HRM  treatment is associated with clinical improvement in diseases of the skin , respiratory , circulatory , digestive and nervous system among others .
The scientific literature of the last decade has shown that a number of non-musculoskeletal disorders are treated with different kinds of  HRM .
Health resort medicine ( HRM ; in German : Kurortmedizin ) is a field of medicine with long-lasting tradition in several European countries .
A number of systematic review s have shown the effectiveness of HRM  in musculoskeletal conditions .
Review s focusing on the effectiveness of HRM in non-musculoskeletal disorders are rare .
This systematic review aims to provide an overview about all types of health resort treatments applied in non-musculoskeletal conditions , to summarize evidence for its effectiveness and to assess the quality of published studies .
Randomized trial of balneotherapy associated with patient education in patients with advanced chronic venous insufficiency.
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 aim ed to assess the efficacy of balneotherapy associated with patient education , as performed in the spa resort of La Léchère , in patients with advanced chronic venous insufficiency ( CEAP clinical classes C4/C5 ) . METHODS The study was a r and omized 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 Léchère . The treated group had the three week spa treatment course in La Léchère , soon after r and omization ; 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 Question naire 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 < .01 ) . Quality of life ( P < .01 ) and symptoms ( P < .001 ) also improved significantly . These differences remained significant after one year follow-up . The control patients improved similarly after their own spa treatment ( day 450 ) . 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
HRM  treatment is associated with clinical improvement in diseases of the skin , respiratory , circulatory , digestive and nervous system among others .
The scientific literature of the last decade has shown that a number of non-musculoskeletal disorders are treated with different kinds of  HRM .
Health resort medicine ( HRM ; in German : Kurortmedizin ) is a field of medicine with long-lasting tradition in several European countries .
A number of systematic review s have shown the effectiveness of HRM  in musculoskeletal conditions .
Review s focusing on the effectiveness of HRM in non-musculoskeletal disorders are rare .
This systematic review aims to provide an overview about all types of health resort treatments applied in non-musculoskeletal conditions , to summarize evidence for its effectiveness and to assess the quality of published studies .