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Active ageing and Hydrotherapy: Preventive Medicine and health education in Spa centres Author: Miguel Felipe Alonso

Prez. Termas Cuntis

If we could give every individual the right amount of nourishment and exercise, not too little and not too mutch, we would have found the safest way to health

Hipocrates, 460 BC

Demographic transition

Projected demography

Projected expectancy of life

Distribution of annual deaths per age group

All age 100-plus deaths

All infant deaths

Causes of death in Africa and Europe


Homecare services

Hospital admissions

Causes of death and its relationship with lifestyle

Cost of physical inactivity for specific chronic diseases in Canada in 2009

Cost are in millions of Canadian dollars

The model of active aging and health education role

Primary and secondary prevention in heart diseases

Metabolic pathway of sedentary lifestyle related to cardiovascular diseases

Health benefits of physical activity: the evidence

Health benefits of physical activity: the evidence

Physical condition in middle and old age: times per age group of marathon runners

- Significant age-related performance losses start from 54 years - Half of the young runners reach the finishing after the best 25 % 65-69 year old runners

To late to start active lifestyle? Changes in physical activity in 50 year old men reduce mortality risk

Resources in spa centres for health promotion and exercise interventions

Preventive medicine and health education in spa centres

In order to improve cost-efficacy of spa treatments, preventive interventions in chronic diseases related with age and lifestyle should be performed in our centres, specially in the actual economic situation Programs combining physical activities, health education, spa therapies and other modalities are widely represented in the recent literature, and were discussed mainly by Socit Franaise de Mdecine Thermale at the 38 th ISMH World Congress Protocols of multidisciplinary approaching in spas are avaliable for various conditions: fibromyalgia, hip and knee osteoarthritis, low back pain, venous insufficience, and COPD In our opinion, general programs for delayng or improving the most ferquent chronic conditions (CVD, COPD, dibetes, osteoporosis, etc) could be performed emphasizing recomendations for Active Ageing

General aspects of health programs in spa centres

Multidimensional approach: physical, mental and social wellness (WHO definition) Multidisciplinary intervention: consultation, rehabilitation, group activities, psychotherapy, trainning, etc Preventive, early detection of risk factors: sedentary lifestyle, inadecuate nutrition, tobacco / alcohol consumption, depressive mood, etc Individual evaluation of physical condition: avoidance of adverse events, improve program efficacy

Health education: consultation, talks, expert conference, group discussion

Mid / long term follow up: evaluate the effeicacy and program observance Promotion of outdoor activities and aquatic exercise during stay in spa

Anxiolytic and / or antidepressant consumption among our patients

Half of the women attending to our centre take psychotropic medication

Depression and cardiovascular diseases

Left: risk factors of cardiovascular diseases Right: risk of mortality after MI and correlation with depressive symptoms (BDI: Beck depression inventory)

Pathophysiologic mechanisms: chronic stress and depression promote atherosclerosis

Brief scheme of psychological disorders among our patients

Cardiac function and aquatic exercise

A : Baseline B : After 8 weeks control C : After 8 weeks aquatic exercise

Biventricular function

Cardiac function and aquatic exercise



Cardiac function and aquatic exercise

White: training group before Black: training group after

Light grey: control group before Dark grey: control group after

Hypertension and aquatic exercise

Coronary disease and water exercise

Pulmonary function and aquatic exercise (COPD patients)

Expiratory maximal pressure Inspiratory maximal pressure

Osteoporosis and aquatic exercise

SF 36 questionnaire

Prevention of falls

Nordic walking (versus traditional walking)

- 23 % higher oxygen uptake - 22 % higher caloric expenditure - 16 % higher heart rate - Walking longer and harder with less exertion - Less impact on lower extremity joints - Fewer complaints and side effects reported

Nordic walking (clinical studies and effects)

Waon therapy: easy japanese sauna protocol for cardiovascular disease