about hydrotherapy and its physiological effect on body

1. Dr. Satyendra Singh
BNYS, MD
PHYSIOLOGICAL EFFECTS OF HYDROTHERAPY
&
CLAY THERAPY

2. CONTENTS:
 Introduction
 Properties of water
 Classification of temperatures
 Physiological basis of hydrotherapy
 Temperature regulation
 Effects of water on different organ systems

3. INTRODUCTION:-
 Hydrotherapy is the external or internal use of water in any of its forms (water, ice,
steam) for health promotion or treatment of various diseases with various temperatures,
pressure, duration, and site.
Mooventhan A, Nivethitha L. Scientific Evidence-Based Effects of
Hydrotherapy on Various Systems of the Body. North American
Journal of Medical Sciences. 2014;6(5):199-209. doi:10.4103/1947-
2714.132935.

4. PROPERTIES OF WATER:
 Density
 Hydrostatic pressure
 Buoyancy
 Viscosity

5. QUALITIES OF WATER RESPONSIBLE FOR ITS PHYSIOLOGICAL
EFFECTS:
 As a nutrient
 As a means of communicating heat to the body
 As a means of abstracting heat from the body by contact and by evaporation
 As a means of producing some percuitent effects

6. HOW IT ACTS
 Vascular area of skin – Internal vascular area associated with it.
 Intensity differs
 Additional effect- mechanical effect.
 Real effect = Sum of two effects

7. EFFECTS OF WATER DEPENDS UPON:
 Temperature
 Duration
 Mode of application
 Site of application
 Condition of the subject

8. CLASSIFICATION OF TEMPERATURES:
Water may be used therapeutically over a wide range of temperatures;
VERY COLD 32 To 55 F
COLD 55 To 65 F
COOL 65 To 80 F
TEPID 80 To 92 F
NEUTRAL 92 To 95 F
WARM 92 To 98 F
HOT 98 To 104 F
VERY HOT 104 F And above

9. PHYSIOLOGICAL BASIS OF HYDROTHERAPY:
 1. SKIN:

10. 2. CIRCULATORY SYSTEM:

11. 3. NERVOUS SYSTEM:

12. THERMAL REGULATION:

13. GENERAL EFFECTS:-
PRIMARY EFFECT SECONDARY EFFECT
COLD Sedative Restorative & tonic
HOT Excitant Depressant, sedative,
atonic

14. PHYSIOLOGICAL EFFECTS OF HYDROTHERAPY
ON DIFFERENT ORGAN SYSTEMS

15. SKIN:-
1. Effect of cold:
a)Contraction of small BV-
Primary effect Secondary effect
• Short cold applications( 32 to 65 F)
produces Pallor & coldness of the
skin( due to contraction of small
BV)
• Prolonged application- blue or
purplish color of the skin
Pallor/ blueness quickly gives place to
redness ( as a result of active
dilatation of small BV)

16. b) Decreased heat elimination & Increased heat
production:
In action, cold applications
causes contraction of BV
lessens the cutaneous circulation
thus diminish the heat elimination
Reflex stimulation of accelerator centers takes
place
resulting in heat production

17.  In reaction,
accelerated cutaneous circulation
exposure of increased quantity of blood
to cooling influences
increased heat elimination
thus maintaining normal body temperature

18. c) Diminished tactile sensibility:
• Applications of a temperature lessens the
acuteness of tactile
below 92 to 98 F sense
• Very brief/prolonged application of
ice/ very cold water abolish tactile
sensibility

19. 2. Effects of hot:
a)Dilatation of capillary vessels:
Primary effect Secondary effect
• Moderate heat ( 100 to 104 F)
produces reddening of skin surface
At the end of application ( 15 to
30mins) vasoconstriction
phenomenon occurs

20.  CURRIE-
• Moderate hot applications ( 99 to 101 F) - vasodilatation
• Very hot applications ( 104 F and above) – vasoconstriction
Application of higher temperature( 104 to 130 F)
pallor of the skin( due to stimulation of
vasoconstrictors)
due to contraction of
involuntary
muscle fibers
connected with hair bulbs
skin is roughened/ goose flesh appearance
+
Shivering

21. b) Increase of cutaneous secretion and respiration:
• A general hot bath/ hot application activity of both
perspiratory
to small surface & sebaceous
• Ordinary rate of perspiration- 1 to 11/2 ounce per hour
• Application of heat ( 110 to 115 F)- perspiration is increased to 50- 60
times the ordinary rate.
• SKIN- 1% of the total respiratory work done by the body
 Under the influence of heat – the proportion of work done is
doubled.
( increased cutaneous circulation facilitation of
interchange of

22. c) Increased heat elimination:
 By dilating the surface vessels
 By increasing the rate of blood current in the skin
 By increased amount of evaporation from surface
 By increasing the conductivity of the skin
d) Decrease of tactile sensibility:
• Normal temperature of the surface – increased tactile
sensibility
• Very hot applications( 113 F & above)- lessens tactile
sensibility
• At a temperature of 130 F & above - abolished

23. TITLE AUTHORS CONCLUSION
Effect of regular sauna on
epidermal barrier function and
stratum corneum water-holding
capacity in vivo in humans: a
controlled study.
Kowatzki et al,
J of Dermatology
June 5th 2008
Sauna (80°C) produced stable
epidermal barrier function;
increase in stratum corneum
hydration; faster recovery of both
elevated water
loss and skin pH; decrease in
casual skin sebum content on skin
surface of forehead; increase in
ionic
concentration in sweat and
epidermal blood perfusion in
volunteers. It suggests protective
effect of ST on skin physiology

24. RESPIRATORY SYSTEM
1. Effects of cold:
Respiratory
movements
CO2 Elimination
Rate

25. 2. Effects of Hot:
Respiratory
movements
• Respiratory frequency
CO2
Elimination

26. TITLE AUTHOR CONCLUSION
Adjustments in oxygen
transport during head-out
immersion in water at
different temperatures.
Choukroun et al, Pulmonary tissue volume
was not affected by any of
the temperatures. Increase
in o2 absorption was
observed in CWI
The effect of cold exposure
on the respiratory function in
children suffering from
inflammatory lung diseases
Kurortol et al, Local cold procedures
improve bronchial patency
while the exposure to heat
results in its worsening

27. TITLE AUTHOR CONCLUSION
Effects of water temperature on
pulmonary volumes in immersed
human subjects
Choukroun et al, The variations of the pulmonary
volumes as a function of Tw are
estimated to be mainly due to
alterations in respiratory muscles
functioning.
Repeated cold water stimulations
(hydrotherapy
according to Kneipp) in patients
with COPD
Goedsche K et al, 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.

28. CIRCULATORY SYSTEM:-
1. Effects of cold:
a) Heart: ( ROEHRIG)
• Very short applications activity
• Prolonged application activity
b) Blood vessels:
• Short, very cold application( 40 to 55 F) vasoconstriction
vasodilation

29. • Cold applications made across the trunk of an artery cause
contraction in its distal portions
 Ice bag applied to axilla -- circulation in the arm
 Ice / cold compress to throat -- cerebral circulation
 Ice bag over the femoral artery -- circulation in leg
c) Pulse rate:(WINTERNITZ) compensatory effect
• Snow rubbed on the inside of the
arm at the bend of elbow in height of
pulse tracing
OR
ice applied to subclavian region …. Contraction
of distal portion
. of

30. • Cold applications to a limited surface of skin
increased pulse rate for 3 minutes , after which the frequency is
gradually diminished
• Cold water drinking lessens the pulse rate 10 to 15
beats/ minutes

31. 2. Effects of hot:
a) Heart:
• effect of general force + temporary slowing of heart
application of heat action
• Final effect Arterial tension
b) Pulse:
• 1st effect of very hot application to skin vasoconstriction of
surface BV
sudden force &
tension of

32.  Hot application cardiac + vascular
. activity

33. TITLE AUTHORS CONCLUSION
Effect of repeated sauna treatment
on exercise tolerance and
endothelial function in patients
with chronic heart failure
Ohori T et al,
J of American cardiology
Sep 23rd 2011
Repeated sauna therapy in
patients with chronic heart failure
improves exercise tolerance in
association with improvement in
endothelial function.
Effect of immersion in CO2-
enriched water on free radical
release and total antioxidant status
in peripheral arterial occlusive
disease
Dogliotti G et al,
International J of Angiology
Feb 30th 2011
CO(2)-enriched water immersion
has a positive effect, reducing free
radical plasma levels and raising
the levels of antioxidants,
suggesting an improvement in the
microcirculation.

34. TITLE AUTHORS CONCLUSION
Effects of immersion in water
containing high
concentrations of CO2 (CO2-
water) at thermoneutral
temperature on
thermoregulation and heart
rate variability in humans
Sato M et al,
International J of
Biometeology
Oct 24th 2008
The present study contributes
evidence supporting the hypothesis
that CO2-water immersion activates
parasympathetic nerve activity in
humans.
What is the biochemical and
physiological rationale for
using cold-water immersion
in sports recovery? A
systematic review.
Bleakley et al,
British journal of sports
medicine
Cold water immersion (CWI) induces
significant physiological and
biochemical changes in the body such
as increase in HR, BP, metabolism,
and peripheral catecholamine
concentration; and decrease in
cerebral blood flow.

35. TITLE AUTHORS CONCLUSION
Changes in the lipid profile of
blood serum in women taking
sauna baths of various duration.
Pilch W et al, After 2 weeks of repeated sauna
session some changes in total
cholesterol and concentration of
LDLC were observed, while
concentration of HDLC increased
after 7th sauna bath in group I.
Those kinds of changes may be
good prognoses of ischemic heart
disease prevention
Repeated sauna therapy
attenuates ventricular remodeling
after myocardial infarction in rats
by increasing coronary vascularity
of noninfarcted myocardium.
Sobajima M et al,
American J of physiology
May 27th 2011
ST attenuates cardiac remodeling
after MI, at least in part, through
improving coronary vascularity in
the noninfarcted myocardium.
Repeated ST might serve as a
novel noninvasive therapy for
patients with MI.

36. MUSCULOSKELETAL SYSTEM:-
Effects of cold:
a) The voluntary muscles:
• Prolonged of low temperature water - muscular irritability of
voluntary
muscles
EX. – stiffness & clumsiness of fingers as the result of exposure to
low temperature
b) The muscular tone:
• A short cold bath ( douche/ spray)- augments muscular energy and
tone
 Short cold bath( 1- 2 secs) powerful restorative in fatigue

37. c) The involuntary muscles:-
 Cold- activity of smooth muscle fibers of skin
goose- flesh appearance
• When applied to feet/ abdomen- excites involuntary muscles of
bowels &
bladder, causing
evacuation of these
cavities
• Cold water to feet( spray)- goose flesh appearance over entire
body
• Cold spray/ douche to one side of body- goose flesh appearance
on

38. Effects of hot:
a)Lessened irritability of voluntary muscles:
• Water bath at a temperature of rapid in muscular
irritability
120 F & above
• This effect of very hot application is utilized therapeutically in,
 Deformities resulting from muscular contraction
 Relief of vaginismus
 In cases of contraction of anal muscle
b) Increased irritability of involuntary muscles:
• Very hot application irritability

39. TITLE AUTHORS CONCLUSION
An Electromyographic Study of
Human Gait both in Water and on
Dry Ground
Alain Chevutschi etal,
J of physical anthropology
2007
Walking in water at an umbilical
level increases the activity of the
erector spinae and activates the
rectus femoris to levels near to or
higher than walking on dry
ground
Leg immersion in warm water,
stretch-shortening exercise, and
exercise-induced muscle damage
Skurvydas et al,
J of Athletic training
2008
Leg immersion in warm water
before stretch-shortening
exercise reduced most of the
indirect markers of exercise-
induced muscle damage.

40. TITLE AUTHORS CONCLUSION
Contrast water immersion hastens
plasma lactate decrease after
intense anaerobic exercise
Morton et al,
J of science & medicine in sport
2007
Contrast water immersion is a
valid method of hastening plasma
lactate decrease during recovery
after intense anaerobic exercise
for both males and females
Effect of Contrast Water Therapy
Duration on Recovery of Running
Performance
Versey et al,
Int J of sports physiology
performance
Dec 12th 2011
CWT for 6 min assisted acute
recovery from high-intensity
running
Cold-water immersion
(cryotherapy) for preventing and
treating muscle soreness after
exercise
Bleakley et al,
J of health & rehabilitation
sciences
15th Feb 2012
cold-water immersion reduces
delayed onset muscle soreness
after exercise compared with
passive interventions involving
rest or no intervention

41. TITLE AUTHORS CONCLUSION
Effects of thermal therapy
combining sauna therapy and
underwater exercise in patients
with fibromyalgia
Matsumoto et al,
J of Complementary Therapies in
Clinical Practice
Sep 24th 2010
Thermal therapy combining sauna
therapy and underwater exercise
improved the QOL as well as the
pain and symptoms of FMS
patients

42. BLOOD:-
1. Effect of cold:
 WINTERNITZ-
• Cold applications No. of blood corpuscles + amount of Hb
white corpuscles than red corpuscles
• Phenomenon,
cold applications
contraction of visceral vessels
corpuscles collected in vessels of liver, spleen, kidneys
& other internal viscera are driven into circulation

43. HENOCQUE-
• Rate of reduction in oxyhemoglobin
CRAWFORD-
• Cold bath - the contrast of color between arterial & venous blood
( indicates increased tissue activity & oxidation)
STRASSER-
• General cold applications- the alkalinity of blood , diminution in
acid
phosphate

44. 2. Effects of hot:
 WINTERNITZ-
• Hot baths- No. of blood corpuscles + amount of Hb, increase in
leukocytes loclly
 HENOCQUE-
• Rate of reduction in oxyhemoglobin locally
 STRASSER-
• General hot applications- the alkalinity of blood by increasing the
amount of acid phosphate

45. TITLE AUTHORS CONCLUSION
Immune changes in humans
during cold exposure: effects of
prior heating and exercise
Brenner et al,
J of applied physiology
Aug 1999
acute cold exposure has immune
stimulating effects that, with
thermal clamping, pre-treatment
with physical exercise can
enhance this response.
Leukocytosis, granulocytosis. Inc.
NK cells
The use of warmed water
treatment to induce protective
immunity against the bacterial
cold-water disease pathogen
Flavobacterium psychrophilum in
ayu fish (Plecoglossus altivelis)
Sugahara K et al,
J of fish immunology
Dec 23rd 2011
Warmed water treatment could not
only cure BCWD( bacterial cold
water disease) but also immunize
the fish against the causative
agent F. psychrophilum.

46. TITLE AUTHORS CONCLUSION
Effect of hyperthermic water bath
on parameters of cellular
immunity.
Rovensky et al,
Int J of clinical pharmacology
2000
Wholebody
hyperthermic
water bath reduced relative total
Tlymphocyte
counts; increased relative CD8+
lymphocyte; NK cell
counts and its activity, which were
probably dependent on increased
somatotropic hormone production

47. EXCRETORY SYSTEM:-
1. Effect of cold:
a) Skin:
• Short cold applications cutaneous vasodilatation & favors
perspiration ( in reaction)
b) Kidneys:
• In animals,
very cold prolonged applications appearance of albumin in
urine
• Fever treated by cold bath toxicity of urine is increased by
6 times
• Cold application to lower 1/3rd excites renal activity
of sternum/ renal douche

48. c) Lungs:
• Short cold applications elimination of CO2 + absorption
of O2
• Prolonged cold applications CO2 elimination
d) Bowels:
• Cold application to feet/ excites involuntary muscles of
bowels
abdomen

49. TITLE AUTHORS CONCLUSION
Role of warm water bath in
inducing micturition in
postoperative urinary retention
after anorectal operations.
Shafik et al,
Int J of Urology
The urethral pressure in both the
normal and retention subjects
showed significant reduction
which increased with higher-
temperature baths. Micturition
on sitting in a warm water bath
seems to be initiated by reflex
internal urethral sphincter
relaxation. A thermo-sphincter
reflex is likely to be involved.

50. NERVOUS SYSTEM:-
1. Effects of cold:
 HELMHOLTZ:
• Cold application to a nerve trunk,
• Short cold application to head,
 Action- brief depression
 Reaction- increased cerebral activity
• Prolonged cold applications – lessens cerebral activity + stupidity,
drowsiness & unconsciousness
ACTION REACTION
Diminishes the rate of transmission of
nervous impulses by 1/6th of the
normal rate
 Nerve quickly recovers
 Pain in the part to which it is
distributed
 Benumbing effect

51. 2. Effects of hot:
 Heat may excite/ exhaust nervous system depending upon the mode of application
 Exciting effect- direct influence of heat upon the nerve filaments.

52.  Exhausting effect-
Certain forms of hot applications
Excitation of protoplasmic/ vital activities of the
body
accumulation of tissue wastes/ excrementitious
elements
diminished oxidation of the wastes by the
body

53. REFLEX EFFECTS:
Reflex areas in relation to internal viscera:
Brain head, face, neck hands & feet
Nasal mucus membrane Neck, face, upper dorsal spine, hands & feet
Stomach Lower dorsal spine & epigastrium
Kidneys Lower 1/3rd of sternum & feet
Bowels Feet & abdomen
Bladder Feet & lower abdomen
Liver Lower right chest
Spleen Lower left chest
Lungs Upper dorsal region
Uterus Lumbar region, abdomen, breasts, inner
surface of thighs & feet

54. TITLE AUTHORS COCLUSION
Motor and sensory nerve
conduction are affected
differently by ice pack, ice
massage, and cold water
immersion.
Herrera et al,
J of physical therapy
Feb 25th 2010
All 3 modalities were effective in
reducing skin temperature and
changing sensory conduction at
a physiological level that is
sufficient to induce a
hypoalgesic effect, CWI is the
most indicated modality for
inducing therapeutic effects
associated with the reduction of
motor nerve conduction.

55. GASTRO-INTESTINAL SYSTEM:-
1. Effects of cold:
• Salivary secretion-
[ 2000 Nov;45(11):957-61.The effect on human salivary flow rate of
the temperature of a gustatory stimulus.Dawes C1, O'Connor
AM, Aspen JM.]
• Gastric & pancreatic secretions – Initial reduction followed by
increased
secretion
[ 1983 Apr; 24(4): 277–283.Perturbation of upper gastrointestinal
function by cold stress.D G Thompson, E Richelson, ]

56. Short & very cold douche secretory activity
over stomach & liver
Cold douche/ ice bag / compress HCL
secretion
to stomach

57. 2. Effects of hot:
Hot douche over stomach & spine HCL secretion
Fomentation to stomach HCL secretion
Hot compress/ fomentation flow of bile & all other
activities
to liver

58. TITLE AUTHORS CONCLUSION
Effect of steam bath on gastric
secretion and some endocrine
changes of athlete-fighters
Fiziol cheloveka et al,
March 2011
Concluded that there was
significant increase in gastric
secretions, aldosterone level and
decrease in the concentrations of
cortisol after steam bath.
Warm water irrigation for dealing
with spasm during colonoscopy:
simple, inexpensive, and effective
Church J M et al,
J of gastrointestinal endoscopy
Nov 2002
The results of this study suggest
that warm water is also effective
in treating the spasm. It has no
side effects and costs practically
nothing.

59. TITLE AUTHORS CONCLUSION
Random control trial of hot
compresses for women those
who used laxatives on severity
of constipation and quality of
life
Izumi et al,
Japan J of Nursing science
15th July 2015
The lumbar application of a 40°C
hot compresses in female adults
with constipation improved their
conditions of defecation and QOL,
even though it did not reduce the
amount of laxatives.

60. REPRODUCTIVE SYSTEM:-
TITLE AUTHORS CONCLUSION
Post episiotomy pain: warm
versus cold sitz bath.
Lafoy J et al,
J of Obstetrics & gynecology of
neonatal nursing
Sep 1989
Both therapies were found
comparable, with the exception
that the cold bath was significantly
more effective in reducing
oedema.
A randomised controlled trial
evaluating the effect of immersion
bath on labour pain
Silva et al,
J of midwifery
July 25th 2007
An immersion bath is a suitable
alternative form of pain relief for
women during labour
The effect of immersion baths on
the length of childbirth labor
Oliviera et al,
Mar 2006
The results showed that
immersion baths did not have any
influence on the length of labor
and on the frequency of uterine
contractions. However, the length
of contractions was statistically

61. TITLE AUTHORS CONCLUSION
Warm sitz bath: are there
benefits after transurethral
resection of the prostate?
Park et al,
Korean J of Urology
Nov 17th 2010
Warm water sitz bath treatment
reduced postoperative
complications such as urethral
stricture
A comparison of cold and
warm sitz baths for relief of
postpartum perineal pain.
Ramler et al, Cold sitz baths were
significantly more effective in
relieving perineal pain when
compared to warm sitz bath
Immersion in water in labour
and birth
Cluett et al,
Apr 15th 2010
water immersion during the
first stage of labour reduces
the use of epidural/spinal
analgesia

62. PHYSIOLOGICAL EFFECTS OF MUD
THERAPY
ON
DIFFERENT ORGAN SYSTEMS

63. TITLE AUTHORS CONCLUSION
EFFECT OF MUD BATH ON
AUTONOMIC AND
RESPIRATORY VARIABLES IN
NORMAL HEALTHY
VOLUNTEERS- A RANDOMIZED
CONTROL TRIAL
Dr. N V Gnanadeep T
Journal of Dental and Medical
Sciences
2016
Application of full mud bath on the
body enhances the sympathetic
activity and has a role in
maintaining the cardiac tone and
preventing various cardiovascular
ailments. Whereas a cold wet
wrap enhances parasympathetic
activity and can be applied
effectively to treat stress,
insomnia and anxiety

64. TITLE AUTHORS CONCLUSION
Beta-endorphin and Stress
Hormones in Patients Affected
by Osteoarthritis Undergoing
Thermal Mud Therapy
A Pizzoferrato et al,
2000 Oct,
J of Minerva Medica
Thermal mud - a significant
reduction in levels of hormones of
the pituitary- adrenal such as
ACTH, Cortisol levels
The effect of peat components on
endocrine and immunological
parameters and on trace
elements--results of two pilot
studies.
Beer AM
2001
Clinical Laboratory.
Shown to be beneficial in post-
menopausal women, as it
increases the levels of estradiol
significantly.
Evaluation of the permeation of
peat substances through human
skin in vitro.
M. Beera A
2003
International Journal of
Pharmaceutics.
Thermal mud stimulation is
proven to increase the
extensibility of collagen rich
tissues and to reduce the matrix
metalloproteinase – 3 plasma
levels in osteo-arthritic patients.

65. TITLE AUTHORS CONCLUSION
Effects of mud pack treatment on
skin microcirculation.
Poensin D et al,
2003
J of Joint Bone Spine
increase in the blood flow and
stimulation of vasomotion as
measured by the Laser-Doppler
flowmetry.
Mud bath therapy influences nitric
oxide, myeloperoxidase and
glutathione peroxidase serum
levels in arthritic patients.
Bellometti S
2000
Int J Clin Pharmacol Res.
exerts beneficial effect on cartilage
homeostasis and on inflammatory
reactions in the body influencing
nitric oxide and decreasing the
serum levels of myeloperoxidase.
Evaluation of the permeation of
peat substances through human
skin in vitro.
Beer A,
2003
International Journal of
Pharmaceutics.
The fulvic and the ulmic acids
along with other water-soluble
compounds of mud has a
stimulatory effect on the contractile
activity of the smooth muscle.

66. TITLE AUTHORS CONCLUSION
A study on the efficacy of
treatment with mud packs and
baths with Sillene mineral water
(Chianciano Spa Italy) in patients
suffering from knee osteoarthritis.
Fraioli A,.
2010
Rheumatology International
Increase in the serum levels of
glutathione peroxidase
Shown to activate the osteoblasts
without the suppression of
osteoclast activity which is a
beneficial result in osteoporotic
condition
Effects of spa therapy on serum
leptin and adiponectin levels in
patients with knee osteoarthritis.
Fioravanti A
2011
Rheumatology International.
Local mud application along with
bicarbonate- sulphate mineral
water is shown to modify plasma
levels of the adipocytokines
including leptin and adiponectin
which are the important mediators
of cartilage metabolism.

67. TITLE AUTHORS CONCLUSION
Hypothalamic–pituitary–adrenal
axis dysregulation in healthy
subjects undergoing mud-bath
applications..;38(5):724-725
Cozzi F, et al
1995
Arthritis & Rheumatism
An increase in the serum levels of
opioid peptides such as
encephalins & endorphins
Mud application also increases the
synthesis of beta endorphins
Environment, health resorts,
tourism. Drivers for a good quality
of life and local development..
Yerevan
Jermuk Thermal Center
(Armenia)
2016
After the balneological treatment
there was a change in the ionic
composition of venous blood
which showed increased solubility
of oxygen, increase in
haemoglobin, and decrease in the
glucose concentration.

68. TITLE AUTHORS CONCLUSION
Effect of naphthalan and
therapeutic mud applications on
clinical and roentgenological
characteristics in patients with
protracted pneumonia.
Rassulova MA,
Vopr Kurortol Fizioter Lech Fiz
Kult.
2009
application of naphthalan and
therapeutic mud reduces the
activity of inflammatory
processes, improve airway
patency and the state of bronchial
mucosa in patients with protracted
pneumonia
Effect of complex rehabilitation by
physical factors (therapeutic mud,
waves of millimeter range) on the
indices of inflammation process
and immune status in patients
with traumas of peripheral
nervous system.
Tarkhan-Muuravi ID
Georgian Med News
2006
therapeutic mud and
electromagnetic therapy
decreases the inflammation
process and body sensitization in
patients with traumas of
peripheral nervous trunks almost
to disappearance of inflammation
process and body sensitization.
Such rehabilitation increased
nonspecific resistance and
normalizes the indices of immune
reactivity

69. TITLE AUTHORS CONCLUSION
A multidisciplinary approach to
study the effects of balneotherapy
and mud-bath therapy treatments
on fibromyalgia.
Laura Bazzichi
2013
Clin Exp Rheumatol.
In fibromyalgia patients mud pack
therapy is shown to produce
beneficial effects by reducing the
Brain Derived Neurotrophic Factor
(BDNF).
Bone mineral density in women on
long-term mud-bath therapy in a
Salus per Aquam (SPA)
environment
Loi A,
2013.
Reumatismo.
Mud therapy increased the bone
mineral density in women even in
a long term when given for 45 to
60 minutes with bicarbonate
alkaline water.

70. TITLE AUTHORS CONCLUSION
Serum levels of a prostaglandin
and a leukotriene after thermal
mud pack therapy.
Bellometti S,
J Investig Med.
1998
significantly decreased the levels
of Prostaglandin E2 (PGE2) and
Leukotriene B4 (LT-B4) in the
serum which indicates the
protective response on the
cartilage and helps in pain relief by
reducing the inflammation
Bone remodelling in osteoarthrosic
subjects undergoing a physical
exercise program.
Bellometti S,
Clinica Chimica Acta.
2002
mud pack therapy when combined
with exercise stimulated the
physiologic bone metabolism and
favours the skeletal health.

71. TITLE AUTHORS CONCLUSION
Effects of mud-pack treatment on
plasma cytokine and soluble
adhesion molecule levels in healthy
volunteers.
Basili S,
Clinica Chimica
Acta.
2001
The mature thermal mud therapy is proven to reduce
the Inter Leukin (IL- 6) and Tumour Necrosis Factor
(TNF - α) which are the inflammatory markers.
Effect of peloid applications of
different temperatures on the
function of the cardiovascular
system in patients with
osteoarthrosis and concomitant
hypertensive disease and ischemic
heart disease.
L'vova NV,
Vopr Kurortol
Fizioter Lech Fiz
Kult.
2009
low-temperature peloidotherapy should be included as
a major component in the treatment of patients with
hypertensive disease and coronary heart disease
since it has the most beneficial effect on general and
intracardiac hemodynamics.

72. TITLE AUTHORS CONCLUSION
Comparison of inta-articular
hyaluronic acid injections and
mud-pack therapy in the treatment
of knee osteoarthritis.
Bostan B
Acta Orthopaedica et
Traumatologica Turcica.
2010;
Research studies also show that
mud pack therapy is equally
efficient as that of intra articular
hyaluronic acid injections in short
term functional improvement and
pain relief in osteoarthritis patients.
Oxidative stress, hemoglobin
content, superoxide dismutase
and catalase activity influenced by
sulphur baths and mud packs in
patients with osteoarthritis.
Jokic A,
Vojnosanitetski pregled.
2010
The sulphur baths and mud packs
has shown to cause a significant
decrease in plasma
melondialdehyde concentration in
osteoarthritis patients. Sulphur and
mud therapy also decrease the
lipid peroxidation in plasma as well
as causes alterations in the
plasma activity of superoxide
dismutase and catalase activity
along with a significant increase in

73. TITLE AUTHORS CONCLUSION
Clinical improvement and serum
amino acid levels after mud-bath
therapy.
Bagnato G,
Int J Clin Pharmacol Res.
2004.
an increase in the serum
concentration of tryptophan,
cysteine and citrulline in
gonarthrosis patients which helps
in alleviating the pain.
Effect of hyperthermic and
isothermic mud application on
hormonal function of normal and
insufficient corpus luteum in
women
Bromirska D.
Ann Acad Med Stetin.
1993
The use of hyper and isothermic
mud has led to a transient
increase in the concentration of
progesterone and estradiol in
blood sera of women with the
normal and insufficient corpus
luteum hormonal function. There
was also a significant rise in the
excretion of adrenaline and nor
adrenaline in urine following the
hyperthermic mud application.

74. TITLE AUTHORS CONCLUSION
The in-vitro percutaneous
migration of chemical elements
from a thermal mud for healing
use.
Tateo
Applied Clay Science.
2009
a transfer of chemical elements
from mud to the skin.
Matured mud was applied for 20
minutes and a significant transfer
of Lithium (Li), Strontium (Sr),
Boron (B), Iodine (I), Rubidium
(Rb), Bromine (Br), Sodium (Na),
Chlorine (Cl), Selenium (Se), and
Calcium (Ca) was observed

75. REFERENCES
 Rational hydrotherapy by Dr. J H Kellogg
 Essentials of medical physiology by Dr. Sembulingam
 Mooventhan A, Nivethitha L. Scientific Evidence-Based Effects of
Hydrotherapy on Various Systems of the Body. North American
Journal of Medical Sciences. 2014;6(5):199-209. doi:10.4103/1947-
2714.132935
 Becker B. Aquatic Therapy: Scientific Foundations and Clinical
Rehabilitation Applications. PM&R. 2009;1(9):859-872.
 PUBMED

76. THANK YOU