Obezite Rehabilitasyonunda Balneoterapi
Özet
Obezite sağlıksız beslenme, fiziksel aktivitelerin azalması ve hareketsiz yaşam tarzının benimsenmesiyle küresel bir salgın haline gelmiştir ve DSÖ'ne göre sigaradan sonra engellenebilir ölümlerin ikinci en sık nedenidir. Obezite birçok hastalığa, ciddi iş gücü kaybına ve yüksek sağlık harcamalarına neden olan bir halk sağlığı sorunudur. Bu nedenle obezite hastalarının kolaylıkla erişebileceği balneoterapi gibi alternatif tedavi seçeneklerine ihtiyaç vardır. Balneoterapi özellikle metabolik açıdan güvenli koşullar altında glukoz metabolizmasını düzenleyerek obezite hastası üzerinde olumlu etki göstermektedir. Genel olarak çeşitli klinik çalışmalar ve incelemelerde obezite tedavisinde balneoterapinin etkin bulunmuş ancak çoğu çalışmada balneoterapiye egzersiz programları, masaj ve rehabilitasyon gibi diğer tedavilerle kombine edildiği için tek başına etkinliğine karar vermek zordur. Balneoterapinin tek başına kilo kaybı, fiziksel aktivite ve bazı yaşam kalitesi parametrelerinde olumlu değişiklikler başlatmasına rağmen bu etkinin terapötik eğitim programı olmadan uzun vadede devam etmediği bildirilmiş. Ayrıca obezitede balneoterapi ile ilgili çalışmaların çoğu balneoterapinin obezite üzerindeki birincil etkisinden ziyade, obez olmanın balneoterapinin osteoartrit ve dejeneratif disk hastalıklarında etkinliğini etkileyip etkilemediği üzerinedir. Balneoterapinin obezite üzerindeki etkisini tam olarak değerlendirebilmek için daha fazla sayıda hastayı içeren, kontrol grubu içeren, egzersiz, fizyoterapi, diyet tedavisi gibi ek müdahalelerin olmadığı randomize çalışmalara ihtiyaç vardır.
Obesity has become a global epidemic due to unhealthy diet, decreased physical activities and adoption of a sedentary lifestyle and it is the second most common cause of preventable deaths after smoking according to WHO. There is a need for alternative treatment options such as balneotherapy that obesity patients can easily access. Balneotherapy has been found effective in the treatment of obesity in various clinical studies and reviews in general but it is difficult to judge its effectiveness alone, as balneotherapy is combined with other treatments such as exercise programs, massage and rehabilitation in most studies. It has been reported that although balneotherapy alone initiates positive changes in weight loss, physical activity and some quality of life parameters, this effect does not continue in the long term without a therapeutic training program. In addition, most of studies on balneotherapy in obesity are on whether being obese affects effectiveness of balneotherapy in osteoarthritis and degenerative disc diseases, rather than the primary effect of balneotherapy on obesity. Randomized studies that include a larger number of patients, a control group, and no additional interventions such as exercise, physiotherapy, and diet therapy are needed in order to fully evaluate effect of balneotherapy on obesity.
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