title: [Repeated cold water stimulations (hydrotherapy according to Kneipp) in patients with COPD].
abstract: BACKGROUND
  Patients with chronic obstructive pulmonary disease (COPD) often suffer from exacerbations caused by infections of the bronchial tract.
  
  
  OBJECTIVE
  What effects do hydrotherapeutic applications according to Kneipp have on lung function, blood gases, immune system and quality of life of patients with COPD?
  
  
  METHODS
  20 patients with COPD (17 males, 3 females); mean age: 64; forced expiratory volume (FEV1): 62 of 100% (on average); no acute exacerbations, no oral corticosteroids. Measurements were performed (I) at 10 weeks pre-treatment, (II) immediately before therapy (I-II: baseline-period), (III) after 10 weeks treatment with 3 cold affusions and 2 cold washings of the upper part of the body (self-treatment) per week each, (IV) 3 months after completion of the treatment (follow- up). The following parameters were measured: lung function, blood gases, routine lab, experimental lab (interleukines, lymphocytes), maximal expiratory flow (PEF), quality of life and respiratory infections.
  
  
  RESULTS
  The pH increased over the course of the study. PEF and the number of lymphocytes significantly increased over the treatment (II-III). Intracellular expression of IL-4 by T lymphocytes decreased. However, the expression of IFN-gamma increased. Frequency of infections was lower during follow-up (IV) than before and during therapy. Quality of life after treatment was estimated to be good in all patients.
  
  
  CONCLUSIONS
  Repeated cold stimulations (affusions) can influence the frequency of respiratory infections and improve subjective well-being. It may cause an immunological modulation in terms of the Th1-type pattern.
authors.affiliation: Institut für Physiotherapie, Klinikum der FSU Jena, Deutschland. k.goedsche@med.uni-jena.de
authors.forename: Katrin
authors.initials: K
authors.lastname: Goedsche
authors.forename: Martin
authors.initials: M
authors.lastname: Förster
authors.forename: Claus
authors.initials: C
authors.lastname: Kroegel
authors.forename: Christine
authors.initials: C
authors.lastname: Uhlemann
mesh_terms: D001784:Blood Gas Analysis; D003080:Cold Temperature; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006875:Hydrotherapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D011788:Quality of Life; D012129:Respiratory Function Tests; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000517:prevention & control; D016896:Treatment Outcome