Abstract
118 papers have been published in english speaking journals with impact factor these last twenty years: 90 randomized Controlled Trials (RCT) and 28 reviews and/or meta-analysis (RMA).
Rheumatolgy is the first topic: 63 RCT, 22 RMA. Knee osteoarthritis is the most investigated condition : 18 RCT, 5 RMA ; chronic inflammatory diseases 12 RCT, 1 RMA; Fibromyalgia 10 RCT, 2 RM ; Chronic low back pain: 11 RCT, 1 RMA. The patients with musculo-skeletal conditions have a significant actual clinical benefit on pain, function and quality of life.
Spa therapy is beneficial for patients with psoriasis (9 RCT) and atopic dermatitis (1 RCT).
Overweight or obese patients treated in spa resorts have a significant weight reduction according (3 RCT).
SPA therapy is also beneficial for patients with chronic venous insufficiency (2 RCT) or chronic occlusive peripheric arterial disease (4 RCT and 2 RMA).
Gynaecology (2 RCT) and psycho-somatic conditions (1 RCT) are more poorly investigated.
The lack of investigation about respiratory lower tract or Ear-Nose-Throat conditions is a questionnable issue.
Despite a significant number of trials, the level of evidence is impaired by many methodological flaws.
The actual medico-economic benefit assessment is based on more limited data of evidence.
