Christian Roques

Cares
Balneotherapy is in France a medical treatment prescribed by doctors and reimbursed by the social security. Last years 590,000 persons attended a  reatment in a Spa resort. The cares are delivered under prescription and supervision of trained doctors according to national standards elaborated by the Department of Health under the supervision of the National Academy of Medicine. 12 therapeutic orientations are considered: rheumatic, respiratory, venous, cardiovascular, metabolic digestive and metabolic urinary, mouth conditions, dermatology, neurology, gynecology, pediatrics, stress related disorders. The Social Security spend for balneotherapy 290 Millions € yearly (0.14 % of Health Expenses). Balneotherapy employs, directly or indirectly,
100,000 persons.

Teaching
Balneotherapy is present in the doctors training second cycle ; different french universities deliver a post-graduate national two years training diploma of medical balneotherapy, hydrology and climatology.

Research: the French Association for Thermal Research (AFRETH) achievements, problems, solutions.
Scientific research in the field of balneotherapy, is implemented by different institutions (universities, teaching hospitals, private organisations, …).
Since its creation in 2005 October, the French Association for Thermal Research (AFRETH) fully implemented 13 call for projects. 136 Pre-projects were examined and 88 were made eligible to the programme; 65 were validated by the scientific committee on the basis of specialized advices by external independant experts. Finally 52 projects were accepted for financial support; globally 13 Millions € have been engaged and/or expanded. 20 clinical studies have been fully implemented and 11 have been published in english speaking journals with impact factor; 5 studies are still in the writing or submission time; the data of 4 studies are under assessment; 3 RCT are in progress; 8 RCT have still to be implemented.

The main scientific achievement can be summarized:
i) a more comfortable body due to less pain from musculo-skeletal origin (Thermarthrose, Rotatherm) or venous origin (Thermes&Veines) and more abilities
in patients with musculo-skeletal conditions (Thermarthrose, Rotatherm), or after treated breast cancer (Pacthe).
ii) a better weight in overweighted patients (Maathermes), in patients with metabolic syndrome (Prisme) or after treated breast cancer (Pacthe);
iii) a better controled stress in patients with generalised anxiety disorders (Stop-Tag), or after treated breast cancer (Pacthe)(patients improved depression and sleep disturbances), allowing a psychotropic drugs (benzodiazepins) withdrawal (Specth);
iv) a more healthy life style due to patients’ education in metabolic conditions (Prisme), after treated breast cancer (Pacthe), in chronic venous conditions (Veinothermes), in elder with cognitive decline risk (MAPT);
v) and at the end a better quality of life for patients after breast cancer (Pacthe), for patients with chronic cuff tendinitis (Rotatherm), chronic venous insufficiency (Thermes&Veines), generalised anxiety disorder (Stop-Tag).

But studies concerning respiratory diseases, sickleave patients with chronic low back pain, deep venous thrombosis sequelae, failed to enrol a sufficient number of patients and were non contributive.

Professor Christian-François ROQUES-LATRILLE MD is Corresponding Member of the National Academy of Medicine, Etus Professor of Physical & Rehabilitation Medicine Toulouse University, Past head of PRM Department Toulouse Teaching Hospital and Past head Physiotherapy Training Institute Toulouse. Dr. Roques is Specialist in Physical & Rehabilitation Medicine (1976), Rheumatology (1974), Pathology (1974), Immunology (1975), Allergology (1976), Public Health Medicine (1976) and Educational Council Foreign Medical Graduate (1971) and he’s President of the Scientific Committee French Association for Balneotherapy Research (AFRETH), of Dax Institute of Thermalism (Bordeaux University) and Vice-President of FEMTEC.