1. Originality

A multicenter, prospective, randomized, controlled, single-blinded study with the 347 participants was performed. The problems treated and analyzed in study with an added value: Stress, anxiety, and depression, as well post-Covid-19 condition. The study was original: unique complex created with the use of natural resources, few parallel treatment modes were evaluated using subjective and objective parameters of different body systems. The effect of 3, 6, and 11 days of spa therapy was analyzed with the follow-up of 6 month.

2. Use of medical methods and created new medical programmes

A complex of procedures using natural resources available in Lithuania was created: water pool, mineral water bath, mud wrapping, salt therapy, and nature therapy procedure. The complex was provided with different durations and outpatient/inpatient modes in daily manner.
The nature therapy procedure was created (45 min outside/seaside treatment using mindfulness and physical therapy using a guide). After that audio of psychologist’s guidance for mindfulness was created.
The experiment with peloids gave insights for the safe peloid treatment.
Primary outcomes were the effect on stress level (by salivatory cortisol and surveys); secondary outcomes: were the effects on stress-related mental and physical health, work and social adaptation, tolerance, and safety of balneotherapy procedures. The observations were: before, after treatment, and after 3 and 6 months of follow-up.

3. Importance of the research for the medical spa sector

This study’s results could help to address the effects of nowadays pace and stress, improve well-being after Covid-19 pandemia. Study provide scientific evidence about possibility of reduction of the consequences of pandemia to human health and the economy, promote the growth of health tourism in
Lithuania. This study is a important continuation of the previous studies of natural resources of Western Lithuania (geothermal water and sapropel) used for the improvement of human health. The study results were disseminated by few publications and different conferences in Lithuania and abroad.
This research is of significant importance to the medical spa sector for several reasons:
Evidence-Based Validation: By providing robust scientific evidence supporting the effectiveness of various natural treatments, this research elevates the credibility of medical spas. It moves beyond anecdotal evidence and establishes a solid foundation for the use of natural resources in stress management and overall well-being.
Innovative Treatment Approaches: The study introduces and evaluates novel treatment modalities, offering medical spas new, scientifically-backed options to incorporate into their service offerings. This innovation allows spas to differentiate themselves in a competitive market by providing cutting-edge, effective treatments.
Holistic Health Focus: The research’s comprehensive approach, which considers both mental and physical health, aligns with the growing demand for holistic wellness solutions. This positions medical spas as leaders in the integrative health movement, meeting the needs of clients seeking more than just relaxation but a complete wellness experience.
Enhanced Client Trust and Engagement: The creation of practical publications, including methodological recommendations and guides, empowers clients and practitioners with knowledge. This transparency and accessibility foster trust and encourage more informed, engaged clients who are likely to value and return to these evidence-based services.
Standardization and Best Practices: The methodological recommendations and Nature Therapy Guide developed from this research help to standardize best practices across the industry. This ensures consistent, high-quality care in medical spas, enhancing overall industry standards and client outcomes.
Global and Local Impact: By mapping Lithuania’s centers that utilize natural resources for treatment, the research highlights the importance of location-specific therapies, potentially attracting both local and international clients. It also supports the global recognition of Lithuania as a leader in natural wellness practices.
Overall, this research contributes significantly to advancing the medical spa sector by providing a scientific basis for natural treatments, promoting innovation, enhancing client trust, and setting new standards for holistic health care.

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H. Manto str. 84 Klaipeda

https://www.ku.lt/en

The primary medical goal is to improve the effectiveness and acceptance of spa and balneology treatments within mainstream healthcare. By scientifically validating these treatments and exploring new technological applications, such as virtual reality, the research aims to provide evidence-based solutions that enhance patient outcomes, promote mental well-being, and support holistic healthcare practices.

1. Originality

1) Testing of virtual reality in spas – the study targets patients with various movement disorders, examining how VR can be integrated into standard rehabilitation programs to enhance treatment outcomes. The VR technology allows for customized therapy within a group setting, creating individualized exercise plans and intensities tailored to each patient’s needs, thereby providing a new dimension of personalized care.
One of the key findings of the study is that the average difference in pain intensity before and after the treatment period was more significant in the experimental group using VR than in the control group receiving standard spa treatment. This suggests that VR can provide a new added value in pain management by potentially enhancing the effectiveness of conventional physical therapy techniques like magnetotherapy, laser therapy, ultrasound, and massages.
2) Objectification of the effects of Karlovy Vary drinking cure – The research study aimed to objectively evaluate the effectiveness of the traditional drinking cure using Karlovy Vary bicarbonate-chloride-sulfate-sodium springs. The goal was to assess improvements in both subjective digestive symptoms and specific quantitative health parameters, including lipid profiles and liver elasticity, before and after a 21-day drinking cure. A key focus of the study is on the drinking cure’s potential effects on liver health, specifically liver steatosis or fatty liver. Through quantitative analysis of lipid parameters and liver elasticity before and after the treatment, the study examines whether the drinking cure can reduce liver fat accumulation and improve liver function. The initial results suggest that the Karlovy Vary springs may positively influence liver steatosis. By exploring the benefits of the Karlovy Vary drinking cure, this research adds new value to the field of preventative and therapeutic strategies for liver health, offering a natural, non-invasive option that may help manage and potentially mitigate the progression of liver steatosis.
3) Center for Spa Research – the structure of this project is divided into vertical thematic priorities and horizontal cross-cutting activities. This approach allows us to comprehensively address the multifaceted needs of the spa and balneology sector, ensuring a holistic and sustainable transformation. The vertical thematic priorities of our project combine medical, environmental, and socio-economic sciences. By directing support towards these vertically defined priority areas—research and innovation specialization domains—we aim to achieve a desirable transformation of the spa industry. The integration of these diverse scientific disciplines enables us to develop innovative solutions that not only improve therapeutic outcomes but also enhance the environmental sustainability and socio-economic resilience of spa towns.
Medical Research: Focuses primarily on the needs of spa facilities, aiming to enhance the efficacy and scientific foundation of spa treatments. This includes exploring new therapies, validating traditional treatments, and incorporating advanced technologies such as virtual reality.
Environmental Research: Targets the specific needs of spa towns, aiming to preserve and enhance the natural resources critical to spa treatments, such as mineral springs, while promoting sustainable practices that benefit both the environment and the spa industry.
Socioeconomic Research: Addresses the needs of public administration by analyzing the socio-economic impact of the spa industry and exploring ways to enhance its contributions to local and regional economies. This includes assessing the economic benefits of spa tourism and its potential to create jobs and promote regional development.
Horizontal activities are those that are not limited to a specific priority but are relevant and important across all parts of the project. These include educational activities, knowledge transfer, and technology transfer. By incorporating these cross-cutting activities, we ensure that the insights and innovations developed through the project are effectively disseminated and implemented across the sector, facilitating widespread adoption and maximizing impact.
Educational Activities: Aim to build capacity among stakeholders, from spa practitioners to policymakers, ensuring that all parties are equipped with the latest knowledge and skills necessary for advancing the spa and balneology sector.
Knowledge and Technology Transfer: Focus on the dissemination and implementation of new research findings and technological innovations, ensuring that the benefits of the project are realized across all aspects of the spa industry.
The project aims to contribute significantly to the transformation of the spa industry through science, innovation, and sustainability. This transformation is expected to lead to substantial improvements in the quality and efficiency of spa care in the Karlovy Vary region and strengthen its position as a center of excellence for spa and balneology research in Europe.
The multidisciplinary scope of the project guarantees long-term sustainability and ensures lasting transformational impacts of the project activities. By addressing the needs of various stakeholders and fostering collaboration across disciplines, the project aims to establish a strong foundation for the continued development and innovation of the spa industry.

2. Use of medical methods and created new medical programmes

As part of the above-mentioned projects, clinical testing is conducted on patients with the approval of the Ethics Committee. For the needs of the research projects, therapeutic plans and treatment protocols are always designed and tailored to the specific needs of the patients. Based on the results of these project activities, improvements are made, and new medical procedures are developed. The Institute conducts rigorous scientific research to evaluate and validate the therapeutic effects of traditional spa treatments, such as mineral baths, mud wraps, and drinking cures. By applying modern research methods and technologies, the Institute provides evidence-based support for these treatments, enhancing their credibility and acceptance within the broader medical community. A key focus of the Institute’s activities is the development of new therapeutic programs that integrate modern medical methods with traditional spa practices. For example, the Institute has pioneered the use of virtual reality (VR) technology in rehabilitation programs for patients with movement disorders. This innovative approach allows for personalized, immersive therapy that can be adapted to each patient’s needs, improving outcomes and patient satisfaction. The Institute actively collaborates with experts from various fields, including medical, environmental, and socio-economic sciences, to develop a holistic approach to spa and balneology. This multidisciplinary collaboration ensures that all aspects of spa treatments are considered, from their medical efficacy to their environmental impact and socio-economic benefits. By fostering these partnerships, the Institute contributes to the overall transformation and modernization of the spa industry.

3. Importance of the research for the medical spa sector

The research conducted by the Institute of Spa and Balneology is of great importance to the medical spa sector as it significantly enhances the credibility and scientific foundation of spa and health tourism. By rigorously testing and validating traditional spa treatments and integrating innovative therapies, our research contributes to the transformation of the spa industry into a more evidence-based and scientifically recognized field.

A grant of 10 million EUR from the European Union has been awarded for the implementation of the Center for Spa Research project over a period of three years. This substantial funding will significantly transform the spa industry, not only in the Czech Republic but also across the entire European Union.

The grant enables us to advance innovative research and development in the field of spa and balneology, fostering new scientific discoveries and the integration of cutting-edge technologies into spa treatments. With this support, the Center for Spa Research will be able to explore new therapeutic methods, validate traditional spa practices with rigorous scientific data, and develop sustainable practices that contribute to the health and well-being of individuals.

Moreover, the project aims to strengthen the role of spa and health tourism as a recognized part of the broader healthcare system. By promoting evidence-based treatments and enhancing the scientific credibility of spa therapies, we can elevate the status of the spa industry in Europe, setting new standards for excellence and innovation.

This initiative is expected to have a long-lasting impact on the spa sector, driving forward a transformative approach that combines traditional healing practices with modern medical research, thereby enhancing the quality and effectiveness of spa treatments throughout Europe.

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nábřeží Jana Palacha 932/20 Karlovy Vary

https://www.i-lab.cz/

Dr. Martin Gehlen, Chief Physician of the Rheumatology and Osteology Department at Klinik DER FÜRSTENHOF in the spa town of Bad Pyrmont, and his team collected evidence for the importance of rehabilitation in the rare blood disorder systemic mastocytosis as part of a scientific study Systemic mastocytosis involves an increase in certain blood cells in one or more organs, which can result in a variety of non-specific symptoms throughout the body. The Klinik DER FÜRSTENHOF is a spa and rehabilitation clinic specializing in the treatment of osteological and rheumatological conditions a clinic in Bad Pyrmont, Germany. It is part of our spa operating company “Niedersächsisches Staatsbad Pyrmont Betriebsgesellschaft GmbH” (Staatsbad Pyrmont). All therapy concepts involve the use of the natural remedies of Bad Pyrmont: mud, healing water, and carbon dioxide.

Indolent systemic mastocytosis (ISM) is a group of heterogenous diseases characterized by abnormal accumulation of mast cells in at least one organ which can cause of osteoporosis. It is known that ISM can be a cause of osteoporosis. However, it was unclear until now how often systemic mastocytosis is causally present in the rehabilitation of patients with osteoporosis and what impact it has on the clinical course and employability.

The research team investigated the relationship between systemic mastocytosis and osteoporosis and the role of spa and rehabilitation medicine in this context. The monocentric, retrospective cohort study included all patients who underwent rehabilitation at Klinik DER FÜRSTENHOF in Bad Pyrmont for osteoporosis between 2005 and 2015. A total of 8392 patients were treated with specific therapy concepts.

The study shows that the course of osteoporosis in systemic mastocytosis is much more severe than in other causes of osteoporosis. In addition, employability is highly threatened if the diagnosis is not made promptly. In all cases studied, the diagnosis of mastocytosis was only made during rehabilitation and on average five years after the diagnosis of osteoporosis. Early diagnosis and targeted therapy could have prevented severe outcomes, such as vertebral fractures.

In summary, it can be concluded that systemic mastocytosis is a significantly underestimated condition in a cohort of patients with osteoporosis undergoing rehabilitation through the German Pension Insurance (DRV). This applies to the frequency, severity of the disease, and the social-medical prognosis. It is highly likely that earlier diagnosis and rehabilitation would have a significant positive impact on the clinical course and employability. From our perspective, the study demonstrates the importance of rehabilitation in a health resort. In all cases, it was only there that the correct diagnosis could be made, and a tailored treatment combining medication and rehabilitative measures could be initiated. This study assists in finding arguments that an early health resort stay is important for improving the health.

1. Short description of the research topic and medical goal

In the study 3 cohorts were formed and compared:
(1) patients with osteoporosis who did not undergo bone biopsy,
(2) patients who later received a diagnostic bone biopsy,
(3) patients diagnosed with ISM.

We were able to demonstrate that ISM is generally a rare cause of osteoporosis, occurring in only 0.5% of cases. However, among younger patients, especially men under 60 years and pre- or perimenopausal women, the prevalence of systemic mastocytosis is much higher, with over 5% of cases. Furthermore, we found that the course of osteoporosis in ISM is much more severe compared to other causes. On average, patients with ISM had twice as many vertebral fractures compared to the control group. It should be noted that the selection for bone biopsy was already due to a severe course of the disease.

In all cases, the definitive diagnosis of mastocytosis was only made during rehabilitation. On average, the diagnosis was made 5 years after the outpatient diagnosis of osteoporosis. This is problematic because early diagnosis with targeted therapy could potentially have prevented further fractures in many cases. The social-medical data indicate that employability is highly threatened if the correct diagnosis is not made in a timely manner.

2. Originality

Patients with osteoporosis and vertebral fractures were studied. The consequences of vertebral body fractures are unbearable pain, restricted movement, quality of life and the ability to work. The study was able to show that the patients whose cause was systemic mastozoytosis had a much more severe course than those with other causes of osteoporosis.
The data suggest that early diagnosis of mastocytosis leads to a significantly better course.

The starting point of the scientific study is the case of a patient who suffered her first vertebral fractures at the age of 51 with a diagnosed osteoporosis. In the following years, significant consequential fractures occurred, leading to severe functional limitations and inability to work. The data collected by Klinik DER FÜRSTENHOF suggested that this could have been prevented if the patient had received specific rehabilitation measures in a specialized osteological clinic after the first fractures, where mastocytosis would have been identified as the cause of the osteoporosis.

Our data suggest that this could have potentially been prevented if the patient had received specific rehabilitation measures identifying mastocytosis as the cause of osteoporosis after the initial fractures.

3. Use of medical methods and created new medical programmes

The decisive benefit of the work is that the early clarification of the cause of osteoporosis improves the prognosis. The early diagnosis in combination with therapeutic applications in the health resort (physiotherapy, movement therapy, moor applications, water applications) help the patients to cope better in everyday life so that they can remain in work.

4. Importance of the research for the medical spa sector

This work is an example of the holistic treatment of diseases in the spa. A clear diagnosis is the basis for selecting physical and balneological treatments. The aim is for patients with osteoporosis to visit the health resort in order to first receive a comprehensive clarification and then a targeted drug and non-drug therapy.

With this application, we submit the work “Osteoporosis Caused by Systemic Mastocytosis: Prevalence in a Cohort of 8392 Patients with Osteoporosis” by Dr. Martin Gehlen. The basis is an article published by us in the international peer-reviewed journal “Calcified Tissue International.” It was awarded the Boxberger Prize in 2022 which demonstrates the importance of our work in the medical spa sector. The prize is one of the most highly endowed scientific awards in the field of health sciences in Germany. A translated press article
“Pyrmonter Clinic Wins Boxberger Prize for Osteoporosis Research” is attached. Additionally, the application includes the poster “Rehabilitation of rare serious diseases” presenting interim results for which we received a poster award at the Rehabilitation Science Colloquium in 2019. To illustrate the clinical significance of the topic, we have attached the short case report “12 Vertebral-Body Fractures and Simultaneous SkinChanges” published in the German Medical Journal (Deutsches Ärzteblatt). The case describes a patient who experienced initial fractures due to osteoporosis at the age of 51.

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Heiligenangerstraße 6, Bad Pyrmont

Germany

https://www.staatsbad-pyrmont.de/