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Climatotherapy and landscape therapy as the most important rehabilitation methods for patients

https://doi.org/10.17749/2949-5873/rehabil.2025.42

Abstract

Landscape therapy and climatotherapy are two of the most conservative methods of restoring patients' lost health. Solutions to the existing problems in this area have recently been suggested by introducing new highly effective rehabilitation methods. However, this approach has limitations, which calls attention to conservative rehabilitation methods with a reassessment of their importance and a shift of the emphasis towards an evidence-based medicine. The review provides information on the action mechanisms of landscape therapy and climatotherapy and presents a number of randomized controlled trials (RCTs) confirming the effectiveness of these rehabilitation methods. The expediency of supplementing the existing rehabilitation programs with a balneotherapy course is shown and the need for additional RCTs to study the effectiveness of landscape therapy, aerotherapy, heliotherapy, thalassotherapy, and speleotherapy in the rehabilitation of patients is given.

About the Authors

N. G. Sidorina
Tomsk Research Institute of Balneology and Physiotherapy – Branch of Federal Scientific and Clinical Center for Medical Rehabilitation and Balneology of the Federal Medical and Biological Agency
Russian Federation

Natalia G. Sidorina

1 Roza Luxemburg Str., Tomsk 634009



A. B. Hajiyeva
Baku Branch of Sechenov University
Azerbaijan

Aygun B. Hajiyeva

139 Huseyn Cavid Ave, Baku AZ1143



A. V. Vorobev
Sechenov University
Russian Federation

Alexander V. Vorobev, PhD, Assoc. Prof.

WoS ResearcherID: F-8804-2017

Scopus Author ID: 57191966265

8/2 Trubetskaya Str., Moscow 119048



References

1. Quality of life: the main driver of modern development. Roscongress. 2021. Available at: https://roscongress.org/sessions/spief-2021-kachestvo-zhizni-osnovnoy-drayver-sovremennogo-razvitiya/discussion/ (in Russ.) (accessed 23.11.2024).

2. Crimmins E.M. Lifespan and healthspan: past, present, and promise. Gerontologist. 2015; 55 (6): 901–11. https://doi.org/10.1093/geront/gnv130.

3. Lee K.E., Choi M., Jeoung B. Effectiveness of rehabilitation exercise in improving physical function of stroke patients: a systematic review. Int J Environ Res Public Health. 2022; 19 (19): 12739. https://doi.org/10.3390/ijerph191912739.

4. Smith S.R., Zheng J.Y., Silver J., et al. Cancer rehabilitation as an essential component of quality care and survivorship from an international perspective. Disabil Rehabil. 2020; 42 (1): 8–13. https://doi.org/10.1080/09638288.2018.1514662.

5. Sakai T., Hoshino C., Hirao M., et al. Rehabilitation of patients with post-COVID-19 syndrome: a narrative review. Prog Rehabil Med. 2023; 8: 20230017. https://doi.org/10.2490/prm.20230017.

6. McMahon S.R., Ades P.A., Thompson P.D. The role of cardiac rehabilitation in patients with heart disease. Trends Cardiovasc Med. 2017; 27 (6): 420–5. https://doi.org/10.1016/j.tcm.2017.02.005.

7. Armand D.L. For us and grandchildren. 2nd ed. Мoscow: Mysl’; 1966: 254 pp. (in Russ.).

8. Gesler W.M. Therapeutic landscapes: medical issues in light of the new cultural geography. Soc Sci Med. 1992; 34 (7): 735–46. https://doi.org/10.1016/0277-9536(92)90360-3.

9. Sayapova A.M. “Veritable contemplation of nature” as the synergetic type of thinking of Goethe. Philology and Culture. 2012; 1: 125–9 (in Russ.).

10. Golubchikov Yu.N. Towards a landscape therapy theory. Geographical Environment and Living Systems. 2023; 1: 101–15 (in Russ.). https://doi.org/10.18384/2712-7621-2023-1-101-115.

11. Barashkov G.N., Sergeev V.N., Karamnova N.S. Terrencures and physical training by walking: rehabilitation – preventive aspects. Russian Journal of Preventive Medicine. 2021; 24 (5): 87–93 (in Russ.). https://doi.org/10.17116/profmed20212405187.

12. Bell S.L., Hickman C., Houghton F. From therapeutic landscape to therapeutic “sensescape” experiences with nature? A scoping review. Wellbeing Space Soc. 2023; 4: 100126. https://doi.org/10.1016/j.wss.2022.100126.

13. Lengen C. The effects of colours, shapes and boundaries of landscapes on perception, emotion and mentalising processes promoting health and well-being. Health Place. 2015; 35: 166–77. https://doi.org/10.1016/j.healthplace.2015.05.016.

14. Thomas F. The role of natural environments within women’s everyday health and wellbeing in Copenhagen, Denmark. Health Place. 2015; 35: 187–95. https://doi.org/10.1016/j.healthplace.2014.11.005.

15. Severin M.I., Raes F., Notebaert E., et al. A qualitative study on emotions experienced at the coast and their influence on well-being. Front Psychol. 2022; 13: 902122. https://doi.org/10.3389/fpsyg.2022.902122.

16. Völker S., Kistemann T. “I’m always entirely happy when I’m here!” Urban blue enhancing human health and well-being in Cologne and Düsseldorf, Germany. Soc Sci Med. 2013; 78: 113–24. https://doi.org/10.1016/j.socscimed.2012.09.047.

17. Bell S.L., Phoenix C., Lovell R., Wheeler B.W. Seeking everyday wellbeing: The coast as a therapeutic landscape. Soc Sci Med. 2015; 142: 56–67. https://doi.org/10.1016/j.socscimed.2015.08.011.

18. Coleman T., Kearns R. The role of bluespaces in experiencing place, aging and wellbeing: Insights from Waiheke Island, New Zealand. Health Place. 2015; 35: 206–17. https://doi.org/10.1016/j.healthplace.2014.09.016.

19. Handlovsky I., Ferlatte O., Kia H., et al. Processes underpinning survival in gay men living with HIV and a history of suicidality. Sociol Health Illn. 2022; 44 (7): 1132–48. https://doi.org/10.1111/1467-9566.13500.

20. Cheesbrough A.E., Garvin T., Nykiforuk C.I.J. Everyday wild: urban natural areas, health, and well-being. Health Place. 2019; 56: 43–52. https://doi.org/10.1016/j.healthplace.2019.01.005.

21. Muenchberger H., Ehrlich C., Kendall E., Vit M. Experience of place for young adults under 65 years with complex disabilities moving into purpose-built residential care. Soc Sci Med. 2012; 75 (12):2151–9. https://doi.org/10.1016/j.socscimed.2012.08.002.

22. Duff C. Exploring the role of “enabling places” in promoting recovery from mental illness: a qualitative test of a relational model. Health Place. 2012; 18 (6): 1388–95. https://doi.org/10.1016/j.healthplace.2012.07.003.

23. Pitt H. Muddying the waters: what urban waterways reveal about bluespaces and wellbeing. Geoforum. 2018; 92: 161–70. https://doi.org/10.1016/j.geoforum.2018.04.014.

24. Milligan C., Bingley A. Restorative places or scary spaces? The impact of woodland on the mental well-being of young adults. Health Place. 2007; 13 (4): 799–811. https://doi.org/10.1016/j.healthplace.2007.01.005.

25. Finlay J., Franke T., McKay H., Sims-Gould J. Therapeutic landscapes and wellbeing in later life: impacts of blue and green spaces for older adults. Health Place. 2015; 34: 97–106. https://doi.org/10.1016/j.healthplace.2015.05.001.

26. Gorman R. Thinking critically about health and human-animal relations: therapeutic affect within spaces of care farming. Soc Sci Med. 2019; 231: 6–12. https://doi.org/10.1016/j.socscimed.2017.11.047.

27. Britton E., Foley R. Sensing water: uncovering health and well-being in the sea and surf. J Sport Social Iss. 2021; 45 (1): 60–87. https://doi.org/10.1177/0193723520928597.

28. Mokos J.T. Stigmatized places as therapeutic landscapes: the beneficial dimensions of river-bottom homeless encampments. Med Anthropol Theory. 2017; 4 (1). https://doi.org/10.17157/mat.4.1.362.

29. Milligan C., Gatrell A., Bingley A. “Cultivating health”: therapeutic landscapes and older people in northern England. Soc Sci Med. 2004; 58 (9): 1781–93. https://doi.org/10.1016/S0277-9536(03)00397-6.

30. Grant G., Pollard N. Health group walks: making sense of associations with the natural landscape. Leisure Studies. 2022; 41 (1): 85–99. https://doi.org/10.1080/02614367.2021.1971284.

31. Bates V. Sensing space and making place: the hospital and therapeutic landscapes in two cancer narratives. Med Humanit. 2019; 45 (1): 10–20. https://doi.org/10.1136/medhum-2017-011347.

32. Jewkes Y., Moran D., Turner J. Just add water: prisons, therapeutic landscapes and healthy blue space. Criminol Criminal Justice. 2019; 20 (4): 381–98. https://doi.org/10.1177/1748895819828800.

33. Vaeztavakoli A., Lak A., Yigitcanlar T. Blue and green spaces as therapeutic landscapes: health effects of urban water canal areas of Isfahan. Sustainability. 2018; 10 (11): 4010. https://doi.org/10.3390/su10114010.

34. Gorman R. Smelling therapeutic landscapes: embodied encounters within spaces of care farming. Health Place. 2017; 47: 22–8. https://doi.org/10.1016/j.healthplace.2017.06.005.

35. Ireland A.V., Finnegan-John J., Hubbard G., et al. Walking groups for women with breast cancer: mobilising therapeutic assemblages of walk, talk and place. Soc Sci Med. 2019; 231: 38–46. https://doi.org/10.1016/j.socscimed.2018.03.016.

36. Macpherson H. Walkers with visual-impairments in the British countryside: picturesque legacies, collective enjoyments and well-being benefits. J Rural Studies. 2017; 51: 251–8. https://doi.org/10.1016/j.jrurstud.2016.10.001.

37. Paterson M. Haptic geographies: ethnography, haptic knowledges and sensuous dispositions. Progress Human Geography. 2009; 33 (6): 766–88. https://doi.org/10.1177/0309132509103155.

38. Jackson J. Growing the community – a case study of community gardens in Lincoln’s Abbey Ward. Renewable Agriculture Food System. 2018; 33 (6): 530–41. https://doi.org/10.1017/S1742170517000643.

39. Abramovic J., Turner B., Hope C. Entangled recovery: refugee encounters in community gardens. Local Environ. 2019; 24 (8): 696–11. https://doi.org/10.1080/13549839.2019.1637832.

40. Cacciatore J., Gorman R., Thieleman K. Evaluating care farming as a means to care for those in trauma and grief. Health Place. 2020; 62: 102281. https://doi.org/10.1016/j.healthplace.2019.102281.

41. Windhorst E., Williams A. “It’s like a different world”: natural places, post-secondary students, and mental health. Health Place. 2015; 34: 241–50. https://doi.org/10.1016/j.healthplace.2015.06.002.

42. Doughty K., Hu H., Smit J. Therapeutic landscapes during the COVID-19 pandemic: increased and intensified interactions with nature. Soc Cultural Geography. 2023; 24 (3–4): 661–79. https://doi.org/10.1080/14649365.2022.2052168.

43. Straughan E. Touched by water: the body in scuba diving. Emotion Space Soc. 2012; 5 (1): 19–26. https://doi.org/10.1016/j.emospa.2010.10.003.

44. Harris A. Lourdes and holistic spirituality: contemporary Catholicism, the therapeutic and religious thermalism. Culture and Religion. 2013; 14 (1): 23–43. https://doi.org/10.1080/14755610.2012.756411.

45. Doughty K. Walking together: the embodied and mobile production of a therapeutic landscape. Health Place. 2013; 24: 140–6. https://doi.org/10.1016/j.healthplace.2013.08.009.

46. Solyeyko O.V., Tsarenko S.O., Maznichenko O.V., et al. Landscape therapy: rehabilitation potential in patients with post-infarction cardiosclerosis. Wiad Lek. 2024; 77 (4): 696–702. https://doi.org/10.36740/WLek202404113.

47. Chun M.H., Chang M.C., Lee S.J. The effects of forest therapy on depression and anxiety in patients with chronic stroke. Int J Neurosci. 2017; 127 (3): 199–203. https://doi.org/10.3109/00207454.2016.1170015.

48. Shirokova V.A., Sobisevich A.V., Savenkova V.M. A. Voyeykov researches of climate medical places of the Caucasus. Bulletin of the Academy of Sciences of Chechen Republic. 2018; 3: 111–6 (in Russ.). https://doi.org/10.25744/vestnik.2018.40.3.018.

49. Salakhova R.Kh. Climatological works of A.I. Voyeykov: their significance and relevance. In: Volodina Yu.K., Borodina O.E., Gromova T.A., et al. (Eds.) Nature of the Simbirsk Volga Region: collection of scientific papers of the XIV Interregional Scientific and Practical Conference. Issue 13. Ulyanovsk: Promotion Technologies Corporation; 2012: 10–5 (in Russ.).

50. Voyeykov A.I. Research of climates for the purposes of climatic treatment and hygiene: report at the V section of the Russian Society for Protection of Public Health, March 12, 1898. Saint Petersburg: P.P. Soikin Printing House; 1898: 19 pp. (in Russ.).

51. Gerasimenko M.Yu., Astakhov P.V., Badalov N.G., et al. Climatotherapy in treatment, rehabilitation and preventive programs. Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2017; 16 (3): 154–9 (in Russ.).

52. Volotovskaya A.V. Therapeutic physical factors as a basis of spa-therapy. Meditsinskie novosti. 2012; 12: 50–3 (in Russ.).

53. Starshinova A.A., Pavlova M.V., Yablonskiy P.K., et al. Evolution of phthisiatry – a search for new methods and drugs effective for the treatment of tuberculosis. Practical Medicine. 2014; 7: 127–32 (in Russ.).

54. Yarosh A.M., Savchenko V.M., Babich-Gordienko I.V. The present state of the study of methods climatotherapy at resorts. Vestnik fisioterapii i kurortologii / Herald of Physiotherapy and Health Resort Therapy. 2015; 21 (1): 22–3 (in Russ.).

55. Fioravanti A., Cantarini L., Guidelli G.M., Galeazzi M. Mechanisms of action of spa therapies in rheumatic diseases: what scientific evidence is there? Rheumatol Int. 2011; 31 (1): 1–8. https://doi.org/10.1007/s00296-010-1628-6.

56. O’Hare J.P., Heywood A., Summerhayes C., et al. Observations on the effect of immersion in Bath spa water. Br Med J (Clin Res Ed). 1985; 291 (6511): 1747–51. https://doi.org/10.1136/bmj.291.6511.1747.

57. Weston C.F., O’Hare J.P., Evans J.M., Corrall R.J. Haemodynamic changes in man during immersion in water at different temperatures. Clin Sci. 1987; 73 (6): 613–6. https://doi.org/10.1042/cs0730613.

58. Epstein M. Renal effects of head-out water immersion in humans: a 15-year update. Physiol Rev. 1992; 72 (3): 563–621. https://doi.org/10.1152/physrev.1992.72.3.563.

59. Golubova T.F., Nuvoli A.V. Effect of iodine-bromine baths on stress-systems indicators in children with autism spectrum disorders. Problems of Balneology, Physiotherapy and Exercise Therapy. 2022; 99 (1): 42–9 (in Russ.). https://doi.org/10.17116/kurort20229901142.

60. Kuczera M., Kokot F. Effect of spa therapy on the endocrine system. I. Stress reaction hormones. Pol Arch Med Wewn. 1996; 95 (1): 11–20 (in Polish).

61. Berczi I., Chalmers I.M., Nagy E., Warrington R.J. The immune effects of neuropeptides. Baillieres Clin Rheumatol. 1996; 10 (2): 227–57. https://doi.org/10.1016/s0950-3579(96)80016-1.

62. Ghersetich I., Freedman D., Lotti T. Balneology today. J Eur Acad Dermatol Venereol. 2000; 14 (5): 346–8. https://doi.org/10.1046/j.1468-3083.2000.00136.x.

63. Cozzi F., Lazzarin P., Todesco S., Cima L. Hypothalamic-pituitary-adrenal axis dysregulation in healthy subjects undergoing mud-bath applications. Arthritis Rheum. 1995; 38 (5): 724–6. https://doi.org/10.1002/art.1780380530.

64. Sukenik S., Flusser D., Abu-Shakra M. The role of spa therapy in various rheumatic diseases. Rheum Dis Clin North Am. 1999; 25 (4): 883–97. https://doi.org/10.1016/s0889-857x(05)70108-3.

65. Olszewski W.L., Grzelak I., Ziolkowska A., Engeset A. Effect of local hyperthermia on lymph immune cells and lymphokines of normal human skin. J Surg Oncol. 1989; 41 (2): 109–16. https://doi.org/10.1002/jso.2930410211.

66. Lange U., Müller-Ladner U., Schmidt K.L. Balneotherapy in rheumatic diseases – an overview of novel and known aspects. Rheumatol Int. 2006; 26 (6): 497–9. https://doi.org/10.1007/s00296-005-0019-x.

67. Valitutti S., Castellino F., Musiani P. Effect of sulfurous (thermal) water on T lymphocyte proliferative response. Ann Allergy. 1990; 65 (6): 463–8.

68. Shani J., Barak S., Levi D., et al. Skin penetration of minerals in psoriatics and guinea-pigs bathing in hypertonic salt solutions. Pharmacol Res Commun. 1985; 17 (6): 501–12. https://doi.org/10.1016/0031-6989(85)90123-7.

69. Beer A.M., Junginger H.E., Lukanov J., Sagorchev P. Evaluation of the permeation of peat substances through human skin in vitro. Int J Pharm. 2003; 253 (1-2): 169–75. https://doi.org/10.1016/s0378-5173(02)00706-8.

70. Ardiç F., Ozgen M., Aybek H., et al. Effects of balneotherapy on serum IL-1, PGE2 and LTB4 levels in fibromyalgia patients. Rheumatol Int. 2007; 27 (5): 441–6. https://doi.org/10.1007/s00296-006-0237-x.

71. Bellometti S., Galzigna L. Serum levels of a prostaglandin and a leukotriene after thermal mud pack therapy. J Investig Med. 1998; 46 (4): 140–5.

72. Bellometti S., Richelmi P., Tassoni T., Bertè F. Production of matrix metalloproteinases and their inhibitors in osteoarthritic patients undergoing mud bath therapy. Int J Clin Pharmacol Res. 2005; 25 (2): 77–94.

73. Bellometti S., Cecchettin M., Galzigna L. Mud pack therapy in osteoarthrosis. Changes in serum levels of chondrocyte markers. Clin Chim Acta. 1997; 268 (1-2): 101–6. https://doi.org/10.1016/s0009-8981(97)00171-x.

74. Shehata M., Schwarzmeier J.D., Hilgarth M., et al. Effect of combined spa-exercise therapy on circulating TGF-beta1 levels in patients with ankylosing spondylitis. Wien Klin Wochenschr. 2006; 118 (9-10): 266–72. https://doi.org/10.1007/s00508-006-0560-y.

75. Ekmekcioglu C., Strauss-Blasche G., Holzer F., Marktl W. Effect of sulfur baths on antioxidative defense systems, peroxide concentrations and lipid levels in patients with degenerative osteoarthritis. Forsch Komplementarmed Klass Naturheilkd. 2002; 9 (4): 216–20. https://doi.org/10.1159/000066031.

76. Bender T., Bariska J., Vághy R., et al. Effect of balneotherapy on the antioxidant system – a controlled pilot study. Arch Med Res. 2007; 38 (1): 86–9. https://doi.org/10.1016/j.arcmed.2006.08.007.

77. State Register of the Russian Federation Resort Fund. Aerotherapy. Available at: https://kurort.minzdrav.gov.ru/articles/13/31 (in Russ.) (accessed 23.11.2024).

78. Razumov A.N., Ezhov V.V., Dovgan I.A., Ponomarenko G.N. Therapeutic effects of climototherapy: scientomatrical analysis of evidence-based studies. Problems of Balneology, Physiotherapy and Exercise Therapy. 2020; 97 (6): 59–67 (in Russ.). https://doi.org/10.17116/kurort20209706159.

79. State Register of the Russian Federation Resort Fund. Heliotherapy (climatotherapy). Available at: https://kurort.minzdrav.gov.ru/articles/13/29 (in Russ.) (accessed 23.11.2024).

80. Szenczi A., Peter I., Nusser N., et al. Is balneotherapy protective against oxidative stress? A pilot study. In Vivo. 2023; 37 (2): 858–61. https://doi.org/10.21873/invivo.13153.

81. Ozkurt S., Dönmez A., Zeki Karagülle M., et al. Balneotherapy in fibromyalgia: a single blind randomized controlled clinical study. Rheumatol Int. 2012; 32 (7): 1949–54. https://doi.org/10.1007/s00296-011-1888-9.

82. Polshchakova T., Gushcha S., Bevz L., Plakida A. The use of radon baths in the rehabilitation of patients with osteochondrosis. Eur Rev Med Pharmacol Sci. 2022; 26 (17): 6107–9. https://doi.org/10.26355/eurrev_202209_29627.

83. Kostrzon M., Sliwka A., Wloch T., et al. Subterranean pulmonary rehabilitation in chronic obstructive pulmonary disease. Adv Exp Med Biol. 2019; 1176: 35–46. https://doi.org/10.1007/5584_2019_354.

84. Katkhanova O.A., Sakhnov S.N. Natural physical factors of the Kuban’ Black Sea coastal area in the rehabilitative treatment of children with psoriasis and concomitant ophthalmoherpes. Problems of Balneology, Physiotherapy and Exercise Therapy. 2009; 2: 36–7 (in Russ.).

85. Larsen M.H., Krogstad A.L., Wahl A.K. Alexithymia, illness perception and self-management competency in psoriasis. Acta Derm Venereol. 2017; 97 (8): 934–40. https://doi.org/10.2340/00015555-2707.

86. Staalesen Strumse Y.A., Nordvåg B.Y., Stanghelle J.K., et al. Efficacy of rehabilitation for patients with ankylosing spondylitis: comparison of a four-week rehabilitation programme in a Mediterranean and a Norwegian setting. J Rehabil Med. 2011; 43 (6): 534–42. https://doi.org/10.2340/16501977-0804.

87. Langhorst J., Musial F., Klose P., Häuser W. Efficacy of hydrotherapy in fibromyalgia syndrome – a meta-analysis of randomized controlled clinical trials. Rheumatology. 2009; 48 (9): 1155–9. https://doi.org/10.1093/rheumatology/kep182.

88. Fedorovich S.V., Arsentjeva N.L. Speleotherapy: today, tomorrow! Health and Ecology Issues. 2008; 1: 88–94 (in Russ.). https://doi.org/10.51523/2708-6011.2008-5-1-19.

89. Ivanova O.N., Ivanova I.S. High-altitude speleotherapy in the treatment of bronchial asthma. Russian Journal of Immunology. 2024; 27 (1): 95–100 (in Russ.). https://doi.org/10.46235/1028-7221-13539-HAS.

90. Fainburg G.Z. The Permian “know-how” for health resort care by a sylvinite speleoclimatic salt caves. Health, Demography, Ecology of the Finno-Ugric Peoples. 2017; 2: 46–51.


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Sidorina N.G., Hajiyeva A.B., Vorobev A.V. Climatotherapy and landscape therapy as the most important rehabilitation methods for patients. Journal of Medical Rehabilitation. 2025;3(1):65-75. (In Russ.) https://doi.org/10.17749/2949-5873/rehabil.2025.42

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