Publication: Talasoterapia y enfermedad neurológica
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2017-02-23
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Universidad Complutense de Madrid
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Abstract
Introducción. La medicina termal (balneoterapia, talasoterapia, hidroterapia) en los últimos años ha experimentado un cambio conceptual (multidisciplinar) y ha iniciado con paso firme el camino a la evidencia científica en todas las fases del proceso terapéutico: prevención-mejoría sintomática-rehabilitación. El desarrollo químico farmacéutico y el incremento de la esperanza de vida mundial han modificado las indicaciones tradicionales de la talasoterapia (y balneoterapia) por otras. Existe un amplio sector de enfermedades en las cuales está justificado otro tipo de intervenciones con un mecanismo de acción diferente y que tenga en cuenta la potencialidad reactiva del sujeto: prevención, tratamiento de cuadros de evolución crónica sobre todo en aquellos con intolerancias medicamentosas y en aquellas secuelas sintomáticas de traumatismos, eventos vasculares o intervenciones quirúrgicas (rehabilitación). El ictus es la enfermedad vascular cerebral que aún hoy es la primera causa de muerte en mujeres (la segunda en hombres) y la principal causa de discapacidad adquirida en el adulto. En los últimos años se ha conseguido un descenso gradual de la mortalidad gracias al desarrollo de nuevas estrategias terapéuticas y preventivas; en cambio, se está observando un leve ascenso en la incidencia explicado principalmente por el envejecimiento de la población, lo cual implica aumentos en la supervivencia con secuelas y prevalencia global (estimadas).La planificación y gestión de los recursos económicos (sanitarios y sociales) de cada país con estos datos epidemiológicos es variable a tenor, todavía, de estudios poco concluyentes. Aunque la prevención primaria es crucial, y seguirá siendo la piedra angular de los esfuerzos para reducir la discapacidad global por ictus, existe demostración acumulada de que la mejora sistemática del manejo del ictus, incluida la rehabilitación puede también reducir la mortalidad y la discapacidad por esta causa. La rehabilitación es un proceso complejo. A pesar de Declaraciones de Consenso y Guías de práctica Clínica, existen diferencias respecto a los servicios de rehabilitación al que tienen acceso los pacientes tras un ictus.. La evidencia refleja beneficios significativos asociados a la rehabilitación intensiva con tiempos más cortos desde el ictus; pero, ni un solo método de medicina física es más (o menos) eficaz en la promoción de la recuperación funcional y movilidad tras el ictus. Las investigaciones clínicas en hidrología médica (a excepción de la hidroterapia) en enfermedades neurológicas son prácticamente inexistentes, pero en algunas enfermedades reumáticas son bastantes contundentes; las ciencias básicas existentes son estimulantes, pero no son lo suficientemente fuertes como para sacar conclusiones firmes respecto a los mecanismos de acción de la medicina termal. Aun así, la talasoterapia (y terapia acuática) en el tratamiento del ictus (con un enfoque holístico) actuaría en diferentes dominios de la ICF, tanto del individuo como ambientales. La posología y los efectos adversos/contraindicaciones no han sido convenientemente estudiados...
Introduction. Health Resort Medicine (balneotherapy, thalassotherapy, hydrotherapy) has developed a conceptual change over the last years (multidisciplinary) and has definitely start the row to the scientific evidence in whole therapeutic process: preventionsymptoms improvement- rehabilitation. Drug development and life expectancy improvements have modified traditional indications of thalassotherapy (and balneotherapy) to others. There is a large pool of diseases in witch other type of interventions appears to be justifiable given the potential reaction of the individual subject: prevention, some chronic diseases, especially those with intolerances or allergies and in sequels from traumatisms, surgical interventions or neurological diseases (rehabilitation). Stroke is the major cause of death in woman (second in man) and major cause of disability in adults. Mortality rate has decreased in the past 20 years thanks to new therapeutic and preventive strategies; however, incidence is slightly growing since the increase of population ageing, with improving sequels survival rate and global prevalence. Economic resources (social and sanitary) management according those epidemiological data may differ from country to country since studies are far from conclusive. Although primary prevention is crucial to decrease global impairment from stroke, evidence about systematic improvement of stroke management, including rehabilitation, reduce also stroke death and disability Stroke rehabilitation is a complex intervention. . Although European consensus and Best practice Guides, you find still differences from type of rehabilitations patient’s access. Evidence reflects significant improvements in intensive rehabilitation as soon as possible from the onset symptoms; however, no one approach to physical rehabilitation is any more (or less) effective in promoting recovery of function and mobility after stroke. Health Resort Medicine neurological clinical trials are very few but in some rheumatic diseases are highly conclusive; existent basic sciences studies are encouraging, but far conclusive for health resort medicine mechanisms of action. However, thalassotherapy (and aquatic therapy) on stroke treatment (holistic approach) may play an important role on some ICF domains. Dosage and side effects/contraindications need further research...
Introduction. Health Resort Medicine (balneotherapy, thalassotherapy, hydrotherapy) has developed a conceptual change over the last years (multidisciplinary) and has definitely start the row to the scientific evidence in whole therapeutic process: preventionsymptoms improvement- rehabilitation. Drug development and life expectancy improvements have modified traditional indications of thalassotherapy (and balneotherapy) to others. There is a large pool of diseases in witch other type of interventions appears to be justifiable given the potential reaction of the individual subject: prevention, some chronic diseases, especially those with intolerances or allergies and in sequels from traumatisms, surgical interventions or neurological diseases (rehabilitation). Stroke is the major cause of death in woman (second in man) and major cause of disability in adults. Mortality rate has decreased in the past 20 years thanks to new therapeutic and preventive strategies; however, incidence is slightly growing since the increase of population ageing, with improving sequels survival rate and global prevalence. Economic resources (social and sanitary) management according those epidemiological data may differ from country to country since studies are far from conclusive. Although primary prevention is crucial to decrease global impairment from stroke, evidence about systematic improvement of stroke management, including rehabilitation, reduce also stroke death and disability Stroke rehabilitation is a complex intervention. . Although European consensus and Best practice Guides, you find still differences from type of rehabilitations patient’s access. Evidence reflects significant improvements in intensive rehabilitation as soon as possible from the onset symptoms; however, no one approach to physical rehabilitation is any more (or less) effective in promoting recovery of function and mobility after stroke. Health Resort Medicine neurological clinical trials are very few but in some rheumatic diseases are highly conclusive; existent basic sciences studies are encouraging, but far conclusive for health resort medicine mechanisms of action. However, thalassotherapy (and aquatic therapy) on stroke treatment (holistic approach) may play an important role on some ICF domains. Dosage and side effects/contraindications need further research...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina Física y Rehabilitación (Hidrología Médica), leída el 11/01/2016