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Balneotherapy for chronic venous insufficiency.

Melissa Andreia de Moraes Silva1, Luis Cu Nakano, Lígia L Cisneros

  • 1Interdisciplinary Surgical Science Program, Universidade Federal de São Paulo (UNIFESP), Rua Napoleao de Barros, 420, São Paulo, Brazil.

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|August 27, 2019
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Balneotherapy, a water-based treatment, may offer moderate improvements in pain, quality of life, and skin pigmentation for chronic venous insufficiency (CVI). However, evidence suggests no clear effect on disease severity, leg ulcers, or edema compared to no treatment.

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Area of Science:

  • Vascular Medicine
  • Physical Therapy
  • Evidence-Based Medicine

Background:

  • Chronic venous insufficiency (CVI) is a prevalent condition affecting lower limb veins, leading to symptoms like edema, pain, and skin changes.
  • CVI presents a significant health burden, with various treatment options available, including surgery, medication, compression, and physiotherapy.
  • Balneotherapy, utilizing water-based treatments, is explored as a cost-effective physical therapy for CVI management.

Purpose of the Study:

  • To evaluate the efficacy and safety of balneotherapy in treating patients diagnosed with chronic venous insufficiency (CVI).
  • To synthesize evidence from randomized controlled trials comparing balneotherapy with control groups or other interventions for CVI.

Main Methods:

  • A comprehensive literature search was conducted across multiple databases (Cochrane Vascular, MEDLINE, Embase, etc.) up to August 2018.
  • Included studies were randomized and quasi-randomized controlled trials comparing balneotherapy to no treatment or other CVI therapies.
  • Data extraction and analysis involved independent review by two authors, with outcomes reported using odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI).

Main Results:

  • Seven randomized controlled trials involving 891 participants were included; no quasi-randomized trials were found.
  • Balneotherapy showed probable moderate improvements in quality of life (HRQoL) and slight improvements in pain compared to no treatment.
  • Evidence suggests potential moderate improvements in skin pigmentation, but no clear effects were observed for disease severity, leg ulcers, or edema. Adverse events were not clearly increased.

Conclusions:

  • Moderate to low-certainty evidence indicates balneotherapy may moderately improve pain, HRQoL, and skin pigmentation in CVI patients.
  • Balneotherapy demonstrated no clear effect on disease severity, leg ulcers, or edema when compared to no treatment.
  • Standardization of outcome measurements and follow-up time points is recommended for future CVI balneotherapy research.