PTOTRCTFrontiers in rehabilitation sciences2025

Balance rehabilitation and Long Covid syndrome: effectiveness of thermal water treatment vs. home-based program.

Maria Chiara Maccarone, Paola Contessa, Edoardo Passarotto and 2 others

PMID 40656219

WHAT IT FOUND

Home-based rehab improved balance faster, while spa thermal water treatment produced more sustained gains over three months.

Neither approach showed superiority at the end of treatment, and both groups experienced technical dropouts that limit confidence in these timing differences.

Key findings

01The home-based group showed decreased antero-posterior oscillation amplitude from baseline to post-treatment, indicating rapid initial improvement in balance stability.

02The spa group showed significantly decreased antero-posterior oscillation amplitude from post-treatment to three-month follow-up compared to home-based, suggesting more sustained long-term benefits.

03The spa intervention was a multi-component package including thermal aerosol, land-based exercise, water-based balance training, and cognitive therapy, making it impossible to isolate the effect of the thermal water alone.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

High dropout rate: 16 of 60 randomised patients were excluded from analysis due to dropouts, technical issues, or poor compliance, leaving only 44 for the primary comparison. The spa intervention was a complex multi-component package (aerosol, land exercise, water exercise, cognitive therapy), so the specific contribution of thermal water cannot be isolated. No significant differences were found in eyes-open conditions, and the primary outcomes were based on secondary post-hoc analyses of specific parameters rather than a single pre-registered primary endpoint. Follow-up was limited to three months for the main analysis, with six-month data excluded due to attrition, preventing assessment of long-term durability. Baseline group differences in age and mean stay time may have influenced the trajectory of improvement.

Declared interests

The research was funded by Fondazione Cassa di Risparmio di Padova e Rovigo and Fondazione per la Ricerca Scientifica Termale (FORST). FORST is a foundation for thermal scientific research, which may have an interest in promoting thermal water treatments.

The easy way to misread this

Do not conclude that thermal water itself caused the sustained balance improvements. The spa group received a comprehensive package including land-based exercise, cognitive therapy, and aerosol treatment, so the effect cannot be attributed to the water alone. Additionally, the spa group's lack of immediate improvement may reflect fatigue from the intensive program rather than a lack of efficacy.

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