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Green and its nuances: > 70 aa Ocher: 50-69 aa Red and its nuances: < 50 aa Brown: < 35 aa
European aging
Map of Europe showing the percentage of the population over 65 in 2010 for each country
Data from the CIA World Factbook
Increased risk
Subjects older than 60 years affected by chronic diseases in UK from 1996 to 2066
65-69
70-74
75-79
80-84
Total
Angina Pectoris
Myocardical infarction Arrhythmia Systemic hypertension
6,1
5,9 18,4 60,0
8,3
8,7 22,1 67,4
8,0
8,2 26,5 66,6
7,6
7,4 26,7 64,7
7,3
7,3 22,4 64,0
Heart failure
3,7
6,5
7,7
11,8
6,5
the most important14,1 factor for risk 11,9 13,2 11,7 15,5 the developing of osteoarthritis 0,3 0,3 0,3 0,2 0,3
10,9 15,1 13,4 11,4 12,6
Osteoarthritis
COPD Peripheral vascular disease
61,7
19,1 4,8
59,8
19,9 7,0
61,1
24,0 7,9
60,2
22,5 8,7
60,9
20,9 6,5
OA epidemiology
Muscoloskeletal diseases are the major cause of severe pain
and long-term disability1
1. European Bone and Joint Health Strategies Project. European Action Toward Better Musculoskeletal Health, 2005. 2. European Opinion Research Group. EEIG. Health, food and alcohol and safety. Special Eurobarometer 186, 2003.s
1. McNeil JM, Binette J.MMWR. 2001;50:120-125 2. CDC. National Arthritis Action Plan. A Public Health Strategy. 1999.
Therapy
joint supplements : Chondroitin, Glucosamine Nonsteroidal Anti-inflammatory Drugs e COX-1 inhibitor Analgesic drugs: paracetamol, tramadol Physiotherapy Thermal medicine
120
am
AS A
Thermal treatments (bath therapy, mud treatments, mud-bath treatments, inhalations and thermal rehabilitation treatments) can be considered as a true and natural answer to prevention, rehabilitation and treatment of serious pathologies.
Moreover, thermal environment can promote a correct life style and balanced diet
Traumatology
Fractures Muscle trauma, Tendon injuries
Rheumatology
Degenerative joint disease Inflammatory joint disease (not in acute phase) Back and neck pain Periarteritis Muscle stiffness and hypotonia
Orthopedic disease
Dysmorphism of the developmental age (scoliosis, kyphosis..) Effects of surgical interventions
Facolt di Medicina e Chirurgia Scuola di Specializzazione in Idrologia Medica Scuola di Specializzazione in Idrologia Medica
MAL. ARTROREUMOPATICHE
Osteoartrosi e altre forme degener. Reumatismi extra articolari
MAL. ORL
Rinopatia vasomotoria Faringolaringiti croniche Sinusiti croniche Sordit rinogena (ototubarite e otitie catarrale cronica) Otiti croniche purul. non colesteatomatose
MAL. DERMATOLOGICHE
Psoriasi Eczema e dermatite atopica Dermatite seborroica ricorrente
MAL. GASTROENTERICHE
Dispepsia di origine gastroenterica e biliare Sindrome del colon iirritabile nella variet con stipsi
MAL. VASCOLARI
Postumi di flebopatie di tipo cronico
MAL. GINECOLOGICHE
Sclerosi dolorosa connettivo pelvico Leucorrea persistente da vaginiti Croniche aspecifiche o distrofiche
Gal J et al 2008
Group 1: Balneotherapy (n=25; 36 C, 20 min; 10 sessions) Group 2: Mud-pack therapy (n=25; 42 C, 20 min; 10 sessions) Group 3: Hot-pack therapy (n=25; 42 C, 20 min; 10 sessions) Join Bone Spine 2007
The maximum walking distance was improved in both Group 1 and 2 (p<0.05) but not in group 3. Joint Bone Spine 2007
Improvement HAM-A scores in BT group 12.0 In paroxetine group 8.7 (p < 0.001).
Stress hormones liberated by fangotherapy. ACTH and -endorphin levels under heat stress
Giusti P, Cima L, Tinello A, Cozzi F, Targa L, Lazzarin P, Todesco
The repeated brief increases in plasma endorphin during thermal treatment result in progressive improvement in articular and muscular symptomatology. The results of our study on plasma levels of ACTH confirm that the thermal stress associated with mud therapy activates the pituitary gland.
Beta-endorphin and stress hormones in patients affected by osteoarthritis undergoing thermal mud therapy
Is mud an anti-inflammatory?
Giacomino MI, de Michele DF.
Mud modifies NO, myeloperoxidase and glutathione peroxidase serum levels in arthritic patients and endorphin and stress hormones in patients affected by osteoarthritis by reducing inflammation. Thermal stress associated with mud therapy activates the pituitary gland. The biochemical effects of peat components are aside from their physical-thermal effects.
We found silver level evidence concerning the beneficial effects of mineral baths compared to no treatment. However, the scientific evidence is weak because of the poor methodological quality and the absence of an adequate statistical analysis and data presentation. Therefore, the noted "positive findings" should be viewed with caution.
Sauna bath and in general thermal therapies have been traditionally considered inappropriate for patients with congestive heart failure (CHF).
Repeated thermal therapy improves impaired vascular endothelial function in patients with coronary risk factors
Repeated sauna treatment improves vascular endothelial and cardiac function in patients with chronic heart failure
20 patients (62 15 yrs) in NYHA functional class II or III CHF were treated in a dry sauna at 60 degrees C for 15 and then kept on bed rest with a blanket for 30, daily for 2 weeks. 10 patients, matched for age, gender and NYHA functional class, served as control group
41 patients with chronic heart failure (mean age 68.3 13.5 years old) underwent Waon therapy 5 times a week for 3 weeks.
6-minute walk distance increased from 337120 to 379 126 m, (p <0.001) FMD improves from 3.52.3% to 5.52.7% (p <0.001)
In summary
Many evidences documented an improvement of cardiovascular hemodynamics in patients with chronic CHF due to ischemic or idiopathic dilated cardiomyopathy. This is presumably due to a reduction in cardiac preload and afterload by thermal systemic arterial, pulmonary arterial, and venous vasodilation. These data suggest that thermal vasodilation has salutary effects even for patients with severe heart failure and may represent a novel nonpharmacological therapy for patients with CHF. The long-term benefits of these interventions warrant further investigation.
In conclusion, thermal therapy could represent an important step in the therapeutic approach to elderly patients affected by OA. Thermal therapy could not only act on joint disease, reducing pain and disability, but also could improve heart failure and depressive symptoms as well as quality of life. Moreover a decrease of pain could reduce the assumption of anti-inflammatory drugs and their adverse effects
All these evaluations will be performed before and after the treatment and also after 3 and 6 months.