Abstract
Non-specific chronic low back pain (nscLBP) has a high socio-economic relevance due to its high incidence, prevalence and associated costs. Therefore, it is essential to evaluate effective therapeutic strategies. This study examines the effects of moderate mountain exercise and spa therapy on orthopedic and psychophysiological parameters. Based on a three-armed randomized controlled trial, guided mountain hiking tours and balneotherapy in thermal water were compared to a control group.
Methods
Eighty patients with diagnosed nscLBP were separated into three groups: The two intervention groups GE (green exercise) and GEBT (green exercise and balneotherapy) undertook daily mountain hiking tours, whereas the GEBT group got an additional treatment with baths in Mg-Ca-SO4 thermal water. The third group (CO) received no intervention. GE and GEBT group were treated for 6 days; all groups were followed up for 120 days.
Results
Compared to GE and CO group, the GEBT treatment showed significant improvements of pain, some orthopedic parameters, health-related quality of life and mental well-being in patients with nscLBP.
Conclusions
The results of this study confirmed a benefit of mountain hiking combined with Mg-Ca-SO4 spa therapy as a multimodal treatment of patients with nscLBP. Further studies should focus on long-term-effects of this therapeutic approach.
Trial registration
ISRCTN, ISRCTN99926592. Registered 06. July 2018 - Retrospectively registered. © 2019 The Author(s).
| Original language | English |
|---|---|
| Journal | BMC Musculoskelet. Disord. |
| Volume | 20 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 17 May 2019 |
UN SDGs
This output contributes to the following UN Sustainable Development Goals (SDGs)
-
SDG 3 Good Health and Well-being
Keywords
- Alpine environment
- Balneotherapy
- Chronic non-specific low back pain
- Green exercise
- Magnesium-calcium-sulfate thermal water
- Moderate altitude
- Mountain exercise
- Mountain hiking
- Nature therapy
- Spa therapy
- adult
- Article
- balneotherapy
- chronic disease
- clinical effectiveness
- controlled study
- daily life activity
- depression
- exercise
- female
- follow up
- green exercise
- human
- low back pain
- major clinical study
- male
- non specific chronic low back pain
- outcome assessment
- psychological well-being
- quality of life
- randomized controlled trial
- spa treatment
- spine mobility
- therapy effect
- thermal balneotherapy
- age
- aged
- heat
- middle aged
- multimodality cancer therapy
- pain measurement
- procedures
- sex factor
- treatment outcome
- young adult
- mineral water
- Adult
- Age Factors
- Aged
- Balneology
- Combined Modality Therapy
- Exercise
- Female
- Hot Temperature
- Humans
- Low Back Pain
- Male
- Middle Aged
- Mineral Waters
- Pain Measurement
- Quality of Life
- Sex Factors
- Treatment Outcome
- Young Adult
Fingerprint
Dive into the research topics of 'Green exercise and mg-ca-SO4 thermal balneotherapy for the treatment of non-specific chronic low back pain: A randomized controlled clinical trial'. Together they form a unique fingerprint.Cite this
- APA
- Author
- BIBTEX
- Harvard
- Standard
- RIS
- Vancouver
}
In: BMC Musculoskelet. Disord., Vol. 20, No. 1, 17.05.2019.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Green exercise and mg-ca-SO4 thermal balneotherapy for the treatment of non-specific chronic low back pain: A randomized controlled clinical trial
AU - Huber, D.
AU - Grafetstätter, C.
AU - Proßegger, J.
AU - Pichler, C.
AU - Wöll, E.
AU - Fischer, M.
AU - Dürl, M.
AU - Geiersperger, K.
AU - Höcketstaller, M.
AU - Frischhut, S.
AU - Ritter, M.
AU - Hartl, A.
N1 - Cited By :24 Export Date: 14 December 2023 Correspondence Address: Hartl, A.; Institute of Ecomedicine, Austria; email: [email protected] Chemicals/CAS: Mineral Waters References: (2019) Jahrbuch der Gesundheitsstatistik 2017, , https://www.statistik.at/web_de/services/publikationen/4/index.html?includePage=detailedViewionName=Gesundheit&pubId=543, Statistik Austria Statistik Austria Accessed Mar 2019; Pensionsversicherungsanstalt, Ö., (2017) Rückenschmerzen 2016; Vauth, C., Greiner, W., Kosten in der Schmerztherapie (2011) Gesundheitsökonomie & Qualitätsmanagement, 16, pp. S3-S9. , S 01; Hildebrandt, J., Mannion, A.F., Brox, J.I., Kovacs, F., Klaber-Moffett, J., Staal, B., Evidenz der Bewegungstherapie und Manuellen Therapie bei chronischen nichtspezifischen Rückenschmerzen - Darstellung der Europäischen Leitlinien - Teil 1 (2005) Physioscience, 1 (2), pp. 59-66; Van Tulder, M., Becker, A., Bekkering, T., Breen, A., Del Real, M.T.G., Hutchinson, A., Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care (2006) Eur Spine J, 15 (2), pp. 169-191; Bundesärztekammer, K.B., (2017) Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen F. Nationale VersorgungsLeitlinie Nicht-spezifischer Kreuzschmerz - Langfassung; Gatchel, R.J., Peng, Y.B., Peters, M.L., Fuchs, P.N., Turk, D.C., The biopsychosocial approach to chronic pain: Scientific advances and future directions (2007) Psychol Bull, 133 (4), pp. 581-624; Gerhardt, A., Hartmann, M., Tesarz, J., Janke, S., Leisner, S., Seidler, G., Subgroups of musculoskeletal pain patients and their psychobiological patterns - The LOGIN study protocol (2012) BMC Musculoskelet Disord, 13, p. 136; Maher, C., Underwood, M., Buchbinder, R., Non-specific low back pain (2017) Lancet., 389, pp. 736-747; Buselli, P., Bosoni, R., Buse, G., Fasoli, P., La Scala, E., Mazzolari, R., Effectiveness evaluation of an integrated automatic thermomechanic massage system (SMATH(R) system) in non-specific sub-acute and chronic low back pain - A randomized double-blinded controlled trial, comparing SMATH therapy versus sham therapy: Study protocol for a randomized controlled trial (2011) Trials., 12, p. 216; Flothow, A., Zeh, A., Nienhaus, A., Unspezifische Rückenschmerzen - Grundlagen und Interventionsmöglichkeiten aus psychologischer Sicht (2009) Gesundheitswesen., 71 (12), pp. 845-856. , 1:STN:280:DC%2BD1MfkvVWgtQ%3D%3D; Furlan, A.D., Clarke, J., Esmail, R., Sinclair, S., Irvin, E., Bombardier, C., A critical review of reviews on the treatment of chronic low back pain (2001) Spine., 26 (7), pp. E155-E162. , 1:STN:280:DC%2BD3M3msFyjtA%3D%3D; Barton, J., Griffin, M., Pretty, J., Exercise-, nature- and socially interactive-based initiatives improve mood and self-esteem in the clinical population (2012) Perspect Public Health, 132 (2), pp. 89-96; Duncan, M.J., Clarke, N.D., Birch, S.L., Talli, J., Hankey, J., Bryant, E., The effect of green exercise on blood pressure, heart rate and mood state in primary school children (2014) Int J Environ Res Public Health, 11, pp. 3678-3688; Gladwell, V., Kuoppa, P., Tarvainen, M., Rogerson, M., A Lunchtime Walk in Nature Enhances Restoration of Autonomic Control during Night-Time Sleep: Results from a Preliminary Study (2016) International Journal of Environmental Research and Public Health, 13 (3), p. 280; Soga, M., Gaston, K.J., Yamaura, Y., Gardening is beneficial for health: A meta-analysis (2017) Prev Med Rep, 5, pp. 92-99; Van Den Berg, A.E., From green space to green prescriptions: Challenges and opportunities for research and practice (2017) Front Psychol, 8, p. 268. , 28289398 5326776; Pittler, M.H., Karagulle, M.Z., Karagulle, M., Ernst, E., Spa therapy and balneotherapy for treating low back pain: Meta-analysis of randomized trials (2006) Rheumatology (Oxford), 45 (7), pp. 880-884. , 1:STN:280:DC%2BD28zotlSiug%3D%3D; Kesiktas, N., Karakas, S., Gun, K., Gun, N., Murat, S., Uludag, M., Balneotherapy for chronic low back pain: A randomized, controlled study (2012) Rheumatol Int, 32 (10), pp. 3193-3199; Karagülle, M., Karagülle, M.Z., Effectiveness of balneotherapy and spa therapy for the treatment of chronic low back pain: A review on latest evidence (2015) Clin Rheumatol, 34 (2), pp. 207-214; Von Korff, M., Ormel, J., Keefe, F.J., Dworkin, S.F., Grading the severity of chronic pain (1992) Pain., 50 (2), pp. 133-149; Fleischhacker, E., Ebenbichler, R., Blome, P., Exploring, H.A., Water health locations in the controversial field between Esoterism and science (2010) Beiträge Zur Hydrogeologie, 57, pp. 173-198; Strand, L.I., Moe-Nilssen, R., Ljunggren, A.E., Back performance scale for the assessment of mobility-related activities in people with back pain (2002) Phys Ther, 82 (12), pp. 1213-1223. , 12444880; Magnussen, L., Strand, L.I., Lygren, H., Reliability and validity of the back performance scale: Observing activity limitation in patients with back pain (2004) Spine (Phila Pa 1976), 29 (8), pp. 903-907; Verra, M., Funktioneller Leistungstest für den Rücken (2009) Physiopraxis, 12, p. 11; Gmoser, T., (2013) MediMouse® Anwendung; Barrett, E., McCreesh, K., Lewis, J., Reliability and validity of non-radiographic methods of thoracic kyphosis measurement: A systematic review (2014) Man Ther, 19 (1), pp. 10-17; Kim, D.Y., Oh, C.H., Yoon, S.H., Park, H.C., Park, C.O., Lumbar disc screening using back pain questionnaires: Oswestry low back pain score, Aberdeen low back pain scale, and acute low back pain screening questionnaire (2012) Korean J Spine, 9 (3), pp. 153-158; Fairbank, J.C., Pynsent, P.B., The Oswestry disability index (2000) Spine (Phila Pa 1976), 25 (22), pp. 2940-2952. , 1:STN:280:DC%2BD38%2FgsFymsA%3D%3D discussion 52; Ostelo, R.W., Deyo, R.A., Stratford, P., Waddell, G., Croft, P., Von Korff, M., Interpreting change scores for pain and functional status in low back pain: Towards international consensus regarding minimal important change (2008) Spine (Phila Pa 1976), 33 (1), pp. 90-94; Wind, H., Gouttebarge, V., Kuijer, P.P., Frings-Dresen, M.H., Assessment of functional capacity of the musculoskeletal system in the context of work, daily living, and sport: A systematic review (2005) J Occup Rehabil, 15 (2), pp. 253-272; Hawker, G.A., Mian, S., Kendzerska, T., French, M., Measures of adult pain: Visual analog scale for pain (VAS pain), numeric rating scale for pain (NRS pain), McGill pain questionnaire (MPQ), short-form McGill pain questionnaire (SF-MPQ), chronic pain grade scale (CPGS), short Form-36 bodily pain scale (SF-36 BPS), and measure of intermittent and constant osteoarthritis pain (ICOAP) (2011) Arthritis Care Res (Hoboken), 63, pp. S240-S252; Bijur, P.E., Silver, W., Gallagher, E.J., Reliability of the visual analog scale for measurement of acute pain (2001) Acad Emerg Med, 8 (12), pp. 1153-1157. , 1:STN:280:DC%2BD3Mnos12hsA%3D%3D; Ferreira-Valente, M.A., Pais-Ribeiro, J.L., Jensen, M.P., Validity of four pain intensity rating scales (2011) Pain., 152 (10), pp. 2399-2404; Kim, E.J., Buschmann, M.T., Reliability and validity of the faces pain scale with older adults (2006) Int J Nurs Stud, 43 (4), pp. 447-456; Bellach, B.M., Ellert, U., Radoschewski, M., The application of the short form questionnaire 36 within the National Health Survey - First results and new questions (2000) Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz, 43 (3), pp. 210-216; Coons, S.J., Rao, S., Keininger, D.L., Hays, R.D., A comparative review of generic quality-of-life instruments (2000) Pharmacoeconomics., 17 (1), pp. 13-35. , 1:STN:280:DC%2BD3M%2Fgt1KitQ%3D%3D; Ware, J.E., Jr., SF-36 health survey update (2000) Spine (Phila Pa 1976), 25 (24), pp. 3130-3139; Wu, S.F., Rapid screening of psychological well-being of patients with chronic illness: Reliability and validity test on WHO-5 and PHQ-9 scales (2014) Depress Res Treat, 2014, p. 239490. , 25505984 4254072; Henkel, V., Mergl, R., Kohnen, R., Maier, W., Moller, H.J., Hegerl, U., Identifying depression in primary care: A comparison of different methods in a prospective cohort study (2003) BMJ., 326 (7382), pp. 200-201; Topp, C.W., Ostergaard, S.D., Sondergaard, S., Bech, P., The WHO-5 well-being index: A systematic review of the literature (2015) Psychother Psychosom, 84 (3), pp. 167-176; Razali, N.M., Wah, Y.B., Power comparisons of shapiro-wilk, kolmogorov-smirnov, lilliefors and anderson-darling tests (2011) J Stat Model Anal., 2 (1), pp. 21-33; Moseley, G.L., Flor, H., Targeting cortical representations in the treatment of chronic pain (2012) Neurorehabil Neural Repair, 26 (6), pp. 646-652; Akers, A., Barton, J., Cossey, R., Gainsford, P., Griffin, M., Micklewright, D., Visual color perception in green exercise: Positive effects on mood and perceived exertion (2012) Environ Sci Technol, 46 (16), pp. 8661-8666. , 1:CAS:528:DC%2BC38XhtFequ7jE; Wooller, J.-J., Barton, Jo., Gladwell, V.F., Micklewright, D., Occlusion of sight, sound and smell during Green Exercise influences mood, perceived exertion and heart rate (2015) International Journal of Environmental Health Research, 26 (3), pp. 267-280; Pretty, J., Peacock, J., Sellens, M., Griffin, M., The mental and physical health outcomes of green exercise (2005) Int J Environ Health Res, 15 (5), pp. 319-337; Bowler, D.E., Buyung-Ali, L.M., Knight, T.M., Pullin, A.S., A systematic review of evidence for the added benefits to health of exposure to natural environments (2010) BMC Public Health, 10, p. 456; Thompson Coon, J., Boddy, K., Stein, K., Whear, R., Barton, J., Depledge, M.H., Does participating in physical activity in outdoor natural environments have a greater effect on physical and mental wellbeing than physical activity indoors? A systematic review (2011) Environ Sci Technol., 45 (5), pp. 1761-1772. , 1:CAS:528:DC%2BC3MXhsFGnsL8%3D; Gladwell, V.F., Brown, D.K., Wood, C., Sandercock, G.R., Barton, J.L., The great outdoors: How a green exercise environment can benefit all (2013) Extrem Physiol Med, 2 (1), p. 3; Grafetstätter, C., Gaisberger, M., Prossegger, J., Ritter, M., Kolarž, P., Pichler, C., Does waterfall aerosol influence mucosal immunity and chronic stress? A randomized controlled clinical trial (2017) J Physiol Anthropol, 36 (1), p. 10; Mitchell, R., Popham, F., Effect of exposure to natural environment on health inequalities: An observational population study (2008) Lancet, 372 (9650), pp. 1655-1660; Haubenhofer, D.K., Elings, M., Hassink, J., Hine, R.E., The development of green care in western European countries (2010) Explore., 6 (2), pp. 106-111; Rogerson, M., Gladwell, V.F., Gallagher, D.J., Barton, J.L., Influences of green outdoors versus indoors environmental settings on psychological and social outcomes of controlled exercise (2016) Int J Environ Res Public Health, 13 (4), p. 363; Hug, S.-M., Hartig, T., Hansmann, R., Seeland, K., Hornung, R., Restorative qualities of indoor and outdoor exercise settings as predictors of exercise frequency (2009) Health Place, 15 (4), pp. 971-980; Bärtsch, P., Saltin, B., General introduction to altitude adaptation and mountain sickness (2008) Scand J Med Sci Sports, 18, pp. 11-110. , Suppl; Johnson, N.J., Luks, A.M., High-altitude medicine (2016) Med Clin North Am, 100 (2), pp. 357-369; Onat, S., Taşoǧlu, Ö., Güneri, F.D., Özişler, Z., Safer, V.B., Özgirgin, N., The effectiveness of balneotherapy in chronic low back pain (2014) Clin Rheumatol, 33 (10), pp. 1509-1515; Nasermoaddeli, A., Kagamimori, S., Balneotherapy in medicine: A review (2005) Environ Health Prev Med, 10 (4), pp. 171-179; Gati, T., Tefner, I.K., Kovacs, L., Hodosi, K., Bender, T., The effects of the calcium-magnesium-bicarbonate content in thermal mineral water on chronic low back pain: A randomized, controlled follow-up study (2018) Int J Biometeorol, 62 (5), pp. 897-905; Bender, T., Karagulle, Z., Balint, G.P., Gutenbrunner, C., Balint, P.V., Sukenik, S., Hydrotherapy, balneotherapy, and spa treatment in pain management (2005) Rheumatol Int, 25 (3), pp. 220-224; Gutenbrunner, C., Bender, T., Cantista, P., Karagulle, Z., A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology (2010) Int J Biometeorol, 54 (5), pp. 495-507; (2016) Non-specific Low Back Pain and Sciatica: Management. NICE Guideline: Short Version. Draft for Consultation, , National Institute for H, Care E; Fioravanti, A., Cantarini, L., Guidelli, G.M., Galeazzi, M., Mechanisms of action of spa therapies in rheumatic diseases: What scientific evidence is there? (2011) Rheumatol Int, 31 (1), pp. 1-8; Morer, C., Roques, C.F., Francon, A., Forestier, R., Maraver, F., The role of mineral elements and other chemical compounds used in balneology: Data from double-blind randomized clinical trials (2017) Int J Biometeorol, 61 (12), pp. 2159-2173
PY - 2019/5/17
Y1 - 2019/5/17
N2 - Background Non-specific chronic low back pain (nscLBP) has a high socio-economic relevance due to its high incidence, prevalence and associated costs. Therefore, it is essential to evaluate effective therapeutic strategies. This study examines the effects of moderate mountain exercise and spa therapy on orthopedic and psychophysiological parameters. Based on a three-armed randomized controlled trial, guided mountain hiking tours and balneotherapy in thermal water were compared to a control group. Methods Eighty patients with diagnosed nscLBP were separated into three groups: The two intervention groups GE (green exercise) and GEBT (green exercise and balneotherapy) undertook daily mountain hiking tours, whereas the GEBT group got an additional treatment with baths in Mg-Ca-SO4 thermal water. The third group (CO) received no intervention. GE and GEBT group were treated for 6 days; all groups were followed up for 120 days. Results Compared to GE and CO group, the GEBT treatment showed significant improvements of pain, some orthopedic parameters, health-related quality of life and mental well-being in patients with nscLBP. Conclusions The results of this study confirmed a benefit of mountain hiking combined with Mg-Ca-SO4 spa therapy as a multimodal treatment of patients with nscLBP. Further studies should focus on long-term-effects of this therapeutic approach. Trial registration ISRCTN, ISRCTN99926592. Registered 06. July 2018 - Retrospectively registered. © 2019 The Author(s).
AB - Background Non-specific chronic low back pain (nscLBP) has a high socio-economic relevance due to its high incidence, prevalence and associated costs. Therefore, it is essential to evaluate effective therapeutic strategies. This study examines the effects of moderate mountain exercise and spa therapy on orthopedic and psychophysiological parameters. Based on a three-armed randomized controlled trial, guided mountain hiking tours and balneotherapy in thermal water were compared to a control group. Methods Eighty patients with diagnosed nscLBP were separated into three groups: The two intervention groups GE (green exercise) and GEBT (green exercise and balneotherapy) undertook daily mountain hiking tours, whereas the GEBT group got an additional treatment with baths in Mg-Ca-SO4 thermal water. The third group (CO) received no intervention. GE and GEBT group were treated for 6 days; all groups were followed up for 120 days. Results Compared to GE and CO group, the GEBT treatment showed significant improvements of pain, some orthopedic parameters, health-related quality of life and mental well-being in patients with nscLBP. Conclusions The results of this study confirmed a benefit of mountain hiking combined with Mg-Ca-SO4 spa therapy as a multimodal treatment of patients with nscLBP. Further studies should focus on long-term-effects of this therapeutic approach. Trial registration ISRCTN, ISRCTN99926592. Registered 06. July 2018 - Retrospectively registered. © 2019 The Author(s).
KW - Alpine environment
KW - Balneotherapy
KW - Chronic non-specific low back pain
KW - Green exercise
KW - Magnesium-calcium-sulfate thermal water
KW - Moderate altitude
KW - Mountain exercise
KW - Mountain hiking
KW - Nature therapy
KW - Spa therapy
KW - adult
KW - Article
KW - balneotherapy
KW - chronic disease
KW - clinical effectiveness
KW - controlled study
KW - daily life activity
KW - depression
KW - exercise
KW - female
KW - follow up
KW - green exercise
KW - human
KW - low back pain
KW - major clinical study
KW - male
KW - non specific chronic low back pain
KW - outcome assessment
KW - psychological well-being
KW - quality of life
KW - randomized controlled trial
KW - spa treatment
KW - spine mobility
KW - therapy effect
KW - thermal balneotherapy
KW - age
KW - aged
KW - heat
KW - middle aged
KW - multimodality cancer therapy
KW - pain measurement
KW - procedures
KW - sex factor
KW - treatment outcome
KW - young adult
KW - mineral water
KW - Adult
KW - Age Factors
KW - Aged
KW - Balneology
KW - Combined Modality Therapy
KW - Exercise
KW - Female
KW - Hot Temperature
KW - Humans
KW - Low Back Pain
KW - Male
KW - Middle Aged
KW - Mineral Waters
KW - Pain Measurement
KW - Quality of Life
KW - Sex Factors
KW - Treatment Outcome
KW - Young Adult
UR - https://www.mendeley.com/catalogue/7ab7a353-f0e7-3050-93f7-84898ee6f04e/
U2 - 10.1186/s12891-019-2582-4
DO - 10.1186/s12891-019-2582-4
M3 - Article
C2 - 31096958
SN - 1471-2474
VL - 20
JO - BMC Musculoskelet. Disord.
JF - BMC Musculoskelet. Disord.
IS - 1
ER -