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Spa Medical Complex Therapies

Spas all across central Europe offer complex ‘rehab’ therapies focused around a natural resource as a basis for their spa stays, primarily for the treatment of mobility disorders such as arthritis, rheumatism and other special diseases.  We at Danubius Health Spa resorts are a classic example of this.  In the past, there has been criticism of the lack of scientific evidence to prove the effectiveness of these therapies.

First of all, it must be clarified that the success of these spa stays or ‘cures’ is not due to one factor or treatment.  Instead, the results lie in a combination of therapies, which use a natural resource as an integral part of the treatment.  In other words, a variety of treatments are prescribed in conjunction with the use of a natural resource (in the case of Danubius, this can include – depending on the country and location – hot spring mineral water, natural CO2 gas or thermo-mineral salt).  It is clear to us that it is this combination of a natural resource and an arsenal of physiotherapy treatments that produces such positive results.

We know that our treatments work, not only because of the results we see in our spa medical sections, but because our guests return time and time again.  In addition to improved mobility, they also benefit from a noticeable reduction of pain, thereby greatly improving their quality of life.

So convinced are we of our results that we evaluate our performance in this field on an ongoing basis, with our latest study being conducted between December 2007 and May 2008.  This study was carried out under the direction of our head doctors on 94 guests with cox-arthrosis in the following hotels in Hungary: Danubius Health Spa Resorts - Margitsziget, Helia, Bük, Sárvár, Aqua, Hévíz and Danubius Hotel Gellért). 

It must be emphasized that we deliberately do not conduct double-blind clinical trials for the simple reason that every guest has an individual health condition, and because of that, as explained, we prescribe a personally-tailored course of treatments unique to each guest’s situation.  As a consequence, it is not possible to compare like with like because no condition or treatment plan is the same.

Clinical Study December 2007 – May 2008

The health status of the guests in the study was examined on arrival and departure, after receiving medical spa treatments during stays of two or three weeks.  The guests received various treatments depending on their condition, which included traditional spa therapies such as physiotherapy, electrotherapy, mud packs, medical massage, hydrotherapy and ‘balneotherapy’.  The specific treatments were prescribed by a doctor on an individual basis according to the health condition of the guest, as is our custom. It is important to note that part of the treatment included bathing in medicinal water, which is recognised by the Hungarian government.

Guests who had undergone an operation on a hip/knee joint, had a total hip/knee replacement, or who suffered restricted motion due to their cardiac condition or spine complaints were not included in this study.  The survey was completed by the same doctor, based on the first medical examination and assessment on the last treatment day.

The patients in the study came from eight countries, including Germany, Hungary, Austria, Switzerland and Russia, and consisted of 59 women and 35 men, with an average age of 67.
Of the 94 patients examined, 58 received a three-week and 36 received a two-week treatment.

We recorded alterations in five sorts of pain sensations, based on the patients’ subjective opinion – at rest, at motion, start of movement, going up stairs and going down stairs.  Here are some of the results:

Before Treatment When Moving Seconds After Treatment When Moving Seconds
none 1 none 14
mild 29 mild 46
medium 39 medium 33
strong 25 strong 1
Before Treatment Going Up Stairs Seconds After Treatment Going Up Stairs Seconds
none 6 none 9
mild 24 mild 52
medium 36 medium 30
strong 28 strong 3

Before Treatment Going Down Stairs Seconds After Treatment Going Down Stairs Seconds
none 12 none 18
mild 33 mild 54
medium 31 medium 22
strong 18 strong 0
Average duration of pain in seconds after start of movement
Gender Average Prior to Treatment Average After Treatment
Men 550 333
Women 180 71
All 317 16

We obtained a similarly favourable result when assessing the visual analogue scale (VAS).  Operationally, the VAS is a horizontal line, 100mm in length, anchored by the words ‘no pain’ at one end and ‘very severe pain’ at the other.  The patient is then asked to mark the line at the point they feel represents their perception of their current state. (In eight cases, the patients indicated ‘0’ pain upon conclusion of the treatment.)

Average of visual analogue scale (VAS)
Gender Average Prior to Treatment Average After Treatment
Men 48 28
Women 54 31
All 52 30

A survey of the maximum distance of pace measured in centimetres brought the following results:

Maximum Distance of pace in cm.
Gender Average Prior to Treatment Average After Treatment
Men 42 46
Women 41 44
All 41 45

Walking time on flat ground (25 metres) and up and down 20 stairs alike showed improvement:

Walking time on flat ground of 25 metres in seconds
Gender Average Prior to Treatment Average After Treatment
Men 46 41
Women 47 40
All 47 40

Time to go up 20 steps in seconds
Gender Average Prior to Treatment Average After Treatment
Men 47 41
Women 52 43
All 50 42

Interestingly, we also discovered a similar level of improvement in guests constrained to use a mobility aid in the street or at home. Of eight patients walking with an aid at home, two were able to abandon it, while among the 27 people using a stick or an elbow crutch, altogether four were able to abandon the aid.

Many of the patients regularly took non-steroid antiphlogistics, primarily diclofenac derivatives. By the end of the treatment period, the number of those able to reduce their dose of non-steroids was significant, and in a few cases (four out of 20 men and ten out of 38 women) they could even eliminate it entirely.

Upon the conclusion of the treatment, we asked the patients how they judged their condition in comparison with their state before the treatment. Of the 94 patients, one person reported a deterioration, 30 felt their condition was the same, 20 reported a slight improvement, 31 expressed a considerable improvement and five claimed an excellent result.  It is equally important to emphasise that every overseas patient declared he/she would be happy to return to Hungary for a repeated complex cure.

In our previous clinical studies, much improvement was also noted three months after treatment.  In actual fact, there can be a negative reaction sometimes immediately after treatment, with the benefits only being felt at a later stage. Unfortunately, in this particular study the results only show the effect immediately after treatment, so based on our past experience we can assume after three months the results would be even more positive.

In 2003, two other clinical studies were carried out in our spas in Hévíz and Sárvár. In our health spa resort in Hévíz, we saw considerable improvement in motion parameters (particularly in relation to the speed of walking on flat surfaces), a considerable reduction in pain and most importantly, an end to the use of pain medication (75% of patients involved in the trial stopped taking their non-steroid medications entirely after the therapy stay). Based on another study conducted in Danubius Health Spa Resort Sárvár, it was established that all three disease groups investigated (knee-joint arthrosis, hip-joint arthrosis and lower back pain) made considerable improvement after treatment (Clinical Studies from Danubius Health Spa Resort Hévíz/Sárvár 2003).

Our head doctor at Danubius Health Spa Resort Margitsziget nicely sums up the effectiveness of our complex spa treatment stays:

‘As a hospital doctor, I was also sceptical of the real medical value of therapeutic cures.  Prescribing pills seemed a lot more straightforward. However, the 17 years spent at Danubius Hotels provide an excellent testimony to how fantastic the results are.  I would like to bring attention to the fact that the spa programme does not merely bring relief to sufferers, but equally plays a tremendous role in preventing the development of diseases.  A week spent at a spa revitalises body and mind, giving us the energy to go back into the world with all its stresses and problems with renewed energy’. (Dr Márta Mogyorósi)

Information in this article is taken from studies conducted by Dr István Fluck, Dr József Szakonyi, Dr Márta Mogyorósi, Dr Miklós Weigl, Dr Péter Horváth and their contributors, compiled by Mike Wallace (Brand Manager, Danubius Health Spa Resorts)

Other relevant literature

  1. Báthori, G., Merétey, K., Korda, J., Gasztonyi, Gy., Görgényi, F., Böhm, U., Bálint, G.: Double-blind examination: The effect of Kiskunhalas thermal water on patients with RA. Hungarian Rheumatology, 1981, 22, 30-36.
  2. Barta, A., Varjú, T., Papp, T., Berecz, I.: Double-blind examination on the clinical testing of Nyíregyháza thermal water. Hungarian Rheumatology, 1988, 29, 19-33.
  3. Szűcs, L., Ratkó, I., Leskó, T., Szoór, I., Genti, Gy., Bálint, G.: Double-blind trial on the effectiveness of Püspökladány thermal water on arthrosis of the knee-joints. J. R. Soc. Health, 1989, 109, 7-9.
  4. Konrád, K., Tátrai, T., Hunka, A., Vereckei, E., Korondi, I.: Controlled balneotherapy trial in the treatment of lower-back pain. Ann. Rheum. Dis., 1992, 51, 820-822.
  5. Kovács, I., Bender, T.: The therapeutic effects of Cserkeszőlő thermal water in osteoarthritis of the knee: a double-blind controlled, follow-up study. Rheumatol. Int. 2002, 21, 218-221.
  6. Bálint, G. Bender, T., Szabó, E.: Spa treatment in arthritis. J. Rheumatol., 1993, 20, 1623-1625.
  7. Bálint, G., Szebenyi, B.: Non-pharmacological therapies in osteoarthritis. Balliers Clin. Rheum. 1997, 11, 795-815.
  8. Bender, T., Géher, P., Bálint, G.: Non-pharmacological treatment of musculoskeletal disease. Clin. J. Pain., 2001, 17, 278.
  9. Bender, T., Karagülle, Z., Bálint, G. P., Gutenbrunner, C., Bálint, P. V., Sukenik, S.: Hydrotherapy, balneotherapy and spa treatment in pain management. Rheum. Int. 2005, 25, 15-26.
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