title: Appropriateness and efficacy of Spa therapy for musculoskeletal disorders. A Delphi method consensus initiative among experts in Italy.
abstract: OBJECTIVE
  The aim of the study was to identify the main aspects concerning appropriateness and efficacy of Spa therapy for musculoskeletal pathologies.
  
  
  METHODS
  A committee of 8 experts from Italian universities, public hospitals, territorial services, research institutes and patient associations was set up. Clinicians from Italian medical centers specialized in rheumatology, rehabilitation and thermal medicine took part in a Delphi process aimed at obtaining consensus statements among the participants.
  
  
  RESULTS
  Large consensus was obtained for statements grouped under the following main themes: treatment indications; choice of treatment modality and treatment efficacy.
  
  
  CONCLUSIONS
  The experts developed a number of consensus statements which may be used as a practical reference to guide the choice of physicians to treat musculoskeletal diseases with Spa therapy.
authors.affiliation: Dipartimento di Medicina Fisica e Riabilitativa, Sapienza Università di Roma, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Paoloni
authors.affiliation: Dipartimento di Medicina Fisica e Riabilitativa, Sapienza Università di Roma, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bernetti
authors.affiliation: SIMG - Società Italiana di Medicina Generale, Florence, Italy.
authors.forename: Ovidio
authors.initials: O
authors.lastname: Brignoli
authors.affiliation: Ufficio Relazioni Esterne, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Coclite
authors.affiliation: Scuola di Specializzazione in Medicina Termale, Sapienza Università di Roma, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Fraioli
authors.affiliation: Rehabilitation Unit, Dipartimento di Neuroscienze, Università degli Studi di Padova, Padua, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Masiero
authors.affiliation: Ufficio Relazioni Esterne, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Antonello
authors.initials: A
authors.lastname: Napoletano
authors.affiliation: Università LUISS, Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Quirino
authors.affiliation: Dipartimento di Chirurgia Generale, Geriatrica, Oncologica e Tecnologie Avanzate, Università degli Studi di Napoli "Federico II", Naples, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Rengo
authors.affiliation: Dipartimento di Ortopedia, Università degli Studi di Napoli "Federico II", Naples, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Ruosi
authors.affiliation: ANMAR - Associazione Nazionale Malati Reumatici Onlus, Turin, Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: Viora
authors.affiliation: Dipartimento di Scienze Biomediche, Biotecnologiche e Traslazionali, Unità di Anatomia e Istologia, Università degli Studi di Parma, Parma, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Vitale
authors.affiliation: Dipartimento di Medicina Fisica e Riabilitativa, Sapienza Università di Roma, Rome, Italy.
authors.forename: Valter
authors.initials: V
authors.lastname: Santilli
mesh_terms: D001452:Balneology; D032921:Consensus; D003697:Delphi Technique; D006801:Humans; D007558:Italy; D009140:Musculoskeletal Diseases / Q000628:therapy*