Human organism is highly sensitive to the change of the geophysical and meteorological conditions. Climatotherapy, which is substantiated by the direct influence of the climatic conditions on health, is based according to this feature of the human organism, when the affected physiological functions of the organism are restored with the help of the climatic factors.

 

With the effect of the climatic factors the resistance of human organism increases in general, at the functioning level of all the systems: systems of thermal adaptation – by aerotherapy, sympathico-adrenal neurohumoral regulation – by heliotherapy, system of the united functioning and training of blood formation, respiratory, locomotor and thermoregulation organs – by thalassotherapy etc. The effect of climatotherapy as of the stimulating treatment mostly depends on the climatic factors, which are used for active treatment. Temperature, pressure, humidity and air movement directly influence the human organism.

 

The main influence of climate on the human organism is characterized by the effect of weather in general. The complex methods of climatology distinguish the weather climate and the moment weather, which gives more accurate description of the meteorological factors change during the whole day and is of great importance for climatotherapeutic procedures. The assessment of the impact of weather and climate on the human organism is based on the heat exchange characteristics of a person with the environment: correspondingly they distinguish comfortable (favourable), subcomfortable (relatively favourable) and unfavourable weather.

 

Favourable weather is characterized by the equal movement of the main meteorological elements by the stable air masses and absence of frontal activity, interdiurnal variability of atmospheric pressure of not more than 4 mbar a day, air temperature of 2 °C a day, wind speed of not more than 3 m/sec with relative humidity from 55 to 85%.

The most favourable conditions for a person are the conditions, when relative humidity is 50%, temperature is 17-19 °C and wind speed doesn’t exceed 3 m/sec.

 

Relatively favourable weather is accompanied by the changes in the stable movement of meteorological elements, weak cyclonic activity with the pronounced frontal passage with the speed of up to 35-40 km/h, interdiurnal variability of atmospheric pressure (5-8 mbar a day), temperature (3-4 °C a day), relative humidity can be lower than 55% and higher than 85%, wind speed is more than 4 m/sec.

 

Unfavourable weather is characterized by sharp changes of meteorological elements by the pronounced cyclonic activity. Interdiurnal variability of atmospheric pressure is more than 8 mbar a day, temperature is more than 4 °C a day.

In the process of climatotherapy one should consider the changes of the rhythms of the human organism work by the change of climatic conditions in different seasons of the year and the difference of terms of beginning and duration of seasons of the year in different landscape conditions. The transition from season to season of the year is connected with the changes of climate-forming factors, and the weather conditions of the previous season determine the beginning of the next one. The beginning and the end of seasons of the year within Ukraine do not coincide neither with calendar dates, nor with astronomical ones. Limits for the conditional selection of the climatic seasons are the dates of stable transition of average daily temperature above 0 °C in winter and 15 °C in summer. These temperatures reflect the peculiarities of thermal conditions in concrete seasons of the year and condition their different duration in certain years.

 

The complex of remedial measures, the so-called meteoprophylaxis, aims at prevention of the development of seasonal and daily organism response to the change of the state of natural place of living. Medical assessment of weather and climate with the detection of meteorological situations, which cause the disturbances of level of health, is a defining factor of meteoprophylaxis. Disturbances of personal and social safety – meteopathic reactions – occur by certain values of meteorological and telluric factors (temperature is below 0 °C, relative humidity is above 85%, atmospheric pressure is below 100.5 and above 102 kPa, wind speed is more than 8 m/s, magnetic induction is above 100 mT) and also by abrupt changes of weather. Moreover, seasonal diseases and reactions are typical for different periods of the calendar year. All these forms climatopathology are connected with the disturbances of the existing mechanisms of individual adaptation, and elderly patients with weakened reactivity and high meteorolability often have them. Having meteorotropic properties, climatotherapeutic factors when applying incorrectly can cause similar reactions, playing the role of a provoking factor of disease exacerbation.

 

They distinguish 4 classes of diseases, connected with the effect of climatic and meteorological and geophysical factors:

It is accepted to classify the seasonal diseases according to the corresponding period of the year. UV-insufficiency of adults and especially children in winter in the northern and middle latitudes is directly connected with the season of winter solstice. Photodermatoses, conjunctivas, solar burns, overheating and pollinoses, caused by pollen of the flowering plants, appear in spring and summer. Cold diseases, chillblain, frostbite, cases of freezing and exacerbation of recurrent depressive disorders prevail in late autumn and winter. Diseases, connected with food poisoning, diseases, caused by poisonous animals and insects and enteric infections, connected with the reproduction of pathogenic microbes, usually apper in the warm season of the year.

 

It is recommended to classify the climatic seasons according to the volume of the used natural therapeutic factors for the resort practice. The complex application of the whole spectrum of methods climatotherapy – aero-, helio- and thalassotherapy – is possible in the summer season (the 15^th of June– the 15^th of September). The autumn season (the 15^th of September – the 15^th of December) is characterized by a combination of heliotherapy (with a gradual decrease of power of flux of UV radiation) and aerotherapy. The winter season (the 15^th of December – the 15^th of March) is limited mainly by aerotherapy. The possibility of taking procedures of heliotherapy together with aerotherapy gradually appears in the spring season (the 15^th of March – the 15^th of June).

 

The medical measures, which reduce dependence on seasonal factors, are the following: identification of patients, who have the history of seasonal pathology, providing planned, routine and urgent seasonal meteoprophylaxis during unfavourable weather, adequate prescription of the climatic, balneology, pelotherapy, apparatus methods of physiotherapy and exercise therapy in different seasons of the year, optimization of microclimate of health resorts buildings, prescription of physiologically based seasonal diet, medical adaptogens, and the formation of correct behaviour stereotypes with the acquisition of skills of the dosed thermal tempering, systemic physical trainings.

 

Climatotherapy is the use of different climatic factors and peculiarities of an a country climate for treatment of patients. The complex of climate and weather stimuli of a natural area of permanent residence of the patient or other natural areas (medical and health areas) affect the organism during this kind of treatment.

 

Climatic factors are the natural stimuli of the organism, affect all the types of its receptors, sensory structures and nerve conductors. They greatly determine the reactivity of the organism in the process of its phylogenesis. The formation of reactions in response occurs at all the levels of structural and functional organization of the organism – from afferent conductors to subcortical and cortical brain structures. Different mechanisms of regulation of functions have been produced in the organism under the influence of factors of different physical nature in the process of evolution. Interaction with the environment and adaptation to its conditions is an integral component of the organism existence.

In different combinations the climatic factors can be effectively applied for stimulation of long-term adaptation mechanisms of the organism. Conditionally they distinguish aerotherapy, heliotherapy and thalassotherapy.

 

AEROTHERAPY (air treatment) is the therapeutic use of fresh air in the open areas. It includes twenty-four-hour aerotherapy and air baths (air effect on the completely or partially bare patient).

Twenty-four-houraerotherapy is the long-term effect of fresh air on the patient during walks and sleep in special climatic pavilions and verandas. Physiological and therapeutic effect of this method is conditioned by cooling a person and increased provision of the organism with oxygen.

Excitation by cold air of mechano- and thermoreceptors of skin and mucous tunics of the upper air passages leads to reflex change of the respiratory pattern and structure of cardiac cycle with the rise of oxygen partial pressure in alveoli. Air ions, which are in the air, terpenes and ozone increase the oxidation potential of oxygen that is absorbed by blood. The restructuring of compensatory reactions of respiration system, blood circulation and thermoregulation takes place under the influence of cold atmospheric air

The thermoregulator tone of neck, body and extremities muscles increases during the action of alternating cold and warm air. The heat production of the organism increases in the result of contractile thermogenesis increase. During the repeated procedures sensitivity of thermal sensor structures of bronchi decreases and positive conditional cold factor reflexes are formed. Twenty-four-hour aerotherapy gains particular importance in the cold season of the year, when patients spend much time in premises.

Therapeutic effects: ventilation-perfusion, restorative, act-protective, neuromyostimulating and vasoactive.

Indications: diseases of myocardium and cardiac valvate apparatus without rhythm disturbance, atherosclerosis of coronary, cerebral and peripheral vessels, coronary heart disease, exertional angina of the 1^st-2^nd functional class, neurocirculatory dystonia of all the forms, essential hypertension of the 1^st-2^nd stage, chronic respiratory diseases (bronchitis, tracheitis, pneumonia) in the phase of remission; pulmonary tuberculosis in the phase of resolution and induration, chronic diseases of digestive and metabolism apparatus out of exacerbation; functional disorders of nervous system not pronounced manifestations, meteopathic reactions.

Contraindication: exacerbations of chronic diseases of peripheral nervous system (neuritis, neuralgia, radiculitis), joints and kidneys, chronic diseases of cardiovascular system with blood circulation insufficiency of the 1^st-3^rd stage, respiratory apparatus with pulmonary insufficiency above the 2^nd stage, frequent recurrent angina, pneumonia, increased sensitivity to cold of 60-year-old and older persons.

 

Air cooling of skin receptors of open body areas and nerve endings mucous tunics of the upper air passages increases the threshold of sensitivity of receptors and trains the mechanisms of thermoregulation, which contributes to tempering of the organism. The lowering of cutaneous coverings temperature and the increase of muscles thermal production take place.

According to V.G. Boksha (1968), aerotherapy, when following the main methodic conditions (acclimatization, gradual regular cold loads, control of health etc.), improves the efficiency of sanatorium treatment by 30%. Combination of aerotherapy with the regular dosed walks along flat country and health paths favour the increase of effectiveness of this type of treatment. When providing aerotherapy in the forest-park area the evident psychoemotional effect is observed. Picturesque views favourably affect the central nervous system (“landscape reflex”).

Aerotherapy is well-compatible with all the physical therapeutic factors. Twenty-four-hour aerotherapy is combined with electrosleep therapy, heliotherapy (in air radiation therapy rooms), exercise therapy (gymnastic exercises).

Therapeutic effects: tempering, immunostimulating, act-protective, ventilation-perfusion, neuromyostimulating, vasoactive and metabolic.

Indications: diseases of myocardium and cardiac valvate apparatus without dysrhythmia, coronary heart disease, exertional angina of the 1^st-2^nd functional class, essential hypertension of the 1^st-2^nd stage, neurasthenia. Chronic bronchopulmonary diseases in the phase of remission, chronic forms of pulmonary tuberculosis, bronchial asthma with rare attacks, thyrotoxicosis, slight form; anaemia; gastritis, gastric ulcer disease out of the aggravation phase, chronic pyelonephritis and glomerulonephritis, diseases of the skin and upper air passages.      Contraindications: acute respiratory diseases, bronchial asthma with frequent attacks, exacerbation of chronic diseases of internal organs, musculoskeletal system and peripheral nervous system, cardiopulmonary decompensation higher than the 2^nd stage.

 

20-30% of UVA-rays penetrate into dermis due to absorption, reflection and dispersion with the less losses, and about 1% of the total energy reaches the hypodermic tissue.

 

 

 

 

 

Indications: hypovitaminosis of vitamin D; initial manifestations of atherosclerosis, arterial hypertension of the 1^st-2^nd stage; rheumatism in the inactive stage, inflammatory diseases of lungs, gastrointestinal tract, kidneys, joints and nervous system out of aggravation; gout, obesity, depressions and seasonal affective disorders; dermatological diseases (psoriasis, atopic dermatitis, scleroderma, ichthyosis); local heliotherapy of lumbar region, shown by chronic lumbodynia and residual phenomena of uncomplicated glomerulonephritis.

 

 

 

 

 

The techniques of thalassotherapy are compatible with many physical therapeutic factors, primarily with other methods of climatotherapy and exercise therapy. One should avoid the sea bathings in the days of prescribing balneological procedures and general mud applications, and alternate them in the course of treatment. The dosed sea bathings are prescribed since 1-2 years old and have no age limits. According to V.G. Boksha (1983), the improvement of breathing by climatotherapy without the use of special procedures is noted in 43.4%, by including the sleep in the air – 56.1%, by the sea aerotherapy – 68.5%, by the sea aerotherapy with bathings – 70%. The combination of thalassotherapy with other methods of climatotherapy and all the factors of the sea (landscape therapy, eating seafood and boating) favours the efficiency of this type of treatment.

Indications: chronic inflammatory diseases out of aggravation (bronchitis, pneumonia, gastritis); bronchial asthma, CHD, exertional angina of the 1^st-2^nd functional class, postinfarction cardiosclerosis (1 year); arterial hypertension of the 1^st-2^nd stage; consequences of injuries and diseases of musculoskeletal apparatus and peripheral nervous system.

 

MICROСlimatotherapy is the use of special climatic factors, typical only for a certain area, with the medical aim. Along with the above mentioned common types of climatotherapy, there are special unique microclimatic conditions for a set of techniques of treatment in some regions of Ukraine. The similar techniques are the following:

 

 

Aerophytotherapy is the inhalation of the air,which is saturated with volatile aromatic substances (volatile production, terpenes, essential oils), discharged by plants. Plants decontaminate the air, ionize it, clean from dust, neutralize the chemically aggressive substances and so on. Aerophytotherapy is provided in the park areas, planted with representatives of certain flora (for example, bay laurel and pine – for bactericidal effect; rosemary – for restorative effect; lavender – for sedative effect etc.), where one can go for a walk, relax on a bench, do respiratory gymnastics. There are scientific grounded recommendations on forming park areas as medical ones, which allow to create alleys, walking paths, parterres, places to stay for patients with concrete diseases of respiratory apparatus and cardiovascular system. This important role here is played by the emotional effect of natural or twenty-four-hour aerotherapy, an essential element of which is the considered organization of the recreational process: accompaniment of groups of patients by medical personnel to provide the requirements for taking the procedures (keeping the rate of walking, the respiratory rhythm, the time of stay in the zone of specific aerotherapy etc.), presence of an organizer of cultural activities or a guide, who can professionally convey an interesting information about trees, grasses, flowers and their role in formation of air. The chaotic development of recreational park areas, carried out during the last years, makes the providing of such medical measure more problematical. Thus, the reasonable use of landscape areas favours their preservation and expansion as the most important component of health and spa complexes.

For reproduction of the effects of aerotherapy the rooms of aromatherapy (see “phytoaromatherapy” in the chapter “alternative traditional and complementary methods of treatment”) have spread in the recent years.

 

Sea twenty-four-houraerotherapy is carried out at the Black Sea and Azov seaside resorts as the daylight stay and night sleep in close proximity to the sea at the coastal beach zone in climatic pavilions or in the open sea at the appropriate swimming means (boats, rafts, sailing yachts). The sea air, saturated with negative ions, ozone (content is 2-3 times higher than in the continental air), volatile production of seaweeds, particles of salts of Na, Ca, Mg (“ionic reflexes from mucous membranes” of upper air passages), J and Br (content is 12 times higher than in the continental air!) affect the organism of a patient. Beach of the sea is the unique inhalatorium.

 

Twenty-four-hour speleotherapy is the treatment of bronchopulmonary system in the natural conditions of salt and underground mines (Solotvyno in Uzhhorod region and Artemivsk in Donetsk region), as well as of a number of karstic caves. Fine-dispersed aerosols of salts of Nа, Ca, Mg and other necessary for the organism chemical elements are formed. Bacterial flora and allergens are absent in such caves. Air with fine-dispersed particles of salt penetrates to the level of bronchial tubes, causing the increase the movement amplitude of lashes of ciliated epithelium, thereby enabling the mucus and secretion discharge, which are in the respiratory tracts. The function of external respiration changes greatly – the maximum lung ventilation and their vital capacity increase. Respiration becomes clearer, rales and cough disappear. In addition, the “salt cloak” that is formed on the surface of the body, positively affects the processes of dermal respiration, providing general regulating effect on many organism functions. Unusual environment of underground hospital favours the activation of psychoemotional sphere. In the result of course of speleotherapy the degree allergization of the organism greatly decreases and immunity to viral bacterial infections, effect of toxins and other environmentally harmful substances rises.

In the sanatorium conditions, together with the similar air conditioning, establishment of the corresponding artificial medical environment is possible (see “Treatment of artificially modified air” in the chapter “apparatus physiotherapy”). Artificial speleotherapy, suggested for the first time by professor M.D. Torokhtin (1977), is the most methodically proven and effective.