Thermal Treatment in the Recovery from Strokes (Cerebrovascular Accidents)

Strokes (Cerebrovascular Accidents - CVAs) occur as a result of a lack of oxygenation to brain cells when the blood supply to a part of the brain is suddenly interrupted, which can even be fatal.

They can be ischemic, when a blood clot blocks a blood vessel in the brain (the most common type), or hemorrhagic, when an artery in the brain ruptures, causing bleeding inside the brain tissue.

If a stroke does not result in a fatal event, it can leave behind more or less severe damage (temporary or permanent cognitive, sensory, motor, and autonomic changes), depending on the affected area of the brain.

These injuries cause complications such as spasticity (involuntary muscle stiffness), neuropathic pain, limited mobility, muscle weakness, and circulatory disorders, having a profound impact on the life of the patient and their family.

Recovery from a stroke sometimes requires a long, multidisciplinary, and continuous process.

In addition to correcting and treating the usually associated cardiovascular risk factors (hypertension, diabetes mellitus, dyslipidemia, obesity, and smoking), rehabilitation approaches can be utilized.

Among complementary approaches to intensive rehabilitation, thermal treatment—specifically using the mineral-medicinal waters of Termas de Chaves—emerges as a fundamental ally.

Symptoms and Sequelae of Strokes

The repercussions of a brain vascular injury depend on the location, extent, and severity of the lesion (the area of the brain affected), manifesting differently from person to person.

The most common symptoms and complications include:

• Loss or decrease in mobility and muscle strength: paresis (partial loss of muscle strength) or plegia (paralysis – loss of movement) of the limbs;
• Spasticity and muscle stiffness: involuntary contractions and hypertonia that hinder posture and movement;
• Chronic and neuropathic pain: burning sensations, "pins and needles," shock-like feelings, or deep pain that is difficult to manage;
• Sensory changes: decrease or alteration in the perception of touch (hypoesthesia or hyperesthesia), pain (hyperalgesia), and temperature;
• Circulatory and trophic changes: lower limb edema and greater susceptibility to joint stiffness.

These manifestations significantly compromise autonomy, daily tasks, and the overall quality of life of patients.

How Thermal Treatment Acts in Post-Stroke Recovery

In the context of brain injuries after a stroke, thermalism acts not as a substitute for physiotherapy or medical follow-up, but rather as an invaluable complementary therapy. Its effectiveness is maximized when integrated into a continuous Physical Medicine and Rehabilitation program.

Thermal treatment is based on harnessing the physical and chemical properties of mineral-medicinal thermal waters, such as the hyperthermal, bicarbonate-rich, and hypermineralized waters of Termas de Chaves.

Hydrotherapy in a thermal environment takes advantage of warm water temperatures (generally between 34°C and 38°C) and the physical forces of buoyancy and hydrostatic pressure.

Immersion in thermal water provides:

• Reduced gravitational impact: the body "loses weight" in water, facilitating movements that would be impossible on land;
• Deep neuromuscular relaxation: heat reduces excessive muscle tone and acts directly to decrease spasticity;
• Stimulation of blood circulation: vasodilation improves tissue perfusion and reduces edema (swelling) in the affected limbs;
• Sensory stimulation: constant contact of warm water with the skin provides beneficial proprioceptive and tactile stimulation for neuronal reorganization.

Thus, the aquatic environment creates a safe and comfortable setting for motor re-education and the preservation of joint range of motion.

Benefits of Thermal Treatment in Post-Stroke Recovery

The regular application of appropriate thermal treatments provides multiple benefits for patients who have suffered a stroke, including:

• Control and relief of chronic and neuropathic pain;
• Reduction of spasticity and muscle spasms;
• Gain in joint range of motion and prevention of fixed contractures;
• Improvement of peripheral circulation and reduction of edemas;
• Facilitation of balance, posture, and mobility training;
• Improvement of walking capacity and motor functionality;
• Reduction in the need for muscle relaxants and analgesic medication;
• Improved mood, stress reduction, and a positive impact on mental health.

The therapeutic and anti-inflammatory properties of the waters at Termas de Chaves offer valuable support for functional recovery and daily patient comfort.

Scientific Evidence and Efficacy of Thermal Treatment

Studies in neurological rehabilitation and medical hydrology support that thermal hydrotherapy has a substantial positive impact on treating these patients.

Evidence demonstrates that combining heat, mineralization, and exercise in a thermal aquatic environment contributes to a sustained reduction in pain and stiffness, with visible improvements in functional autonomy.

Results vary depending on the level and extent of the brain injury, the time elapsed since the stroke, and adherence to the therapeutic plan.

What Should I Know Before Starting Treatment?

Before starting any thermal treatment plan, consulting a hydrologist physician is essential.

The hydrologist physician will perform a detailed clinical evaluation of the patient's neurological and general condition, defining a safe, personalized thermal plan aligned with the rest of the rehabilitation team.

Thermal treatment should be viewed as a structured complement to the regular rehabilitation plan.

Advantages of Thermal Treatment Compared to Other Approaches

When compared or combined with exclusively pharmacological or conventional interventions, thermal treatment offers clear advantages:

• Natural, non-invasive, and highly tolerated approach;
• Pain-free motor exercise without joint impact, thanks to buoyancy;
• Absence of side effects associated with long-term medication use;
• Lasting and progressive beneficial effects with regular thermal cycles;
• Substantial improvement in overall well-being and overall quality of life.

Article originally published in Health and Well-Being - www.saudebemestar.pt and written in partnership with Termas de Chaves.