EFFECT OF HAMMAM EXPERIENCE ON GENERAL HEALTH AND PERCEIVED WELL-BEING

ANALYSIS OF THE EFFECT OF HAMMAM EXPERIENCE ON GENERAL HEALTH AND PERCEIVED WELL-BEING COMPARED TO MASSAGE AND PLACEBO : A RANDOMIZED CROSS-SECTIONAL STUDY.

The main objective of this study is to analyze the effect of a Hammam experience, a massage experience and a placebo in a healthy general population on their general health and perception of well-being, assessed with biophysiological, physical and psychoemotional markers, and its impact on chronic stress. Our hypothesis is that the Hammam experience will produce a more favorable acute (just after the experience) and subacute (24 hours after the experience) response on the study variables than the other interventions with at least a moderate effect size.

Study Overview

• Status: Completed
• Conditions: Wellness; General Health; Chronic Stress
• Intervention / Treatment: Other: Hamman experience; Other: Massage; Other: Placebo Comparator

• Study Type: Interventional
• Enrollment (Actual): 22
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Spain
  • Granada, Spain, 18016
    • University of Granada

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Men and women (50%) 25-65 years old
• No metabolic risk.
• Resident in the province of Granada.
• Socio-economic level: medium-high
• Experience in self-care
• Spanish level C2

Exclusion Criteria:

• Pregnancy
• Participation in treatments and relaxation techniques or taking medication (anxiolytics) frequently (≥ 1 per week) in the last 12 months
• Medical situations limiting participation in the study: acute musculoskeletal pathologies (fractures, wounds, etc.) or local inflammatory processes, diagnosed psychiatric disease, vascular diseases (thrombosis), contagious diseases, fever, thermoregulation problems, incontinence, craniocerebral trauma or infarction (< 6 months), thermal allergies, hypertension, or any uncontrolled systemic disease).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Single

Number of Arms

6

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Arm 1 (ABC); Participants in this arm will rotate through three treatments (Treatment A Hamman experience and massage, Treatment B massage only, and Treatment C placebo) in a randomized sequence. Each treatment will be separated by a washout period to minimize carryover effects. All participants will experience each treatment at different periods, serving as their own control.	Other: Hamman experience; There will be a circuit in the Hammam Al Andalus baths with baths in all pools (warm, hot or cold water) and sauna for 30 minutes. The time in each pool will be determined by the sensation and tolerance of each participant. In addition, participants will receive foam with aromatic oils on the participant's body (arms, trunk and legs). This foam will be left for about 10 minutes on the participant's body, while a manual body therapy is performed. The force to be applied will be very weak, a superficial rubbing will be performed to prepare the tissue, followed by a maintained pressure and then sliding pressures are performed. The application time should not exceed 15 minutes.; Other Names: Balneotherapy and massage; Other: Massage; Duration of 45 minutes. A complete dorsal and ventral body massage will be performed, with superficial maneuvers at a slow pace of traditional massage.; Other: Placebo Comparator; The person will be instructed to stay for 45 minutes during which he/she will receive different electrotherapy techniques with the devices disconnected, a mobile device that simulates a beep will be placed so that the patient believes that the device is connected.
Experimental: Arm 2 (ACB)	Other: Hamman experience; There will be a circuit in the Hammam Al Andalus baths with baths in all pools (warm, hot or cold water) and sauna for 30 minutes. The time in each pool will be determined by the sensation and tolerance of each participant. In addition, participants will receive foam with aromatic oils on the participant's body (arms, trunk and legs). This foam will be left for about 10 minutes on the participant's body, while a manual body therapy is performed. The force to be applied will be very weak, a superficial rubbing will be performed to prepare the tissue, followed by a maintained pressure and then sliding pressures are performed. The application time should not exceed 15 minutes.; Other Names: Balneotherapy and massage; Other: Massage; Duration of 45 minutes. A complete dorsal and ventral body massage will be performed, with superficial maneuvers at a slow pace of traditional massage.; Other: Placebo Comparator; The person will be instructed to stay for 45 minutes during which he/she will receive different electrotherapy techniques with the devices disconnected, a mobile device that simulates a beep will be placed so that the patient believes that the device is connected.
Experimental: ARM 3 (BAC)	Other: Hamman experience; There will be a circuit in the Hammam Al Andalus baths with baths in all pools (warm, hot or cold water) and sauna for 30 minutes. The time in each pool will be determined by the sensation and tolerance of each participant. In addition, participants will receive foam with aromatic oils on the participant's body (arms, trunk and legs). This foam will be left for about 10 minutes on the participant's body, while a manual body therapy is performed. The force to be applied will be very weak, a superficial rubbing will be performed to prepare the tissue, followed by a maintained pressure and then sliding pressures are performed. The application time should not exceed 15 minutes.; Other Names: Balneotherapy and massage; Other: Massage; Duration of 45 minutes. A complete dorsal and ventral body massage will be performed, with superficial maneuvers at a slow pace of traditional massage.; Other: Placebo Comparator; The person will be instructed to stay for 45 minutes during which he/she will receive different electrotherapy techniques with the devices disconnected, a mobile device that simulates a beep will be placed so that the patient believes that the device is connected.
Experimental: Arm 4 (BCA)	Other: Hamman experience; There will be a circuit in the Hammam Al Andalus baths with baths in all pools (warm, hot or cold water) and sauna for 30 minutes. The time in each pool will be determined by the sensation and tolerance of each participant. In addition, participants will receive foam with aromatic oils on the participant's body (arms, trunk and legs). This foam will be left for about 10 minutes on the participant's body, while a manual body therapy is performed. The force to be applied will be very weak, a superficial rubbing will be performed to prepare the tissue, followed by a maintained pressure and then sliding pressures are performed. The application time should not exceed 15 minutes.; Other Names: Balneotherapy and massage; Other: Massage; Duration of 45 minutes. A complete dorsal and ventral body massage will be performed, with superficial maneuvers at a slow pace of traditional massage.; Other: Placebo Comparator; The person will be instructed to stay for 45 minutes during which he/she will receive different electrotherapy techniques with the devices disconnected, a mobile device that simulates a beep will be placed so that the patient believes that the device is connected.
Experimental: Arm 5 (CAB)	Other: Hamman experience; There will be a circuit in the Hammam Al Andalus baths with baths in all pools (warm, hot or cold water) and sauna for 30 minutes. The time in each pool will be determined by the sensation and tolerance of each participant. In addition, participants will receive foam with aromatic oils on the participant's body (arms, trunk and legs). This foam will be left for about 10 minutes on the participant's body, while a manual body therapy is performed. The force to be applied will be very weak, a superficial rubbing will be performed to prepare the tissue, followed by a maintained pressure and then sliding pressures are performed. The application time should not exceed 15 minutes.; Other Names: Balneotherapy and massage; Other: Massage; Duration of 45 minutes. A complete dorsal and ventral body massage will be performed, with superficial maneuvers at a slow pace of traditional massage.; Other: Placebo Comparator; The person will be instructed to stay for 45 minutes during which he/she will receive different electrotherapy techniques with the devices disconnected, a mobile device that simulates a beep will be placed so that the patient believes that the device is connected.
Experimental: Arm 6 (CBA)	Other: Hamman experience; There will be a circuit in the Hammam Al Andalus baths with baths in all pools (warm, hot or cold water) and sauna for 30 minutes. The time in each pool will be determined by the sensation and tolerance of each participant. In addition, participants will receive foam with aromatic oils on the participant's body (arms, trunk and legs). This foam will be left for about 10 minutes on the participant's body, while a manual body therapy is performed. The force to be applied will be very weak, a superficial rubbing will be performed to prepare the tissue, followed by a maintained pressure and then sliding pressures are performed. The application time should not exceed 15 minutes.; Other Names: Balneotherapy and massage; Other: Massage; Duration of 45 minutes. A complete dorsal and ventral body massage will be performed, with superficial maneuvers at a slow pace of traditional massage.; Other: Placebo Comparator; The person will be instructed to stay for 45 minutes during which he/she will receive different electrotherapy techniques with the devices disconnected, a mobile device that simulates a beep will be placed so that the patient believes that the device is connected.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Balance of the autonomic nervous system upon waking	Evaluated through heart rate variability upon waking up. It will always be performed under the same conditions in an unlit, quiet environment without noise/distractions, with the person in supine position and after emptying the bladder. A total time of 5 min will be recorded through H-10 polar band.	Measurement 1: Upon waking on the session day (6:00-7:00 a.m.); Measurement 2: 30 minutes before session (8:00 a.m.); Measurement 3: 5 minutes after session (10:00 a.m.); Measurement 4: Upon waking the day after session (6:00-7:00 a.m.); Measurement 5: 2

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sleep satisfaction	Assessed through a Likert scale in which 0 corresponds to the option "Not all all satisfactory" and 10 with "Very satisfactory"	Measurement 2: 30 minutes before session (8:00 a.m.); Measurement 5: 24 hours post-session (8:00 a.m.).
Hours of sleep	Assessed through an open question in which participants are asked "What time did you go to bed to sleep?", "What time did you wake up in the morning?" and "How many hours and minutes do you think you slept in total at night?"	Measurement 2: 30 minutes before session (8:00 a.m.); Measurement 5: 24 hours post-session (8:00 a.m.).
Perception of well-being	Assessed with the EBS-8 subjective well-being scale, which assesses the two components of well-being: life satisfaction and positive affect and with a visual analog scale 0-10.	Measurement 2: 30 minutes before session (8:00 a.m.); Measurement 3: 5 minutes after session (10:00 a.m.); Measurement 5: 24 hours post-session (8:00 a.m.).
Mood	The Mood Rating Scale (EVEA) will be used, which evaluates mood states with a range from 0 to 10 and as a time reference "right now". It consists of 4 subscales: sadness-depression, anxiety, anger-hostility and joy.	Measurement 2: 30 minutes before session (8:00 a.m.); Measurement 3: 5 minutes after session (10:00 a.m.); Measurement 5: 24 hours post-session (8:00 a.m.).
Mental agility	Assessed by the "Trail Marking Test", which assesses t used to evaluate attention, flexibility of thought and visuospatial ability. It consists of two parts. In both cases, the subject will need a pencil and the evaluator a stopwatch, counting the execution time for each of the parts as soon as the pertinent indications have been given. In part A, the participant will join in ascending order all the numbers from 1 to 25 arranged on a sheet of paper. In exercise B, the process will be repeated, but alternating letters and numbers in alphanumeric order. In both cases, the time spent will be quantified.	Measurement 2: 30 minutes before session (8:00 a.m.); Measurement 3: 5 minutes after session (10:00 a.m.); Measurement 5: 24 hours post-session (8:00 a.m.).
Distress	Assessed through a distress thermometer, a likert scale in which 0 corresponds to the option "No distress" and 10 with "Extreme distress"	Measurement 2: 30 minutes before session (8:00 a.m.); Measurement 3: 5 minutes after session (10:00 a.m.); Measurement 5: 24 hours post-session (8:00 a.m.).
Flexibility	The "sit and reach" test will be performed, for the evaluation of flexibility in which the subject, who is seated on the edge of a chair (placed against a wall for safety reasons), and one foot resting on the sleep, will extend the other leg forward with the knee straight, the heel resting on the sleep and the ankle at 90º, placing one hand on top of the other with the tips of the central fingers equal. The participant will be instructed to inhale and, on exhalation, extend the hand forward toward the toes by bending at the hip. The distance will be measured between the fingertips and toes so that, if the fingertips touch the toes, the score is 0, if they do not touch, the resulting distance in cm will be negative and, if they overlap, we are talking about a distance in cm positive.	Measurement 2: 30 minutes before session (8:00 a.m.); Measurement 3: 5 minutes after session (10:00 a.m.); Measurement 5: 24 hours post-session (8:00 a.m.).
Functional capacity	With the sit-to-stand test 30 seconds, which measures how many times a person can transition from sitting in a chair to standing and back to sitting within 30 seconds.	Measurement 2: 30 minutes before session (8:00 a.m.); Measurement 3: 5 minutes after session (10:00 a.m.); Measurement 5: 24 hours post-session (8:00 a.m.).
Fatigue	After completing the 30-second sit-to-stand test, participants rate their perceived level of fatigue using the Borg CR10 scale. This scale ranges from 0 (no fatigue at all) to 10 (extreme fatigue) and provides a subjective measure of exertion following the activity.	Measurement 2: 30 minutes before session (8:00 a.m.); Measurement 3: 5 minutes after session (10:00 a.m.); Measurement 5: 24 hours post-session (8:00 a.m.).
Overall stress regulation	Salivary samples will be collected first thing in the morning, using a timer and ensuring the entire sample is collected within three minutes. Without ingestion of caffeine and/or stimulant substances 12 hours before, as well as with complete oral hygiene (dental brushing and use of mouthwash, preferably) the night before. Salivary samples (400µL) will be collected in specific collection kits for 2ml salivary sample and cryovials (Salimetrics, LLC, Carlsbad, United States), to proceed to their subsequent immediate freezing at -80ºC until the pertinent analysis of cortisol through ELISA is performed.	Measurement 1: Upon waking on the session day (6:00-7:00 a.m.); Measurement 3: 5 minutes after session (10:00 a.m.); Measurement 4: Upon waking the day after session (6:00-7:00 a.m.).
Systolic blood pressure	Measured with the patient seated after at least 10 minutes of rest using a sphygmomanometer.	Measurement 2: 30 minutes before session (8:00 a.m.); Measurement 3: 5 minutes after session (10:00 a.m.); Measurement 5: 24 hours post-session (8:00 a.m.).
Diastolic blood pressure	Measured with the patient seated after at least 10 minutes of rest using a sphygmomanometer.	Measurement 2: 30 minutes before session (8:00 a.m.); Measurement 3: 5 minutes after session (10:00 a.m.); Measurement 5: 24 hours post-session (8:00 a.m.).
Heart rate	Measured with the patient seated after at least 10 minutes of rest using a sphygmomanometer	Measurement 2: 30 minutes before session (8:00 a.m.); Measurement 3: 5 minutes after session (10:00 a.m.); Measurement 5: 24 hours post-session (8:00 a.m.).
Blood oxygen saturation	Measured using a pulse oximeter placed on the fingertip, ensuring the patient is seated and at rest for at least 10 minutes prior to measurement.	Measurement 2: 30 minutes before session (8:00 a.m.); Measurement 3: 5 minutes after session (10:00 a.m.); Measurement 5: 24 hours post-session (8:00 a.m.).

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Attitude and beliefs towards holistic treatment	Through the Complementary and Alternative Medicine Health Belief Questionnaire (CHBQ), validated to Spanish.It has 10 items and addresses perception of the effectiveness of alternative therapies; willingness to use holistic treatments; and trust in complementary medicine practitioners.	Measurement 0: At enrollment
Previous experience participating in holistic therapeutic modalities.	Assessed through a yes/no questionnaire to determine prior experiences, followed by an open-ended question to record the type of modality if applicable	Measurement 0: At enrollment
Level of perceived stress	The Perceived Stress Scale (PSS-10) is a self-assessment tool used to measure the level of perceived stress in individuals in his or her life during the past month. The scale consists of 10 questions that explore different aspects of perceived stress, such as how often individuals feel that their life is out of control, feel nervousness, or are unable to cope with their responsibilities. The total score is obtained by summing the item responses. Some questions are positively worded and are reverse scored.	Measurement 0: At enrollment
Resilience	The Connor-Davidson Resilience Scale (CD-RISC) is a self-assessment tool that measures a person's ability to overcome adversity. It is composed of 25 items that are answered on a 5-point Likert scale, ranging from 0 (never) to 4 (almost always). Total scores can range from 0 to 100, with higher scores indicating greater resilience.	Measurement 0: At enrollment
Age	Will be collected using an open-ended questionnaire where participants will provide their exact age	Measurement 0: At enrollment
Place of Residence	Will be collected using an open-ended questionnaire where participants will provide their Place of Residence	Measurement 0: At enrollment
Employment status	Will be assessed through a multiple-choice questionnaire, allowing participants to select the most appropriate response for their situation.	Measurement 0: At enrollment
Marital Status	Will be assessed through a multiple-choice questionnaire, allowing participants to select the most appropriate response for their situation.	Measurement 0: At enrollment
Level of Education	Will be assessed through a multiple-choice questionnaire, allowing participants to select the most appropriate response for their situation.	Measurement 0: At enrollment
Family Income	Will be collected using a range-based question, where participants will indicate the income bracket that best reflects their household's monthly or annual income	Measurement 0: At enrollment
Height	Measured using a calibrated stadiometer with participants standing upright and barefoot	Measurement 0: At enrollment
Weight	Measured using digital scale, with participants standing barefoot, and in light clothing.	Measurement 0: At enrollment
Waist Circumference	Measured using a non-stretchable tape, ensuring standard anatomical landmarks are used: between last ribs and iliac creast, at the narrowest point	Measurement 0: At enrollment
Hip Circumference	Measured using a non-stretchable tape, ensuring standard anatomical landmarks are used: above the greater trochanter	Measurement 0: At enrollment
Waist-Hip Ratio	Calculated by dividing waist circumference by hip circumference	Measurement 0: At enrollment
Drug consumption	These behaviors will be assessed through a structured questionnaire, including frequency and quantity of use over the past months.	Measurement 0: At enrollment
Sedentary Behavior	Measured using questions about time spent sitting or reclining during typical weekdays and weekends, excluding sleep hours	Measurement 0: At enrollment
Physical Activity Levels	Physical activity will be assessed using the International Physical Activity Questionnaire (IPAQ), which captures the type, frequency, and duration of physical activities performed weekly, categorized into light, moderate, and vigorous intensity levels.	Measurement 0: At enrollment

Collaborators and Investigators

• Sponsor: Universidad de Granada
• Collaborators: AL ÁNDALUS BAÑOS ÁRABES (Hammam Granada)

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2024
• Primary Completion (Actual): April 30, 2025
• Study Completion (Actual): November 15, 2025

Study Registration Dates

• First Submitted: December 7, 2024
• First Submitted That Met QC Criteria: January 16, 2025
• First Posted (Actual): January 22, 2025

Study Record Updates

• Last Update Posted (Actual): November 18, 2025
• Last Update Submitted That Met QC Criteria: November 15, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: massage; wellness; balneotherapy; chronic stress; general health; hamman
• Additional Relevant MeSH Terms: Therapeutics; Complementary Therapies; Physical Therapy Modalities; Rehabilitation; Therapy, Soft Tissue; Musculoskeletal Manipulations; Massage; Balneology
• Other Study ID Numbers: HAM24

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No