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Clime- and Heliotherapy. Introduction. Therapeutic usable Clime (Healing Clime) is the result of special dose of temporary and local changing atmospheric factors controlled by physicians. The dose can be contrary to the personally comfort feeling of patients in according to the indications.
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Introduction • Therapeutic usable Clime (Healing Clime) is the result of special dose of temporary and local changing atmospheric factors controlled by physicians. The dose can be contrary to the personally comfort feeling of patients in according to the indications. • “The doctor is the creator of the cure clime” (Pfleiderer)
Climetherapy Definitions Clime regions Clime factors Dose factors Effects Indications and contra-indications Cure types and structures Heliotherapy Radiation sources Effect of environment to the global radiation Radiation and skin Photochemical and -biological effects Therapeutic and toxic effects Photo-Brine-Therapy Indications, contra-indications and risks Themes
Definitions I • Climetherapy is a part of Health Resort Medicine. It is applied as a complex measure together with other global adjusted therapeutic measures in the cure systems. Climetherapy belongs on a treatment concept of many different effective factors. • In Heliotherapy one important factor of Climetherapy will be used.
Definition II • Climetherapy is the special treatment of sick patients by modification their exposition in the free atmosphere (Schmidt-Kessen). • Photo therapy or Light therapy is the therapeutic use of photon radiation in ultra violet, visible and infrared range. • Heliotherapy is the Photo therapy by Sunshine. • Thalasso therapy is the therapy by use of the remedies of the sea.
Definition III • Climetherapy • Cure treatment by use of active and strong elements of clime • Sea-clime • High-altitude clime • Climecure (cure in the clime) • Cure treatment in areas without strong elements of clime by physiotherapy. • Areas in woods and medium altitudes (Dirnagl)
Definitions III • Weather is the result of circulation in the atmosphere • Clime is the long time mean value of the local weather elements. • Bio-clime is the clime, which contact the body surface and has biological effects. (Schmidt-Kessen)
Clime regions • Sea-clime • moist, cool, windy • Aerosol, low pollution • Clime of medium altitudes • Wood air, not windy • Clime of high altitudes (1200 –2000 m) • dry, cool, high part of UV • Decrease of max. O2-uptake about 2%/per 1000m • up to 1800 m no house-dust-mite can live
General principle of Climetherapy In-door-clime (save clime) Out-door-clime(stress clime) Adaptation to natural environment factors Coddling situation Careful situation in health resort Air pollution at home
Mechanical factors • Air pressure • Wind pressure • Gravitation
Thermal factors • Air temperature • Radiation temperature • Humidity • Air movement (wind, draw-winch)
Actinic factors • UV-B (280-315 nm) • UV-A (315-400 nm) • UV-A1 (artificial) (350-400 nm) • Visible Light (380-780 nm) • near infrared radiation (760-2500 nm)
Chemical factors • Ozone • Natural concentration: 0,01 - 0,06 ppm • Maximal working level: 0,1 ppm • Exhausted by reaction with the earth surface 4 mg/d/m2 • Volatile oils • Aerosols • Radon • Missing air pollution
Electric factors I • Ions of air • 102 - 103 ions/ cm3 of 1019 air molecules/cm3 • about 4 ions/cm2 per breath have contact to the lung surface • Electrical DC fields • Field of fine weather : 100 V/m • Field of low-pressure front: >1 kV/m • Field of the skin surface by movement: >1 kV/m
Electric factors II • Electric AC field(by atmospheric impulse radiation, Sferics) • 10-Hz-Field • Magnetic DC field • 0,5 Gauss • Magnetic AC field • by 10-Hz-Field: 10-8 - 10-10 Gauss • by 50-Hz-AC in houses: 1-5 Gauss
Dose factors of the weather • cold - hot • shadow - sunshine • calm - windy • dry - moist • fog - rain • clean air – air pollution
Dose factors by activity of the patient • Resting • Sitting • Going • Jogging • Sporting
Dose factors by shielding the patient • Warm dresses • Wind-tight dresses • Water-tight dresses
Weather-phases in Bioclimatology 1 Fine weather (cool to moderate warm) East part of high pressure 2 Active fine weather (warm and dry) Middle part of high pressure 3 Over loaded fine weather (very hot and dry) West part high pressure 4 Beginning change of weather (warm and moist) frontal side of low pressure 5 Changed weather (cold and moist) 6z Active cold air (cold to cool, rain, windy) backside of low pressure 6 Weather normalisation (cold and dry)
Weather and sickness • Weather phase 4 (frontal side of low pressure): • inflammation in any case • asthma-attacks, • disorders by hypotension • acute disorders of the heart • thromboses • Weather phase 5 (changed weather) • fast normalisation of the disorders
Weather and sickness • Weather phase 6z (backside of low pressure) • acute and spastic disorders • bile-bladder colic • cardiac pain • cardiac-attacks • disturbance by hypertension
Weather and sickness • Weather phase 6 (Weather normalisation) • headache • migraine • sleep disturbances • depressions
Which factors of weather are maximal effective in weather feeling ? Change of • hot and dry (phase 3) to • cold and moist (phase 5)
Hypothesis of increasing pain in rheumatoid arthritis • Decrease of air temperature • Decrease of join temperature • Decrease of synovial temperature • Increase of synovial viscosity • Decrease of join mobility • Increase of pain
What is the main reason in weather sickness? Disturbance in peripheral temperature regulation. Cause? Lack in training Problems in civilisation.
Complaints in connection with weather changes Unbroken sleep disturbance Increased making mistakes Increased forgetfulness Flicker of eyes Attack of vertigo Heart sensations Pain in postoperative scar Depressive mood • Weariness • Bad mood • Unpleasure to work • Head pressure, headache • Restless sleep • Initial insomnia and concentrating disturbance • Nervosity • Pain in points of bone-fractures
Follow up of non-adaptation and disability in temperature regulation • Vasoconstriction of peripheral blood vessels • Blood flow from peripheral vessels into the systemic circulation • Hypertension
Main therapeutic clime effects • Improvement of the thermoregulation • Increase of the physical efficiency • Inurity and decrease in susceptibility of infection • Improvement of the skin state • Vitamin D3-formation • Relief of the respiratory tract
Coldness adaptation • Decrease in coldness sensitivity • Pain threshold moves to lower temperature • Initial increase of blood pressure decrease • More increase of heart rate after adaptation • Increase of reactive heat by metabolism
Indications inHealth Resorts with healthy clime • Situation after deficiency of training • Therapy: Terrain cure by cool conditions • Respiratory tract diseases • Therapy: Terrain cure and respiratory exercise • Osteoporosis • Therapy: Terrain cure and Heliotherapy • Skin diseases (Psoriasis, Neurodermitis) • Therapy: Terrain cure and Heliotherapy
Structures of Health Resorts with healthy clime in high altitude • Net of terrain ways minimum 30 km (5 to 15 % ascent) • Clime pavilion • Rest- and gymnastic-field • Equipment in hydrotherapy • Bike travel ways • Patient-consultation and -leading
Cure forms • Out-patient clime cure • Clime compact cure
Treatment by low coldness stimulation • Regimen refrigerants • Training en repos
Change of aerobic metabolism by adaptation to coldness Physical endurance performance increase • by terrain cure in cold conditions, • by rest cure in fresh air.
Change of lactate concentration in blood during ergometric control by rest cure in fresh air Before treatment 3 weeks later By A. Schuh 1995
Change of lactate concentration in blood during ergometric control by terrain cure in cool conditions Before treatment 3 weeks later By A. Schuh 1995
Other expositions and indications • Rest cure in fresh air (1-3times daily 2 hrs.) • convalescence of bedridden patients • Sleep treatment in fresh air (cool breathing air) • weather sickness • disorders of circulatory and sleep regulations • Air bath (use of bathing dress, kinesitherapy in cold air) • hypotonic circulatory regulation disorders • adipose • fibromyalgia
Indication in Sea Health Resorts • Chronic diseases of respiratory tract • Rhinitis, sinusitis paranasalis (in Summer time), pharyngitis, laryngitis • Hay rhinitis (on islands), rhinitis vasomotorica • Chronic relapsing bronchitis • Asthma-syndrome, allergic asthma (on islands) • Situation post pneumonia and pleurisy
Indication in Sea Health Resorts • Heart- and circulation diseases • Functional circulation disorders, hypo-tension • Early stage of arteriosclerosis • Well compensated essential hypertension • In-patient rehabilitation after cardiac infarction, cardiac- and vascular operations • Symptom-complex of varicose
Indication in Sea Health Resorts • Skin diseases • Eczematous diseases, keratosis, urticaria chronica • Erythemato-squamous and papular dermatosis, Psoriasis vulgaris (May to July) • Dermatosis with blusters • Pyodermia, acne vulgaris • Phlebopathy
Indication in Sea Health Resorts • Chronic diseases of locomotoric system (treatment with mud or other peloides) • Arthrosis, spondylitis and osteochondrosis • Post-treatment after accident- and war-lesions and post operations
Indication in Sea Health Resorts • Women’s diseases • Chronic inflammation processes of the genitals (treatment by use of slime) • Concrescence complaints (treatment by use of slime) • Cycles disorders, Ovarian insufficiency (treatment by use of slime) • Vegetative-endocrine syndrome • Postmenopausal syndrome
Indication in Sea Health Resorts • Diseases of children • Chronic relapsing diseases of the upper and lower respiratory tract. • Infantile asthma syndrome, allergic asthma (on islands) • Hypotonic circulation disorders • Skin diseases • Disorders of development
Indication in Sea Health Resorts • General weakness situations • convalescence • Dystonia, autonomic nervous disorders
Indications in Thalassotherapy of the respiratory tract Months: I II III IV V VI VII VIII IX X XI XII without Decompensation Diseases of the respiratory tract With moderate Decompensation Sinusitides and Otitides Cardiac-circulation diseases with weather sensitivity Nervous excitability Delivate, extremely susceptible patients and infants Babies, ill infants, old humans
Indications in Thalassotherapy of the skin Months: I II III IV V VI VII VIII IX X XI XII for children and adults, and occupational eczema Neurodermitis By strong asthenia or dystonia autonomic nervous disorders Urticaria, Strophulosis, Furunculosis Dyshidrotic Eczema Acne vulgaris and Acne juvenilis Ichthyosis vulgaris und Psoriasis vulgaris Prurigo
Stimulus dosage during cure treatment • 4 - 8 days spar, • After this time in low steps as strong as possible increase, • Individual dosage.
Permanence of the first sun-bathby start of exposition May 1st min 180 Skin Type 150 IV III 120 II I 90 60 30 0 6 8 10 12 14 16 18 h Daytime