Serielle Kaltwasserreize (Kneipp’scher Oberguss) bei Patienten mit chronisch obstruktiver Bronchitis (COPD)

Abstract

Patients with chronic obstructive pulmonary disease (COPD) often suffer from exacerbations caused by infections of the bronchial tract. Objective: What effects do hydrotherapeutic applications according to Kneipp have on lung function, blood gases, immune system and quality of life of patients with COPD? Patients and Methods: 20 patients with COPD (17 males, 3 females); mean age: 64; forced exspiratory volume (FEV1): 62 of 100% (on anverage); no acute exacerbations, no oral corticosteroids. Measurements were performed (I) at 10 weeks pre-treatment, (II) immediately before therapy (I–II: baseline-period), (III) after 10 weeks treatment with 3 cold affusions and 2 cold washings of the upper part of the body (self-treatment) per week each, (IV) 3 months after completion of the treatment (follow- up). The following parameters were measured: lung function, blood gases, routine lab, experimental lab (interleukines, lymphocytes), maximal exspiratory flow (PEF), quality of life and respiratory infections. Results: The pH increased over the course of the study. PEF and the number of lymphocytes significantly increased over the treatment (II–III). Intracellular expression of IL-4 by T lymphocytes decreased. However, the expression of IFN-γ increased. Frequency of infections was lower during follow-up (IV) than before and during therapy. Quality of life after treatment was estimated to be good in all patients. Conclusions: Repeated cold stimulations (affusions) can influence the frequency of respiratory infections and improve subjective well-being. It may cause an immunological modulation in terms of the Th1-type pattern.

Health resort medicine in non-musculoskeletal disorders: is there evidence of its effectiveness?

“…One examined the influence of Kneipp hydrotherapy on lung function, blood gases and immune system among others and pointed out a trend towards reduction of incidence of respiratory infections and an immunological modulation (Goedsche et al 2007). A significant withingroup improvement in vital capacity and exercise capacity as evaluated by the 6-Minute Walk Test is reported after 4 weeks of spa therapy including swim training and exercises in a hot spring pool, inhalation of iodine salt solution and fangotherapy (Takata et al 2008).…”

“…Most of the 22 uncontrolled studies report significant within-group improvements over time. In fact, evidence was found suggesting that (1) mineral water drinking cure may reduce dyspeptic symptoms (Anti et al 2004;Bertoni et al 2002;Gasbarrini et al 2006); (2) inhalation therapy with sulphurous thermal water can improve middle ear function in patients with chronic inflammatory ear disease (Costantino 2008b;Costantino et al 2006), nasal flows and nasal resistance in patients with chronic sinonasal disease (Staffieri and Abramo 2007) and, in combination with radon therapy, pulmonary function of asthmatics (Mitsunobu et al 2003); inhalation therapy with radioactive hydrofluoric oligomineral water may reduce mucociliary transport time and can normalize the nasal cytology in patients with chronic sinonasal inflammation (Passali et al 2013); (3) Kneipp applications may decrease dysesthesia in patients with peripheral neuropathy (Uehleke and Woehling 2008) and positively influence the frequency of respiratory infections and subjective well-being in patients with COPD (Goedsche et al 2007); (4) balneotherapy administered in various modalities positively influences inflammation and qol in patients with atopic dermatitis and psoriasis (Casas et al 2011;Merial-Kieny et al 2011;Taieb et al 2011;Tsoureli-Nikita et al 2002) and improves qol and clinical symptoms in patients with inherited ichthyosis (Bodemer et al 2011); (5) aquatic exercise may improve functional capacity and qol in patients with advanced heart failure (Municino et al 2006); and (6) spa therapy can improve qol and mood in breast cancer patients (Strauss- Blasche et al 2005), positively influence the steroid spectrum in thyroidectomized women (Jandova et al 2008), improve burnout-related complaints and quality of sleep in subjects with mild or full burnout syndrome (Blasche et al 2010), improve metabolic syndrome (Gin et al 2013) and enhance exercise capacity in patients with COPD (Takata et al 2008).…”

Physikalische Therapie: Therapiemittel Wasser (2)

“…Eine leichte Verbesserung der Lungenfunktionsparameter und eine deutliche Senkung der Anzahl an Infektionen von 20 COPD-Patienten (17 männlich, 3 weiblich) wurde in einer Untersuchung der Wirksamkeit von seriellen Obergüssen nach Kneipp im Rahmen einer Dissertation beobachtet. Die Wirkung auf die Infektionsanfälligkeit («Th1-Reaktion») entspricht der umgangssprachlichen Abhärtung [12]. …”

Scientific evidence-based effects of hydrotherapy on various systems of the body

“…[11] Repeated cold water stimulations reduced frequency of infections; increased peak expiratory flow, lymphocyte counts, and expression of gamma-interferon; modulated interleukin expression; and improved quality of life (QOL) in patients with chronic obstructive pulmonary disease. [21]…”