseases.
  
  
  METHODS
  The pain intensity and hemodynamic responses of 472 patients involved in a spa and physical therapy program were studied retrospectively. Assessment criteria were pain [Visual Analog Scale (VAS)] and hemodynamic responses (heart rate, blood pressure, respiratory rate). Assessments took place before, immediately after treatment, and after completion of the spa program (before discharge).
  
  
  RESULTS
  The patients with ankle arthrosis, fibromyalgia and cervical disc herniation reported the highest VAS score before treatment program (P < 0.05). After the therapy program, VAS scores were seen to decrease compared to before treatment (P < 0.05). The patients with osteoarthritis of the hip (1.3+/-1.2) and soft tissue rheumatism (1.3+/-1.2) had the lowest VAS score before discharge compared to patients with other pathologies (P < 0.05). No statistically significant differences were detected between both sexes in terms of pain improvement (P > 0.05). On discharge, all hemodynamic responses decreased significantly compared to before and immediately after initiation of the therapy program (P < 0.01).
  
  
  CONCLUSIONS
  To decrease pain and high blood pressure without hemodynamic risk, a combined of spa and physical therapy program may help to decrease pain and improve hemodynamic response in patients with irreversible pathologies.
authors.affiliation: Dumlupinar University, Health Institution of Higher Education, Department of Physical Therapy and Rehabilitation, Tanvanly Yolu, 43100 Kutahya, Turkey. alicimbizphd@hotmail.com
authors.forename: Ali
authors.initials: A
authors.lastname: Cimbiz
authors.forename: Vahdettin
authors.initials: V
authors.lastname: Bayazit
authors.forename: Hasan
authors.initials: H
authors.lastname: Hallaceli
authors.forename: Ugur
authors.initials: U
authors.lastname: Cavlak
mesh_terms: D001168:Arthritis / Q000628:therapy; D001452:Balneology; D001794:Blood Pressure; D002908:Chronic Disease; D005260:Female; D006339:Heart Rate; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000628:therapy; D059408:Pain Management; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D012189:Retrospective Studies; D012216:Rheumatic Diseases / Q000628:therapy