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Therapeutic effect of spa therapy and short wave therapy in knee osteoarthritis: a randomized, single blind, controlled trial

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Abstract

Spa therapy and short wave therapy are two of the most commonly used non-pharmacological approaches for osteoarthritis. The aim of this study was to assess their efficacy in comparison to conventional therapy in patients with osteoarthritis of the knee in a single blind, randomized, controlled trial. Seventy-four outpatients were enrolled; 30 patients were treated with a combination of daily local mud packs and arsenical ferruginous mineral bath water from the thermal resort of Levico Terme (Trento, Italy) for 3 weeks; 24 patients were treated with short wave therapy for the same period and 20 patients continued regular, routine ambulatory care. Patients were assessed at baseline, upon completion of the 3-week treatment period, and 12 weeks later. Spa therapy and short wave therapy both demonstrated effective symptomatic treatment in osteoarthritis of the knee at the end of the treatment, but only the spa therapy was shown to have efficacy persistent over time. Our study demonstrated the superiority of arsenical ferruginous spa therapy compared to short wave therapy in the treatment of osteoarthritis of the knee, probably in relationship to the specific effects of the minerals in this water.

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References

  1. Lawrence RC, Helmick CG, Arnett FC, et al (1998) Estimates of the prevalence of arthritis and selected musculoskeletal disorders in US. Arthritis Rheum 41:778–799

    Article  PubMed  CAS  Google Scholar 

  2. Garcia Rodriguez LA, Hernandez-Diaz S (2001) The risk of upper gastrointestinal complications associated with non-steroidal anti-inflammatory drugs, glucocorticoids, acetaminophen, and combination of these agents. Arthritis Res 3:98–101

    Article  PubMed  CAS  Google Scholar 

  3. Perlman AI, Eisenberg DM, Panush RS (1999) Talking with patients about alternative and complementary medicine. Rheum Dis Clin North Am 25:815–822

    Article  PubMed  CAS  Google Scholar 

  4. Szucs L, Ratko I, Lesko T, Szoor I, Genti G, Balint G (1989) Double-blind trial on the effectiveness of the Puspokladany thermal water on arthrosis of the knee joints. J R Soc Health 109:7–9

    PubMed  CAS  Google Scholar 

  5. Sukenik S, Buskila D, Neumann L, Kleiner-Baumgarten A, Zimlichman S, Horowitz J (1990) Sulphur baths and mud pack treatment for rheumatoid arthritis at the dead sea area. Ann Rheum Dis 49:99–102

    Article  PubMed  CAS  Google Scholar 

  6. Wigler I, Elkayam O, Paran D, Yaron M (1995) Spa therapy for gonarthrosis: a prospective study. Rheumatol Int 15:65–68

    Article  PubMed  CAS  Google Scholar 

  7. Nguyen M, Revel M, Dougados M (1997) Prolonged effects of 3 week therapy in a spa resort on lumbar spine, knee and hip osteoarthritis: follow-up after 6 months. A randomized controlled trial. Br J Rheumatol 36:77–81

    Article  PubMed  CAS  Google Scholar 

  8. Neumann L, Sukenik S, Bolotin A et al (2001) The effect of balneotherapy at the dead sea on the quality of life of patients with fibromyalgia syndrome. Clin Rheumatol 20:15–19

    Article  PubMed  CAS  Google Scholar 

  9. vanTubergen A, Landewe R, van der Heijde D et al (2001) Combined spa-exercise therapy is effective in patients with ankylosing spondylitis: a randomized controlled trial. Arthritis Rheum 45:430–438

    Article  CAS  Google Scholar 

  10. Flusser D, Abu-Shakra M, Friger M (2002) Therapy with mud compresses for knee osteoarthritis: comparison of natural mud preparation with mineral depleted mud. J Clin Rheumatol 8:197–203

    Article  PubMed  Google Scholar 

  11. Kovacs I, Bender T (2002) The therapeutic effects of Cserkeszolo thermal water in osteoarthritis of the knee: a double blind, controlled, follow-up study. Rheumatol Int 21:218–221

    Article  PubMed  Google Scholar 

  12. Sukenik S, Flusser D, Abu-Shakra M (1999) The role of spa therapy in various rheumatic diseases. Rheum Dis Clin North Am 25:883–897

    Article  PubMed  CAS  Google Scholar 

  13. Verhagen AP, de Vet HC, de Bie RA, Kessels AG, Boers M, Knipschild PG. Balneotherapy for rheumatoid arthritis and osteoarthritis. Cochrane Database Syst Rev 2: CD000518

  14. Moffet JA, Richardson PH, Frost H, Osborn A (1996) A placebo controlled double blind trial to evaluate the effectiveness of pulsed short wave therapy for osteoarthritic hip and knee pain. Pain 67:121–127

    Article  Google Scholar 

  15. Shields N, Gormley J, O’Hare N (2002) Short wave diathermy: current clinical and safety practices. Physiother Res Int 7:191–202

    Article  PubMed  Google Scholar 

  16. Altman R, Asch E, Bloch D, et al (1986) Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee diagnostic and therapeutic criteria committee of the American Rheumatism Association. Arthritis Rheum 29:1039–1049

    Article  PubMed  CAS  Google Scholar 

  17. Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502

    PubMed  CAS  Google Scholar 

  18. Lequesne MG, Mery C, Samson M, Gerard P (1987) Indexes of severity for osteoarthritis of the hip and knee. Validation-value in comparison with other assessment tests. Scand J Rheumatol [Suppl 65]:85–89

    Google Scholar 

  19. Meenan RF, Gertman PM, Mason JH (1980) Measuring health status in arthritis. The arthritis impact measurement scales. Arthritis Rheum 23:146–152

    Article  PubMed  CAS  Google Scholar 

  20. Salaffi F, Cavalieri F, Nolli M, Ferraccioli G (1991) Analysis of disability in knee osteoarthritis. Relationship with age and psychological variables but not with the radiographic score. J Rheumatol 18:1581–1586

    PubMed  CAS  Google Scholar 

  21. Dougados M, Nguyen M, Listrat V, Amor B (1989) Score d’ équivalence des AINS (abstract 1134). Rev Rhum Mal Osteoartic 56:251

    Google Scholar 

  22. Guillemin F, Virion JM, Escudier P, De Talance N, Weryha G (2001) Effect on osteoarthritis of spa therapy at Bourbonne-les-Bains. Joint Bone Spine 68:499–503

    Article  PubMed  CAS  Google Scholar 

  23. Fioravanti A, Bisogno S, Nerucci F, Cicero MR, Locunsolo S, Marcolongo R (2000) Evaluation of the efficacy and tolerance of radioactive fangotherapy in gonarthrosis. Comparative study versus short wave therapy. Minerva Med 91:291–298

    PubMed  CAS  Google Scholar 

  24. Cozzi F, Lazzarin P, Todesco S, Cima L (1995) Hypothalamic-pituitary-adrenal axis dysregulation in healthy subjects undergoing mud-bath applications. Arthritis Rheum 38:724–726

    Article  PubMed  CAS  Google Scholar 

  25. Bellometti S, Galzigna L (1998) Serum levels of a prostaglandin and a leukotriene after thermal mud pack therapy. J Investig Med 46:140–145

    PubMed  CAS  Google Scholar 

  26. Bellometti S, Cecchettin M, Galzigna L (1997) Mud pack therapy in osteoarthrosis. Changes in serum levels of chondrocyte markers. Clin Chim Acta 268:101–106

    Article  PubMed  CAS  Google Scholar 

  27. Bellometti S, Galzigna L, Richelmi P, Gregotti C, Berté F (2002) Both serum receptors of tumor necrosis factor are influenced by mud pack treatment in osteoarthrotic patients. Int J Tissue React 24:57–64

    PubMed  CAS  Google Scholar 

  28. Bellometti S, Richelmi P, Tassoni T, Berté F (2005) Production of matrix metalloproteinases and their inhibitors in osteoarthritic patients undergoing mud bath therapy. Int J Clin Pharmacol Res 25:77–94

    PubMed  CAS  Google Scholar 

  29. Bellometti S, Cecchettin M, Lalli A, Galzigna L (1996) Mud pack treatment increases serum antioxidant defenses in osteoarthrosic patients. Biomed Pharmacother 50:37

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The authors would like to thank Colleen Connell for her assistance with the translation of the text.

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Correspondence to Antonella Fioravanti.

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Cantarini, L., Leo, G., Giannitti, C. et al. Therapeutic effect of spa therapy and short wave therapy in knee osteoarthritis: a randomized, single blind, controlled trial. Rheumatol Int 27, 523–529 (2007). https://doi.org/10.1007/s00296-006-0266-5

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  • DOI: https://doi.org/10.1007/s00296-006-0266-5

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