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LIFELONG LEARNING PROGRAMME sub-programme Leonardo da Vinci THERMAL BATHS for ACTIVE AGEING

AGEING

AGEING IS THE BIOLOGICAL PROCESS CHARACTERIZED BY CHANGED TO DIFFERENT THAT OCCUR DURING THE LIFE

These changed lead an increasing difficulty of adaption to environment, in a broad sense, and as a result cause of greater fragility
VARIABILES IN THE PROCESS OF AGEING NATURAL VARIABLES LIFESTYLES SOCIAL AND ECONOMIC SITUATION ,CULTURAL LEVEL
Fausto Bonsignori MD , Medical Director Petriolo Terme

AGEING and POPULATION

THE POPULATION OF EUROPEAN REGION IS AGEING RAPIDLY

THE MEDIAN AGE IS ALREADY THE HIGSTET IN THE WORLD THE PROPORTION OF PEOPLE AGED 65 AND OLDER IS FORECAST TO INCREASE FROM 14% IN 2010 TO 25% IN 2050

People in every part of the Region are living longer, but their chances of spending these later years in good health and well-being vary within and between countries.

Fausto Bonsignori MD , Medical Director Petriolo Terme

AGEING and POPULATION

LIFE EXPECTANCY IN ITALY : 1939 : 54,9 years 1959 : 65,9 years 2011 : 79,9 MAN ( + 7 months in just 4 years ) 84,5 WOMAN ( + 5 months in just 4 years) TUSCANY : 1.267.623 > 60 years 39.914 > 90 years Universit del Sacro Cuore, Roma 2013
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THERMAL MEDICINE

CRENOTHERAPY ( from greek cren = source ) is the branche of medicine that studies the ACTION OF VARIUS THERAPEUTIC MEANS OF THERMAL ENVIRONMENT.

CRENOTHERAPY stand for THERMAL MEDICINE

MEDICAL HYDROLOGY is the branch of medicine that studies the

TERAPEUTIC APPLICATION OF WATER WITH SPECIFIC


PHARMACOLOGICAL ACTIONS
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Thermal medicine Crenotherapy

internal TM

External TM Balneother . showers Mud th.

Microcl. therapy

Thalasso therapy

Drinking t. Irrigation inhalation


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Fausto Bonsignori MD , Medical Director Petriolo Terme

BALNEOTHERAPY DEFINITION

BATH WITH CURATIVE INTENT, IN WARM OR WARMED MINERAL WATER

PURE OR DILUTED WATER WATER CONCENTRADED IN BRINE AND THEN DILUTED

Fausto Bonsignori MD , Medical Director Petriolo Terme

TERMAS de CUNTIS

Fausto Bonsignori MD , Medical Director Petriolo Terme

SANATORIUL TECHIRGHIOL

Fausto Bonsignori MD , Medical Director Petriolo Terme

BALNEOTHERAPY METHODS

BALNEOTHERAPY IN SINGLE HYDROTHERAPIC BATH


BALNEOTHERAPY WITH ELEMENTS BALNEOTHERAPY IN POOLS LOCAL BALNOTHERAPY

WATER PASSAGE
JET SHOWER

RAIN SHOWER (VICHY SHOWER)


SCOTTISCH SHOWER

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Fausto Bonsignori MD , Medical Director Petriolo Terme

BALNEOTHERAPY METHODS Techirghiol : therapeutic pool

Cuntis : therapeutic pool

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Fausto Bonsignori MD , Medical Director Petriolo Terme

BALNEOTHERAPY METHODS Individual therapeutic bath in Cuntis Local balneotherapy in Techirghiol

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Fausto Bonsignori MD , Medical Director Petriolo Terme

ELDERLY PATIENT : INDICATIONS

RHEUMATOLOGY : articular and extra-articular chronic disease DERMATOLOGY : seborrheic D. , atopic D. , psoriasis ANGIOLOGY : chronic lynphatic-venous insufficiency of the legs PREVENTIVE MEDICINE : secondary and tertiary prevention REHABILITATION : traumatic and neurological injures, post thrombotic syndrome, heart disease

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Fausto Bonsignori MD , Medical Director Petriolo Terme

MECHANISM OF ACTION SYSTEMIC or LOCAL ACTIONS ASPECIFIC or ASPECIFIC ACTIONS

THERMAL ACTION

OSMOTIC ACTION
DIRECT or INDIRECT ENDOCRINE ACTION ACTION of MINERALIZATION ACTION on BASAL METABOLISM
Fausto Bonsignori MD , Medical Director Petriolo Terme

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RHEUMATIC DISEASES

In Italy the rheumatic diseases effect abaut 6 million people or abaut 10% of the population, the proportion is much after the age of 65 Pathology Osteoarthritis Extra-articular rheumatism Ankylosing spondylitis Gout Other
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% on RD 7 2,63 12,71 7,45 2,03 2,44


Fausto Bonsignori MD , Medical Director Petriolo Terme

BALNEOTHERAPY ACTION IN RD

COMBINED ACTION of MECHANICAL, CHEMICAL and PHYSICAL INCENTIVES


THERMAL ASSIMILATION and INVERSION Uniform temperature in woole body . Strong thermal increase in periarticular areas

a ) improvement of microcirculation and better tissue oxygenation b ) activation of lysososmial enzymes active on the connettive matrix. Improving the microcirculation-tissue exchange
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BALNEOTHERAPY ACTIONS IN RD

MECHANICAL ACTIVITIES Muscle tone, articular mobility, pain PHYSICAL ACTIVITIES Surface-periarticular hyperemia . Increased oxygenation. Removal of inflammation factors CHEMICAL ACTIVITIES 17 Fausto Bonsignori MD , Medical Director Petriolo Terme According to water characteristics

BALNEOTHERAPY ACTIONS IN RD

ANTI INFIAMMATORY Inibition secrection of prostaglandin E (PGE2) and leucotrien B4

ACTION ON CARTILAGE METABOLISM Reduction of condrolesive cytokinins ( IL-1 e TNF alfa ) Increase of protective factors ( IGF-1)

HORMONAL STIMULATION Beta Endorphin , enkephalins, serotonin - modulation

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PHYSICAL ACTIVITY IN WATER Therapeutic cycling in the water Therapeutic walking in the water

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Fausto Bonsignori MD , Medical Director Petriolo Terme

GUIDELINES WHEN TO BALNEOTHERAPY Balneotherapy is contraindicated in the acute phase. Complementary and sequential therapy compared to drug therapy or surgical in chronic degenarite disease, with no signs of acute and stable biochemical indices Quantitative and qualitative reduction of recurrences Lower drugs consumption and reduced tachyphylaxis

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Fausto Bonsignori MD , Medical Director Petriolo Terme

GUIDELINES POOLS Max height 120-130 cm , diving handrail along perimeter 10 cm chairs and beds ( 40 and 20 cm ) , whirpools HYDROTERAPIC SINGLE BATH standard size length 210-220 cm , width 85-90 cm , capacity 200-220 lt , whirpools
TEMPERATURE TREATMENT TIME BODY IMMERSION 33-35 C (VARIABLE) 20 MIN 3/4

AFTER TREATMENT
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REST PERIOD OF 20 MIN


Fausto Bonsignori MD , Medical Director Petriolo Terme

GUIDELINES

LOCAL BALNEOTHERAPHY baths for hands and feets temperature variable , time 20 Whirlpools WATER PASSAGE 2 long (8-10 mt) and narrow pools , near but no connected, 50-60 cm, deep, water with different temperature : 2730c/24-26c . Whirlpools, cobblestone floor. Fausto Bonsignori MD , Medical Director Petriolo Terme 22

THERAPEUTIC SHOWERS

UNDERWATER SHOWER Operator directs the underwater jet (1-3 atm ) toward the patient immersed
JET SHOWER Operator directs, with specific method, a powerful ject of thermal water. Patient standing at a distance of 2,5-3 m treatment time : 10
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THERAPEUTIC SHOWERS
RAIN SHOWER ( VICHY SHOWER ) patient lying on particolar bed. Multiple filiform jets of thermal water on the whole body. Treatment time : 15 SCOTTISH SHOWER patient standind surrounded by dispenser that emit thermal water at different temperature. Alternating or simultaneously. Treatment time 5
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THANKS TO OUR ROMANIAN AND SPANISH FRIENDS FOR THEIR COLLABORATION

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Fausto Bonsignori MD , Medical Director Petriolo Terme

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Fausto Bonsignori MD , Medical Director Petriolo Terme

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Fausto Bonsignori MD , Medical Director Petriolo Terme

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Fausto Bonsignori MD , Medical Director Petriolo Terme

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Fausto Bonsignori MD , Medical Director Petriolo Terme

HYDROBIKE

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Fausto Bonsignori MD , Medical Director Petriolo Terme

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