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O. Dubois - One of the best experts on this subject based on the ideXlab platform.
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1083 – Withdrawal from benzodiapezines in Spa Treatment
European Psychiatry, 2013Co-Authors: O. DuboisAbstract:The recent results stemming from the STOP-TAG [Dubois O, et al.; Balneotherapy versus paroxetine in the Treatment of generalized anxiety disorder , Complementary Therapies in Medicine (fev 2010) 18, 1-7] study have shown the way to demonstrating the considerable efficacy of psychiatric Spa therapy compared to a reference Treatment (Paroxetine) in generalized anxiety disorders. The study carried out on 237 patients has clearly indicated the impact of balneotherapy in this indication with indisputable evidence. The questionable problem of withdrawal from benzodiapezines is a well-known issue throughout European countries, particularly in France. For instance, 11.2% of the French are regular benzodiapezine consumers and 70% of the prescriptions are made out to them for as long as 5 years!No therapy has ever actually shown a satisfactory efficacy to treat the problem. The given elements converge to propose programmes of a psycho-educative kind. As a result, this has led us to the conclusion that a protocol, which would be set up and supervised by university academics, ensured by trained psychologists with medical withdrawal follow-up to be carried out within the Spa therapy, could well allow withdrawal from this medication. The Spa therapy, through its proven anxiolytic activity, is able to favour the substituting of Treatment by benzodiapezine, and as a result would make withdrawal easier. We propose here to set out the psycho-educative protocol with the support of an experiment on 73 patients, carried out in 2010 and 2011 in France together with the results of this study.
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1083 withdrawal from benzodiapezines in Spa Treatment
European Psychiatry, 2013Co-Authors: O. DuboisAbstract:The recent results stemming from the STOP-TAG [Dubois O, et al.; Balneotherapy versus paroxetine in the Treatment of generalized anxiety disorder , Complementary Therapies in Medicine (fev 2010) 18, 1-7] study have shown the way to demonstrating the considerable efficacy of psychiatric Spa therapy compared to a reference Treatment (Paroxetine) in generalized anxiety disorders. The study carried out on 237 patients has clearly indicated the impact of balneotherapy in this indication with indisputable evidence. The questionable problem of withdrawal from benzodiapezines is a well-known issue throughout European countries, particularly in France. For instance, 11.2% of the French are regular benzodiapezine consumers and 70% of the prescriptions are made out to them for as long as 5 years!No therapy has ever actually shown a satisfactory efficacy to treat the problem. The given elements converge to propose programmes of a psycho-educative kind. As a result, this has led us to the conclusion that a protocol, which would be set up and supervised by university academics, ensured by trained psychologists with medical withdrawal follow-up to be carried out within the Spa therapy, could well allow withdrawal from this medication. The Spa therapy, through its proven anxiolytic activity, is able to favour the substituting of Treatment by benzodiapezine, and as a result would make withdrawal easier. We propose here to set out the psycho-educative protocol with the support of an experiment on 73 patients, carried out in 2010 and 2011 in France together with the results of this study.
Laurie Mobdillon - One of the best experts on this subject based on the ideXlab platform.
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Stress management in obesity during a thermal Spa residential programme (ObesiStress): protocol for a randomised controlled trial study
BMJ Open, 2019Co-Authors: Frédéric Dutheil, Elodie Chaplais, Audrey Vilmant, Daniel Courteix, Pascale Duché, Armand Abergel, Daniela Pfabigan, Shihui Han, Omar Izem, Laurie MobdillonAbstract:Introduction Stress and obesity are two public health issues. The relationship between obesity and stress is biological through the actions of stress on the major hormones that regulate appetite (leptin and ghrelin). Many Spa resorts in France specialise in the Treatment of obesity, but no thermal Spa currently proposes a specific programme to manage stress in obesity. The ObesiStress protocol has been designed to offer a new residential stress management programme. This thermal Spa Treatment of obesity implements stress management strategies as suggested by international recommendations. Methods and analysis 140 overweight or obese participants with a Body Mass Index of >25 kg/m(2) and aged over 18 years will be recruited. Participants will be randomised into two groups: a control group of usual practice (restrictive diet, physical activity and thermal Spa Treatment) and an intervention group with stress management in addition to the usual practice. In the present protocol, parameters will be measured on five occasions (at inclusion, at the beginning of the Spa (day 0), at the end of the Spa (day 21), and at 6 and 12 months). The study will assess the participants' heart rate variability, cardiac remodelling and function, electrodermal activity, blood markers, anthropometric profile, body composition, psychology and quality of life via the use of questionnaires and bone parameters. Ethics and dissemination The ObesiStress protocol complies with the ethics guidelines for Clinical Research and has been approved by the ethics committee (CPP Sud-Est VI, Clermont-Ferrand - ANSM: 2016-A01774-47). This study aimed to highlight the efficacy of a 21-day thermal Spa residential programme of stress management in obesity through objective measurements of well-being and cardiovascular morbidity. Results will be disseminated during several research conferences and articles published in peer-reviewed journals.
Bernadette Satger - One of the best experts on this subject based on the ideXlab platform.
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a multicenter randomized controlled trial evaluating balneotherapy in patients with advanced chronic venous insufficiency
Journal of Vascular Surgery, 2014Co-Authors: Patrick H Carpentier, Bernadette Satger, S Blaise, C Genty, Carole Rolland, C Roques, Jeanluc BossonAbstract:Background Apart from compression therapy, physical therapy has scarcely been evaluated in the Treatment of chronic venous disorders (CVDs). Spa Treatment is a popular way to administer physical therapy for CVDs in France, but its efficacy has not yet been assessed in a large trial. The objective was to assess the efficacy of Spa therapy for patients with advanced CVD (CEAP clinical classes C4-C5). Methods This was a single-blind (Treatment concealed to the investigators) randomized, multicenter, controlled trial (French Spa resorts). Inclusion criteria were primary or post-thrombotic CVD with skin changes but no active ulcer (C4a, C4b, or C5). The treated group had the usual 3-week Spa Treatment course soon after randomization; the control group had Spa Treatment after the 1-year comparison period. All patients continued their usual medical care including wearing compression stockings. Treatment consisted of four balneotherapy sessions per day for 6 days a week. Follow-up was performed at 6, 12 and 18 months by independent blinded investigators. The main outcome criterion was the incidence of leg ulcers at 12 months. Secondary criteria were a modified version of the Venous Clinical Severity Score, a visual analog scale for leg symptoms, and the Chronic Venous Insufficiency Questionnaire 2 and EuroQol 5D quality-of-life autoquestionnaires. Results Four hundred twenty-five subjects were enrolled: 214 in the Treatment group (Spa) and 211 in the control group (Ctr); they were similar at baseline regarding their demographic characteristics, the severity of the CVD, and the outcome variables. At 1 year, the incidence of leg ulcers was not statistically different (Spa: +9.3%; 95% confidence interval [CI], +5.6 - +14.3; Ctr: +6.1%; 95% CI, +3.2 - +10.4), whereas the Venous Clinical Severity Score improved significantly in the Treatment group (Spa: −1.2; 95% CI, −1.6 - −0.8; Ctr: −0.6; 95% CI, −1.0 - −0.2; P = .04). A significant difference favoring Spa Treatment was found regarding symptoms after 1 year (Spa: −0.03; 95% CI, −0.57 - +0.51; Ctr: +0.87; 95% CI,+0.46 - +1.26; P = .009). EuroQol 5D improved in the Treatment group (Spa: +0.01; 95% CI, −0.02 - +0.04) while it worsened (Ctr: −0.07; 95% CI, −0.10 - −0.04) in the control group ( P P = .008). The control patients showed similar improvements in clinical severity, symptoms, and quality of life after their own Spa Treatment (day 547). Conclusions In this study, the incidence of leg ulcers was not reduced after a 3-week Spa therapy course. Nevertheless, our study demonstrates that Spa therapy provides a significant and substantial improvement in clinical status, symptoms, and quality of life of patients with advanced venous insufficiency for at least 1 year.
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randomized trial of balneotherapy associated with patient education in patients with advanced chronic venous insufficiency
Journal of Vascular Surgery, 2009Co-Authors: Patrick H Carpentier, Bernadette SatgerAbstract:Objectives Except for compression therapy, physical therapy has scarcely been evaluated in the Treatment of chronic venous disorders (CVD). Spa Treatment is a popular way to administer physical therapy for CVD in France, but its efficacy has not been evaluated yet. This study aimed to assess the efficacy of balneotherapy associated with patient education, as performed in the Spa resort of La Lechere, in patients with advanced chronic venous insufficiency (CEAP clinical classes C4/C5). Methods The study was a randomized controlled trial, Spa therapy being administered on top of the usual medical care. Evaluation was by a blinded independent investigator. Subjects were patients with primary or post-thrombotic CVD with skin changes but no active ulcer (C4a, C4b, or C5), living in Grenoble area, and willing to undergo a Spa Treatment course in La Lechere. The treated group had the three week Spa Treatment course in La Lechere, soon after randomization; the control group also had a Spa Treatment, but starting at day 365. The Treatment consisted of four balneology sessions per day, six days a week during three weeks, and three educational workshops. An independent follow-up was performed in Grenoble hospital every three months for 15 months. The main outcome criterion was the severity of the skin changes, as evaluated by means of malleolar chromametry. Quality of life, as measured by the Chronic Venous Insufficiency Questionnaire 2 scale, a visual analog scale (VAS) for leg symptoms, and the occurrence of leg ulcers were used as secondary criteria. The year after Spa Treatment in the treated group was compared with the year before Spa Treatment in the control group. Results Fifty-nine subjects were enrolled (29 in the Treatment group and 30 in the control group). No statistically significant difference between groups was found at study onset regarding age, sex, etiology, CEAP "C" class, and the outcome variables. After Treatment, chromametry showed significantly decreased pigmentation and erythema in the Treatment group compared with the controls ( P P P Conclusion This study shows that Spa therapy, associating balneotherapy and patient education, is able to improve significantly the skin trophic changes of the CVD patients and their CVD related quality of life and symptoms. This effect is of large magnitude and remains significant one year after the Treatment course.
Kokot F - One of the best experts on this subject based on the ideXlab platform.
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Effect of Spa therapy on the endocrine system. I. Stress reaction hormones
Polskie Archiwum Medycyny Wewnetrznej, 1996Co-Authors: Kuczera M, Kokot FAbstract:UNLABELLED The present study aimed to assess a.) the influence of Spa Treatment in Wysowa on the circadian rhythm of plasma concentration of ACTH, cortisol, growth hormone and prolactin, and b.) the influence of kind of pathology on the hormonal profile of the above mentioned hormones. Four groups of patients were examined. The first one comprised 48 patients with essential hypertension, the second one--47 patients with inflammatory renal disease with normal excretory renal function, the third one--39 patients with gastrointestinal diseases and cholelithiasis and the fourth one--41 patients with neurovegetative neurosis. The hormonal parameters were assessed during a clinical check-up, and after 4 and 20 days of Spa therapy in Wysowa respectively. In all examined groups Spa Treatment was accompanied by a significant increase of serum concentrations of all examined hormones. Spa Treatment did not influence the circadian rhythm of ACTH, cortisol, growth hormone and prolactin plasma concentration in all examined groups of patients. CONCLUSION Spa therapy shows a marked influence on secretion of "stress" hormones, but does not influence the circadian rhythm of plasma concentration of these compounds.
Patrick H Carpentier - One of the best experts on this subject based on the ideXlab platform.
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a multicenter randomized controlled trial evaluating balneotherapy in patients with advanced chronic venous insufficiency
Journal of Vascular Surgery, 2014Co-Authors: Patrick H Carpentier, Bernadette Satger, S Blaise, C Genty, Carole Rolland, C Roques, Jeanluc BossonAbstract:Background Apart from compression therapy, physical therapy has scarcely been evaluated in the Treatment of chronic venous disorders (CVDs). Spa Treatment is a popular way to administer physical therapy for CVDs in France, but its efficacy has not yet been assessed in a large trial. The objective was to assess the efficacy of Spa therapy for patients with advanced CVD (CEAP clinical classes C4-C5). Methods This was a single-blind (Treatment concealed to the investigators) randomized, multicenter, controlled trial (French Spa resorts). Inclusion criteria were primary or post-thrombotic CVD with skin changes but no active ulcer (C4a, C4b, or C5). The treated group had the usual 3-week Spa Treatment course soon after randomization; the control group had Spa Treatment after the 1-year comparison period. All patients continued their usual medical care including wearing compression stockings. Treatment consisted of four balneotherapy sessions per day for 6 days a week. Follow-up was performed at 6, 12 and 18 months by independent blinded investigators. The main outcome criterion was the incidence of leg ulcers at 12 months. Secondary criteria were a modified version of the Venous Clinical Severity Score, a visual analog scale for leg symptoms, and the Chronic Venous Insufficiency Questionnaire 2 and EuroQol 5D quality-of-life autoquestionnaires. Results Four hundred twenty-five subjects were enrolled: 214 in the Treatment group (Spa) and 211 in the control group (Ctr); they were similar at baseline regarding their demographic characteristics, the severity of the CVD, and the outcome variables. At 1 year, the incidence of leg ulcers was not statistically different (Spa: +9.3%; 95% confidence interval [CI], +5.6 - +14.3; Ctr: +6.1%; 95% CI, +3.2 - +10.4), whereas the Venous Clinical Severity Score improved significantly in the Treatment group (Spa: −1.2; 95% CI, −1.6 - −0.8; Ctr: −0.6; 95% CI, −1.0 - −0.2; P = .04). A significant difference favoring Spa Treatment was found regarding symptoms after 1 year (Spa: −0.03; 95% CI, −0.57 - +0.51; Ctr: +0.87; 95% CI,+0.46 - +1.26; P = .009). EuroQol 5D improved in the Treatment group (Spa: +0.01; 95% CI, −0.02 - +0.04) while it worsened (Ctr: −0.07; 95% CI, −0.10 - −0.04) in the control group ( P P = .008). The control patients showed similar improvements in clinical severity, symptoms, and quality of life after their own Spa Treatment (day 547). Conclusions In this study, the incidence of leg ulcers was not reduced after a 3-week Spa therapy course. Nevertheless, our study demonstrates that Spa therapy provides a significant and substantial improvement in clinical status, symptoms, and quality of life of patients with advanced venous insufficiency for at least 1 year.
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randomized trial of balneotherapy associated with patient education in patients with advanced chronic venous insufficiency
Journal of Vascular Surgery, 2009Co-Authors: Patrick H Carpentier, Bernadette SatgerAbstract:Objectives Except for compression therapy, physical therapy has scarcely been evaluated in the Treatment of chronic venous disorders (CVD). Spa Treatment is a popular way to administer physical therapy for CVD in France, but its efficacy has not been evaluated yet. This study aimed to assess the efficacy of balneotherapy associated with patient education, as performed in the Spa resort of La Lechere, in patients with advanced chronic venous insufficiency (CEAP clinical classes C4/C5). Methods The study was a randomized controlled trial, Spa therapy being administered on top of the usual medical care. Evaluation was by a blinded independent investigator. Subjects were patients with primary or post-thrombotic CVD with skin changes but no active ulcer (C4a, C4b, or C5), living in Grenoble area, and willing to undergo a Spa Treatment course in La Lechere. The treated group had the three week Spa Treatment course in La Lechere, soon after randomization; the control group also had a Spa Treatment, but starting at day 365. The Treatment consisted of four balneology sessions per day, six days a week during three weeks, and three educational workshops. An independent follow-up was performed in Grenoble hospital every three months for 15 months. The main outcome criterion was the severity of the skin changes, as evaluated by means of malleolar chromametry. Quality of life, as measured by the Chronic Venous Insufficiency Questionnaire 2 scale, a visual analog scale (VAS) for leg symptoms, and the occurrence of leg ulcers were used as secondary criteria. The year after Spa Treatment in the treated group was compared with the year before Spa Treatment in the control group. Results Fifty-nine subjects were enrolled (29 in the Treatment group and 30 in the control group). No statistically significant difference between groups was found at study onset regarding age, sex, etiology, CEAP "C" class, and the outcome variables. After Treatment, chromametry showed significantly decreased pigmentation and erythema in the Treatment group compared with the controls ( P P P Conclusion This study shows that Spa therapy, associating balneotherapy and patient education, is able to improve significantly the skin trophic changes of the CVD patients and their CVD related quality of life and symptoms. This effect is of large magnitude and remains significant one year after the Treatment course.
