Physical rehabilitation of long-term hypomobilized subjects with complex wounds: multidisciplinary approach from wound healing to balneokinesis in a sulfur SPA facility

Chronic or complex lower-limb wounds often lead to prolonged immobility and functional decline due to pain, restrictive dressings, and delayed rehabilitation. Extended inactivity results in muscle atrophy, joint stiffness, and reduced mobility, while related conditions such as osteomyelitis, osteoporosis, and algodystrophy benefit from gradual mechanical loading. Aquatic therapy facilitates progressive weight-bearing and pain relief; however, conventional chlorinated pools may irritate fragile or recently healed skin. Balneokinesis—aquatic rehabilitation performed in sulphurous thermal water—offers a safer, more therapeutic alternative, as hydrogen sulfide (H₂S) supports healing, reduces inflammation, and promotes tissue regeneration.