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Rehabilitation in a warm climate (climate therapy)

Sometimes patients in Sweden can be offered rehabilitation in a warmer climate. This is mainly patients with neurological diseases, rheumatic diseases and psoriasis. The rehabilitation stay is often around three to four weeks and often includes physical activity and physiotherapy. For patients with psoriasis, exposure to the sun is an important element of the care.

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SBU Enquiry Service

Consists of structured literature searches to highlight studies that can address questions received by the SBU Enquiry Service from Swedish healthcare or social service providers. We assess the risk of bias in systematic reviews and when needed also quality and transferability of results in health economic studies. Relevant references are compiled by an SBU staff member, in consultation with an external expert when needed.

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Published: Report no: ut201930 Registration no: SBU 2018/579

Question

What scientific studies are there on the effect of rehabilitation in a warm climate (climate therapy)?

Identified literature

Table 1 Systematic reviews.
Included studies Population Outcome
Forseth et al 2010 [1]
RCT: 1
Cross over: 1
Non-controlled prospective studies: 4		 Patients with reumatic diseases Differs between studies, examples of outcomes were disease activity, body functions and pain.
Authors' conclusion:
“Well-designed studies to validate and improve the low-to-moderate evidence found for the efficacy of comprehensive rehabilitation in a warm climate among patients with inflammatory rheumatic disease are greatly needed.”
Kunnskapssentret 2012 [2]
18 studies identified Patients where treatment in warmer climate could be considered favorably -
Authors' conclusion:
Systematic literature search only, no conclusions in the report.
Koopman et al 2015 [3]
1 Study identified Patients with postpolio syndrome Activity limitations, muscle strength, muscle endurance, fatigue, pain, adverse events.
Authors' conclusion:
“Due to insufficient good-quality data and lack of randomised studies, it was impossible to draw definite conclusions about the effectiveness of interventions for PPS (post polio symtoms)”
The national board of health and welfare, Socialstyrelsen, National Guidelines- psoriasis, 2019 [4]
18 studies identified. Of those 17 studies were non-controlled. 1 RCT Patients with psoriasis Symptom relief
Authors conclusion:
”Hälso- och sjukvården bör erbjuda klimatvård med vårdteam i minst tre veckor till personer med svår psoriasis som har otillräcklig effekt av andra behandlingsalternativ och särskilt behov av utbildning, förändrade levnadsvanor och fysisk aktivitet. Avgörande för rekommendationen är att tillståndet har en stor till mycket stor svårighetsgrad och att åtgärden ökar förutsättningarna för symtomlindring och minskar risken för framtida besvär. Åtgärden ger också patienterna möjlighet att utbyta erfarenheter och hjälper dem att utveckla copingstrategier (strategier för att hantera sjukdomen).”
”Det vetenskapliga underlaget är otillräckligt, men åtgärden har stöd i beprövad erfarenhet enligt ett systematiskt konsensusförfarande.”

References

  1. Forseth KO, Hafstrom I, Husby G, Opava C. Comprehensive rehabilitation of patients with rheumatic diseases in a warm climate: a literature review. J Rehabil Med 2010;42:897-902.
  2. Vist GE MM. Behandlingsreiser. Kunnskapssenteret 2012.
  3. Koopman FS, Beelen A, Gilhus NE, de Visser M, Nollet F. Treatment for postpolio syndrome. The Cochrane database of systematic reviews 2015:CD007818.
  4. Socialstyrelsen. Nationella riktlinjer för vård vid psoriasis. 2019.
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