Evidence map›Paper›PMID 40002498›Full record

ArticleBrain sciences2025

Balneotherapy as a Complementary Intervention for Stress and Cortisol Reduction: Findings from a Randomized Controlled Trial.

Lolita Rapolienė, Dovydas Rapolis, Aelita Bredelytė, Giedrė Taletavičienė, Antonella Fioravanti, Arvydas Martinkėnas

Abstract read
In one paragraph

Article in Brain sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Lolita RapolienėFaculty of Health Sciences, Klaipėda University, 92294 Klaipeda, Lithuania.ORCID 0000-0002-5089-4095
Dovydas RapolisFaculty of Medicine, Vilnius University, 03101 Vilniaus, Lithuania.ORCID 0009-0000-5343-3326
Aelita BredelytėFaculty of Health Sciences, Klaipėda University, 92294 Klaipeda, Lithuania.ORCID 0000-0002-5782-0937
Giedrė TaletavičienėDruskininkai Hospital, 66251 Druskininkai, Lithuania.
Antonella FioravantiOMTh-Organizzazione Mondiale del Termalismo (World Hydrotermal Organization), 38056 Levico Terme, Italy.ORCID 0000-0002-7325-5579
Arvydas MartinkėnasFaculty of Health Sciences, Klaipėda University, 92294 Klaipeda, Lithuania.ORCID 0000-0003-1759-0433

Funding

Lietuvos Mokslo Taryba S-REP-22-6
6 · The paper itself

Abstract

backgroundIn our modern era, stress has become a pervasive challenge, affecting individuals across all ages and backgrounds. Acute or chronic stress and elevated cortisol levels are known to impair neurological function and hinder rehabilitation outcomes. Therefore, effective treatment methods that reduce stress, enhance mental health, and promote overall well-being are urgently needed. The aim of this study was to evaluate the seasonal impact of balneotherapy on distress, as measured by the General Symptoms Distress Scale (GSDS), and well-being, as assessed using the Arizona Integrative Outcomes Scale (AIOS), and the effect of winter balneotherapy on salivary cortisol levels.

methodsIn 2023, a multicenter, single-blind, parallel-group, randomized controlled trial was carried out across six medical spa centers in Lithuania. Participants with a stress intensity greater than 3 points on the Visual Analogue Scale (VAS) underwent combined natural resource-based therapies over a 1- to 2-week treatment period. Outcomes were assessed using the General Symptom Distress and Arizona Integrative Outcomes scales, along with salivary cortisol measurements after winter intervention.

resultsThe results demonstrated a significant reduction in distress intensity by 1-3.5 points (VAS), with winter interventions showing greater efficacy compared to summer. Participants also experienced an increase in well-being by up to 3 points (VAS), improved stress management by up to 1.9 points (VAS), and a reduction in salivary cortisol levels by 0.9 units following winter-based treatments. Some gender differences emerged in specific groups.

conclusionsOur study provides robust evidence for the stress-reducing effects of balneotherapy, particularly highlighting the enhanced efficacy of winter interventions. These findings are especially relevant for neurological rehabilitation, where stress reduction and improved autonomic regulation can support neuroplasticity, recovery processes, and overall quality of life. This research offers valuable insights for developing holistic, seasonally optimized strategies to aid stress management and promote neurological health.

Indexed as

balneotherapycortisoldistressmineral waterpeloidssalt therapywell-being

Identifiers

PMID40002498
PMCPMC11853121

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Registered trials

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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.