SynthesisInternational journal of biometeorology2018
Effects of balneotherapy and spa therapy on levels of cortisol as a stress biomarker: a systematic review.
Synthesis in International journal of biometeorology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
46 citing papers in PubMed, 4 syntheses or guidelines pooled it, 93 citations in OpenAlex.
- Clinical efficacy of medical hydrology: an umbrella review.International journal of biometeorology · 2021Pooled it
- Efficacy of aquatic therapy for neck pain: a systematic review.International journal of biometeorology · 2020Pooled it
- Effects of forest bathing (shinrin-yoku) on levels of cortisol as a stress biomarker: a systematic review and meta-analysis.International journal of biometeorology · 2019Pooled it
- Mud therapy and skin microbiome: a review.International journal of biometeorology · 2018Pooled it
- Effects of balneotherapy on stress, anxiety, and depression: results of a multicenter randomized controlled trial with six-month follow-up.BMC complementary medicine and therapies · 2026Trial
- Evaluation of the benefits of neutral bicarbonate ionized water baths in an open-label, randomized, crossover trial.Scientific reports · 2024Trial
- Salivary cortisol levels and stress in adults with profound intellectual and multiple disabilities participating in the Structured Water Dance Intervention: a randomised controlled crossover trial.Scientific reports · 2022Trial
- Effects of complex spa therapy in patients with osteoarthritis of the spine receiving treatments in health resorts in south-eastern Poland.Scientific reports · 2022Trial
- The effects of inpatient versus outpatient spa therapy on pain, anxiety, and quality of life in elderly patients with generalized osteoarthritis: a pilot study.International journal of biometeorology · 2018Trial
- Physical activity patterns and vaccination attitudes among thermal spa attendees: a cross-sectional study.BMC public health · 2026Article
- Does the predominance of central sensitization alter the effect of balneotherapy combined with conventional physical therapy in patients with chronic low back and knee pain?International journal of biometeorology · 2026Observational
- Determinants of consumption level among target population in Chinese hot spring medical and long-term care integration with rehabilitation services model and value perception analysis based on the importance-performance analysis framework.Frontiers in rehabilitation sciences · 2026Article
- A health resort-based intervention reduces insomnia with minimal changes in quality of life in COVID-19 survivors and non-COVID-19 controls.Frontiers in public health · 2026Article
- Ethnopharmacological knowledge and physicochemical properties of hot springs in Bhutan.BMC complementary medicine and therapies · 2025Article
- Neuroimmunomodulation induced by mud-bath therapy: clinical benefits and bioregulation of the innate/inflammatory responses induced by a peloid enriched with rosmarinic acid in elderly patients with osteoarthritis.International journal of biometeorology · 2025Article
- Balneotherapy as a Complementary Intervention for Stress and Cortisol Reduction: Findings from a Randomized Controlled Trial.Brain sciences · 2025Article
- Health Resort Treatment Mitigates Neuropsychiatric Symptoms in Long COVID Patients: A Retrospective Study.Healthcare (Basel, Switzerland) · 2025Article
- Emerging Evidence on Balneotherapy and Thermal Interventions in Post-COVID-19 Syndrome: A Systematic Review.Healthcare (Basel, Switzerland) · 2025Review
- Spa Therapy Efficacy in Mental Health and Sleep Quality Disorders in Patients with a History of COVID-19: A Comparative Study.Diseases (Basel, Switzerland) · 2024Article
- Novel Insight into the Association between Balneotherapy and Functional State and Health Perception in Chronic Low Back Pain: A Cross-Sectional Study.Journal of clinical medicine · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Balneotherapy and spa therapy are well-known practices, even though limited evidence has been produced about their biological effects. This systematic review primarily aims at assessing if balneotherapy, mud/peloid therapy, and spa therapy may influence cortisol levels. Secondarily, it aims at understanding if these interventions may improve stress resilience. PubMed/Medline, Embase, and Cochrane Library were searched for relevant articles in English or Italian about studies involving healthy and sub-healthy subjects or patients with a diagnosed disease about effects of balneotherapy, mud/peloid therapy, and spa therapy on serum and salivary cortisol levels. Fifteen studies involving 684 subjects were included. Five studies investigated biological effects of balneotherapy alone. Two of them reported significant changes of cortisol levels in healthy participants. The other three studies reported no significant variations in patients with rheumatic conditions. No studies investigated biological effects of mud/peloid therapy alone. Ten studies investigated biological effects of spa therapy with or without included mud/peloid therapy, and in all but two studies, significant variations of cortisol levels were reported. Our main findings suggest that balneotherapy may have the potential to influence cortisol levels in healthy subjects, in such a way as to improve stress resilience. Spa therapy with or without included mud/peloid therapy demonstrated the same potential to influence cortisol levels also in sub-healthy subjects and in patients with a diagnosed disease. Therefore, balneotherapy and spa therapy may be considered as useful interventions for the management of stress conditions. Further investigation is needed because of limited available data.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.