Skip to main content

Advertisement

Log in

Effect of balneotherapy on temporospatial gait characteristics of patients with osteoarthritis of the knee

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

Effects of balneotherapy on gait properties of patients with osteoarthritis of the knee were investigated prospectively. A total of 30 patients with knee osteoarthritis received balneotherapy consisting of two daily thermomineral water baths for 2 weeks. Patients were evaluated using gait analysis and clinical scores, both within 2 weeks, before and after spa treatment. Patients were walking faster in their control analyses (0.81 ± 0.21 to 0.89 ± 0.19 m/s; P = 0.017), with a shorter mean stance time (63.0 ± 3.3 to 61.8 ± 2.5% stride; P = 0.007), an increased cadence (96 ± 13.1 to 100 ± 11.9 steps/min; P = 0.094) and stride length (996 ± 174 to 1,058 ± 142 mm; P = 0.017). Balneotherapy also resulted in a significant decrease in Lequesne knee osteoarthritis index (12.1 ± 3.7 to 10.0 ± 3.3 points; P = 0.003), VAS for pain (58 ± 25 to 33 ± 15; P = 0.0001), VAS for patients’ (56 ± 24 to 29 ± 19; P < 0.001) and investigator’s global assessment (55 ± 20 to 26 ± 15; P < 0.0001) and WOMAC score (2.1 ± 0.7 to 1.6 ± 0.8; P = 0.0004). Balneotherapy has positive effects on gait properties and clinical health quality parameters of patients with knee osteoarthritis in short-term evaluations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. The burden of musculoskeletal conditions at the start of the new millennium: report of a WHO scientific group, technical report series no 919. WHO Technical Report Series

  2. 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  CAS  PubMed  Google Scholar 

  3. Gupta S, Hawker GA, Laporte A, Croxford R, Coyte PC (2005) The economic burden of disabling hip and knee osteoarthritis (oa) from the perspective of individuals living with this condition. Rheumatology (Oxford) 44:1531–1537

    Article  CAS  Google Scholar 

  4. van Saase JL, van Romunde LK, Cats A, Vandenbroucke JP, Valkenburg HA (1989) Epidemiology of osteoarthritis: Zoetermeer survey. Comparison of radiological osteoarthritis in a Dutch population with that in 10 other populations. Ann Rheum Dis 48:271–280

    Article  PubMed  Google Scholar 

  5. Felson DT, Zhang Y, Hannan MT et al (1995) The incidence and natural history of knee osteoarthritis in the elderly: The Framingham Osteoarthritis Study. Arthritis Rheum 38:1500–1505

    Article  CAS  PubMed  Google Scholar 

  6. Recommendations for the medical management of osteoarthritis of the hip and knee (2000) 2000 update. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Arthritis Rheum 43:1905–1915

    Google Scholar 

  7. American Academy of Orthopaedic Surgeons (2008) Guideline on treatment of osteoarthritis of the knee (non-arthroplasty). AAOS, Rosemont

    Google Scholar 

  8. Jordan KM, Arden NK, Doherty M et al (2003) Eular recommendations 2003: an evidence-based approach to the management of knee osteoarthritis: report of a Task Force of the Standing Committee for International Clinical Studies including Therapeutic Trials (escisit). Ann Rheum Dis 62:1145–1155

    Article  CAS  PubMed  Google Scholar 

  9. Balogh Z, Ordogh J, Gasz A, Nemet L, Bender T (2005) Effectiveness of balneotherapy in chronic low back pain: a randomized single-blind controlled follow-up study. Forsch Komplementarmed Klass Naturheilkd 12:196–201

    Article  PubMed  Google Scholar 

  10. Pittler MH, Karagulle MZ, Karagulle M, Ernst E (2006) Spa therapy and balneotherapy for treating low back pain: meta-analysis of randomized trials. Rheumatology (Oxford) 45(7):880–884

    Article  CAS  Google Scholar 

  11. Donmez A, Karagulle MZ, Tercan N et al (2005) Spa therapy in fibromyalgia: a randomised controlled clinic study. Rheumatol Int 26:168–172

    Article  PubMed  Google Scholar 

  12. Yurtkuran M, Çeliktaş M (1996) A randomized, controlled trial of balneotherapy in the treatment of patients with primary fibromyalgia. Phys Med Rehab Kurort 6:109–112

    Article  Google Scholar 

  13. Dönmez A, Karagülle Z, Turan M (1995) Balneotherapie mit akratoterme bei gonartrose. Zeitschrift Naturamed 7:20–23

    Google Scholar 

  14. Odabaşı E, Karagülle MZ, Karagülle M, Turan M, Karagülle O (2002) Comparison of two traditional spa therapy regimens in patients with knee osteoarthritis; an exploratory study. Phys Med Rehab Kurort 12:337–341

    Article  Google Scholar 

  15. Elkayam O, Wigler I, Tishler M et al (1991) Effect of spa therapy in Tiberias on patients with rheumatoid arthritis and osteoarthritis. J Rheumatol 18:1799–1803

    CAS  PubMed  Google Scholar 

  16. Forestier R (2000) Magnitude and duration of the effects of two spa therapy courses on knee and hip osteoarthritis: an open prospective study in 51 consecutive patients. Joint Bone Spine 67:296–304

    CAS  PubMed  Google Scholar 

  17. 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  CAS  PubMed  Google Scholar 

  18. Sukenik S, Flusser D, Codish S, Abu-Shakra M (1999) Balneotherapy at the Dead Sea area for knee osteoarthritis. Isr Med Assoc J 1:83–85

    CAS  PubMed  Google Scholar 

  19. 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

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  21. Yurtkuran M, Yurtkuran M, Alp A et al (2006) Balneotherapy and tap water therapy in the treatment of knee osteoarthritis. Rheumatol Int 27:19–27

    Article  PubMed  Google Scholar 

  22. Zhang W, Moskowitz RW, Nuki G et al (2007) Oarsi recommendations for the management of hip and knee osteoarthritis. Part I. Critical appraisal of existing treatment guidelines and systematic review of current research evidence. Osteoarthritis Cartilage 15:981–1000

    Article  CAS  PubMed  Google Scholar 

  23. Verhagen AP, Bierma-Zeinstra SM, Boers M et al (2007) Balneotherapy for osteoarthritis. Cochrane Database Syst Rev CD006864

  24. Al-Zahrani KS, Bakheit AM (2002) A study of the gait characteristics of patients with chronic osteoarthritis of the knee. Disabil Rehabil 24:275–280

    Article  CAS  PubMed  Google Scholar 

  25. Gok H, Ergin S, Yavuzer G (2002) Kinetic and kinematic characteristics of gait in patients with medial knee arthrosis. Acta Orthop Scand 73:647–652

    Article  PubMed  Google Scholar 

  26. Kaufman KR, Hughes C, Morrey BF, Morrey M, An KN (2001) Gait characteristics of patients with knee osteoarthritis. J Biomech 34:907–915

    Article  CAS  PubMed  Google Scholar 

  27. Butler RJ, Marchesi S, Royer T, Davis IS (2007) The effect of a subject-specific amount of lateral wedge on knee mechanics in patients with medial knee osteoarthritis. J Orthop Res 25:1121–1127

    Article  PubMed  Google Scholar 

  28. Gaasbeek RD, Groen BE, Hampsink B, van Heerwaarden RJ, Duysens J (2007) Valgus bracing in patients with medial compartment osteoarthritis of the knee. A gait analysis study of a new brace. Gait Posture 26:3–10

    Article  PubMed  Google Scholar 

  29. Solak AS, Kentel B, Ates Y (2005) Does bilateral total knee arthroplasty affect gait in women? Comparison of gait analyses before and after total knee arthroplasty compared with normal knees. J Arthroplasty 20:745–750

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  31. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840

    CAS  PubMed  Google Scholar 

  32. 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

    Article  CAS  PubMed  Google Scholar 

  33. Lequesne MG, Samson M (1991) Indices of severity in osteoarthritis for weight-bearing joints. J Rheumatol Suppl 27:16–18

    CAS  PubMed  Google Scholar 

  34. Bruce B, Fries JF (2005) The health assessment questionnaire (haq). Clin Exp Rheumatol 23:S14–S18

    CAS  PubMed  Google Scholar 

  35. Davis R, Ounpuu S, Tyburski D, Gage J (1991) A gait analysis data collection and reduction technique. Hum Mov Sci 10:575–587

    Article  Google Scholar 

  36. Schoonjans F (2006) Medcalc Mariakerke. Belgium

  37. Karagulle M, Karagulle MZ, Karagulle O, Donmez A, Turan M (2007) A 10-day course of spa therapy is beneficial for people with severe knee osteoarthritis: a 24-week randomised, controlled pilot study. Clin Rheumatol 26:2063–2071

    Article  PubMed  Google Scholar 

  38. 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 

  39. Evcik D, Kavuncu V, Yeter A, Yigit I (2007) The efficacy of balneotherapy and mud-pack therapy in patients with knee osteoarthritis. Joint Bone Spine 74:60–65

    Article  PubMed  Google Scholar 

  40. Fioravanti A, Valenti M, Altobelli E et al (2003) Clinical efficacy and cost-effectiveness evidence of spa therapy in osteoarthritis. The results of “Naiade” Italian Project. Panminerva Med 45:211–217

    CAS  PubMed  Google Scholar 

  41. Balint GP, Buchanan WW, Adam A et al (2007) The effect of the thermal mineral water of Nagybaracska on patients with knee joint osteoarthritis: a double blind study. Clin Rheumatol 26:890–894

    Article  PubMed  Google Scholar 

  42. 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  CAS  PubMed  Google Scholar 

  43. Tishler M, Rosenberg O, Levy O, Elias I, Amit-Vazina M (2004) The effect of balneotherapy on osteoarthritis. Is an intermittent regimen effective? Eur J Intern Med 15:93–96

    Article  PubMed  Google Scholar 

  44. Uysal B, Dönmez A, Karagülle MZ (2006) Balneotherapy in knee osteoarthritis; a randomised controlled clinic study. In: Karagülle MZ, Dönmez A (eds) 35th congress of the international society of medical hydrology and climatology. İstanbul, p 121

  45. Kubota K, Kurabayashi H, Tamura K, Kawada E, Tamura J, Shirakura T (1992) A transient rise in plasma beta-endorphin after a traditional 47°C hot-spring bath in Kusatsu-spa, Japan. Life Sci 51:1877–1880

    Article  CAS  PubMed  Google Scholar 

  46. Yurtkuran M, Ulus H, Irdesel J (1993) The effect of balneotherapy on plasma endorphine level in patient with osteoarthritis. Phys Rehabil Kur Med 3:130–132

    Article  Google Scholar 

  47. Forestier R, Francon A (2008) Crenobalneotherapy for limb osteoarthritis: systematic literature review and methodological analysis. Joint Bone Spine 75:138–148

    Article  PubMed  Google Scholar 

  48. Cantarini L, Leo G, Giannitti C, Cevenini G, Barberini P, Fioravanti A (2007) Therapeutic effect of spa therapy and short wave therapy in knee osteoarthritis: a randomized, single blind, controlled trial. Rheumatol Int 27:523–529

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Önder Kılıçoğlu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kılıçoğlu, Ö., Dönmez, A., Karagülle, Z. et al. Effect of balneotherapy on temporospatial gait characteristics of patients with osteoarthritis of the knee. Rheumatol Int 30, 739–747 (2010). https://doi.org/10.1007/s00296-009-1054-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-009-1054-9

Keywords

Navigation