Tskaltubo and the Future of Structured Spa-Based Therapeutic Systems: Integrating Radon Balneotherapy, Rehabilitation, and Preventive Health in Evidence-Based Care

Tskaltubo and the Future of Structured Spa-Based Therapeutic Systems: Integrating Radon Balneotherapy, Rehabilitation, and Preventive Health in Evidence-Based Care This commentary examines the role of structured spa-based therapeutic systems (SSTS) as an emerging framework for integrating traditional balneotherapy into modern evidence-based healthcare. Against the backdrop of increasing chronic disease burden, population ageing, and healthcare system fragmentation, the paper explores how multimodal, environment-based interventions may contribute to rehabilitation, recovery, and preventive health. Using the Tskaltubo spa system in Georgia as a case study, the article analyzes its historical development, physicochemical characteristics, and clinical applications. Particular attention is given to radon balneotherapy, which represents a unique intersection between potential therapeutic benefit and established radiation risk. The paper critically evaluates biological mechanisms, clinical evidence, safety considerations, and regulatory challenges, highlighting the need for standardized protocols, high-quality clinical trials, and system-level integration. It introduces the concept of SSTS as a structured, multimodal intervention platform that combines environmental, physiological, and behavioral components within a coordinated care model. This work contributes to ongoing international discussions on integrative medicine, rehabilitation systems, and preventive healthcare, providing a foundation for the systematic evaluation and responsible integration of spa-based therapeutic environments into contemporary health systems.