title: Health resort medicine in non-musculoskeletal disorders: is there evidence of its effectiveness?
abstract: Health resort medicine (HRM; in German: Kurortmedizin) is a field of medicine with long-lasting tradition in several European countries. A number of systematic reviews have shown the effectiveness of HRM in musculoskeletal conditions. Reviews focusing on the effectiveness of HRM in non-musculoskeletal disorders are rare. This systematic review aims to provide an overview about all types of health resort treatments applied in non-musculoskeletal conditions, to summarize evidence for its effectiveness and to assess the quality of published studies. MEDLINE, Web of Knowledge and Embase were searched for articles published between January 2002 and December 2013. We used a broad search strategy in order to find studies investigating the effects of HRM in non-musculoskeletal disorders. Two authors independently extracted data and assessed quality using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies (EPHPP-QAT). Forty-one studies (19 of them with control group) from eight countries examining the efficacy of various forms of spa treatment for 12 disease groups were included. The studies are markedly heterogeneous regarding study design, population and treatment. HRM treatment is associated with clinical improvement in diseases of the skin, respiratory, circulatory, digestive and nervous system among others. However, small samples, the lack of control groups and an insufficient follow-up often limit the generated evidence. The scientific literature of the last decade has shown that a number of non-musculoskeletal disorders are treated with different kinds of HRM. The challenge for the future will be to carry out thoroughly designed studies in larger patient populations to corroborate the impact of HRM treatment on non-musculoskeletal disorders.
authors.affiliation: Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig Maximilians University, Marchioninistr. 17, 81377, Munich, Germany. marita.stier-jarmer@med.lmu.de.
authors.forename: Marita
authors.initials: M
authors.lastname: Stier-Jarmer
authors.affiliation: Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig Maximilians University, Marchioninistr. 17, 81377, Munich, Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Kus
authors.affiliation: Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig Maximilians University, Marchioninistr. 17, 81377, Munich, Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Frisch
authors.affiliation: Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig Maximilians University, Marchioninistr. 17, 81377, Munich, Germany.
authors.forename: Carla
authors.initials: C
authors.lastname: Sabariego
authors.affiliation: Public Health and Health Services Research, Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig Maximilians University, Marchioninistr. 17, 81377, Munich, Germany.
authors.forename: Angela
authors.initials: A
authors.lastname: Schuh
mesh_terms: D001452:Balneology; D000529:Complementary Therapies; D006294:Health Resorts; D006801:Humans; D006875:Hydrotherapy; D016896:Treatment Outcome
keywords: Balneotherapy; Health promotion; Hydrotherapy; Spa therapy; Systematic review