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Contribution of Balneotherapy in Fibromyalgia Patients Receiving Conventional Physical Therapy

Year 2023, , 19 - 25, 16.04.2023
https://doi.org/10.46332/aemj.941039

Abstract

Purpose: This study aims to investigate the role of applying additional balneotherapy to fibromyalgia patients while receiving conventional physical therapy.

Materials and Methods: 107 female patients diagnosed with fibromyalgia for the first time were studied in two groups. Group 1 included patients receiving Transcutaneous Electrical Nerve Stimulation and physical therapy modalities, including superficial hot and therapeutic ultrasounds. Patients in Group 2 received balneotherapy in addition to the therapeutic modalities given to the first group. All patients went through a 10-session treatment program. The evaluation was based on the Fibromyalgia Impact Questionnaire (FIQ), Visual Analogue Scale (VAS), Pittsburgh Sleep Quality Index (PSQI), and Quality of Life Short Form-36 (SF-36) before and after the treatment. The total amount of paracetamol tablets consumed was also recorded.

Results: There were significant recovery in post-treatment pain VAS, FIQ, and PSQI scores in both groups, compared to before treatment, but the improvements were more pronounced after the balneotherapy. The drug consumption was also significantly lower, and patients treated with balneotherapy expressed better general health and social function scores of SF-36.

Conclusion: A combination of balneotherapy with conventional physical modalities appears to be an effective treatment option for fibromyalgia as it positively contributes to the patient's pain, functional status, quality of life and sleep, and drug consumption.

References

  • 1. Evcik D, Ketenci A, Sindel D. The Turkish Society of Physical Medicine and Rehabilitation (TSPMR) guideline recommendations for the management of fibromyalgia syndrome. Turk J Phys Med Rehabil. 2019;65(2):111-123.
  • 2. Şas S, Koçak FA, Tuncay F. Fibromiyalji sendromunda yaşam kalitesinin değerlendirilmesi. Ahi Evran Med J. 2019;3(2):48-53.
  • 3. Sarzi-Puttini P, Giorgi V, Marotto D, Atzeni F. Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment. Nat Rev Rheumatol. 2020;16(11):645-660.
  • 4. Kia S, Choy E. Update on Treatment Guideline in Fibromyalgia Syndrome with Focus on Pharmacology. Biomedicines. 2017;5(2):20.
  • 5. Eroksuz R, Erol Forestier FB, Karaaslan F, et al. Comparison of intermittent and consecutive balneological outpatient treatment (hydrotherapy and peloidotherapy) in fibromyalgia syndrome: a randomized, single-blind, pilot study. Int J Biometeorol. 2020;64(3):513-520.
  • 6. Prabhakar A, Kaiser JM, Novitch MB, Cornett EM, Urman RD, Kaye AD. The Role of Complementary and Alternative Medicine Treatments in Fibromyalgia: a Comprehensive Review. Curr Rheumatol Rep. 2019;21(5):14.
  • 7. Hauser W, Ablin J, Perrot S, Fitzcharles MA. Management of fibromyalgia: practical guides from recent evidence-based guidelines. Pol Arch Intern Med. 2017;127(1):47-56.
  • 8. Bender T, Balint G, Prohaszka Z, Geher P, Tefner IK. Evidence-based hydro- and balneotherapy in Hungary--a systematic review and meta-analysis. Int J Biometeorol. 2014;58(3):311-323.
  • 9. Fioravanti A, Cantarini L, Guidelli GM, Galeazzi M. Mechanisms of action of spa therapies in rheumatic diseases: what scientific evidence is there? Rheumatol Int. 2011;31(1):1-8.
  • 10. Abacı E.A., Balcı N. Bel Ağrıları ve Kaplıca Tedavisi. Turkiye Klinikleri J PM&R-Special Topics. 2018;11 (1):30-36.
  • 11. Özgen M. Fibromiyaljide Kaplıca Tedavisi Turkiye Klinikleri J PM&R-Special Topics. 2018;11(1):37-42.
  • 12. Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2017;76(2):318-328.
  • 13. Ablin J, Fitzcharles MA, Buskila D, Shir Y, Sommer C, Hauser W. Treatment of fibromyalgia syndrome: recommendations of recent evidence-based interdisciplinary guidelines with special emphasis on complementary and alternative therapies. Evid Based Complement Alternat Med. 2013;2013:485272.
  • 14. Clauw DJ. Fibromyalgia: a clinical review. JAMA. 2014;311(15):1547-1555.
  • 15. Wolfe F, Clauw DJ, Fitzcharles MA, et al. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum. 2016;46(3):319-329.
  • 16. Burckhardt CS, Clark SR, Bennett RM. The fibromyalgia impact questionnaire: development and validation. J Rheumatol. 1991;18(5):728-733.
  • 17. Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatol Int. 2000;20(1):9-12.
  • 18. Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983;17(1):45-56.
  • 19. Buysse DJ, Reynolds CF, 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213.
  • 20. Ağargün YM, Kara H, Anlar Ö. Pitsburg Uyku Kalitesi İndeksi’nin geçerliliği ve güvenirliği. Türk Psikiyatri Derg. 1996;7(2):107-111.
  • 21. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical care. 1992;30(6):473-483.
  • 22. Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş A. Kısa form 36 (KF 36)’nın Türkçe versiyonunun güvenirliliği ve geçerliliği. İlaç ve Tedavi Derg. 1995;12(2):102-106.
  • 23. Atzeni F, Gerardi MC, Masala IF, Alciati A, Batticciotto A, Sarzi-Puttini P. An update on emerging drugs for fibromyalgia treatment. Expert Opin Emerg Drugs. 2017;22(4):357-367.
  • 24. Alkan H, Ardıç F. Kaplıca Tedavisinde Etki Mekanizmaları. Turkiye Klinikleri J PM&R-Special Topics. 2018;11(1):10-20.
  • 25. Ardic F, Ozgen M, Aybek H, Rota S, Cubukcu D, Gokgoz A. Effects of balneotherapy on serum IL-1, PGE2 and LTB4 levels in fibromyalgia patients. Rheumatol Int. 2007;27(5):441-446.
  • 26. Cheleschi S, Gallo I, Tenti S. A comprehensive analysis to understand the mechanism of action of balneotherapy: why, how, and where they can be used? Evidence from in vitro studies performed on human and animal samples. Int J Biometeorol. 2020;64(7): 1247-1261.
  • 27. Langhorst J, Musial F, Klose P, Hauser W. Efficacy of hydrotherapy in fibromyalgia syndrome-a meta-analysis of randomized controlled clinical trials. Rheumatology. 2009;48(9):1155-1159.
  • 28. Karagulle M, Kardes S, Karagulle MZ. Real-life effectiveness of spa therapy in rheumatic and musculoskeletal diseases: a retrospective study of 819 patients. Int J Biometeorol. 2017;61(11):1945-1956.
  • 29. Naumann J, Sadaghiani C. Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome: a qualitative systematic review and meta-analysis of randomized controlled trials. Arthritis Res Ther. 2014;16(4):R141.
  • 30. Buskila D, Abu-Shakra M, Neumann L, et al. Balneotherapy for fibromyalgia at the Dead Sea. Rheumatol Int. 2001;20(3):105-108.
  • 31. Evcik D, Kizilay B, Gokcen E. The effects of balneotherapy on fibromyalgia patients. Rheumatol Int. 2002;22(2):56-59.
  • 32. Altan L, Bingol U, Aykac M, Koc Z, Yurtkuran M. Investigation of the effects of pool-based exercise on fibromyalgia syndrome. Rheumatol Int. 2004;24(5): 272-277.
  • 33. Fioravanti A, Manica P, Bortolotti R, Cevenini G, Tenti S, Paolazzi G. Is balneotherapy effective for fibromyalgia? Results from a 6-month double-blind randomized clinical trial. Clin Rheumatol. 2018;37(8): 2203-2212.
  • 34. Kesiktas N, Karagulle Z, Erdogan N, Yazicioglu K, Yilmaz H, Paker N. The efficacy of balneotherapy and physical modalities on the pulmonary system of patients with fibromyalgia. J Back Musculoskelet Rehabil. 2011;24(1):57-65.
  • 35. Cao CF, Ma KL, Li QL, et al. Balneotherapy for Fibromyalgia Syndrome: A Systematic Review and Meta-Analysis. J Clin Med. 2021;10(7):1493.
  • 36. Nguyen M, Revel M, Dougados M. 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. 1997;36 (1):77-81.
  • 37. Ozkurt S, Donmez A, Zeki Karagulle M, Uzunoglu E, Turan M, Erdogan N. Balneotherapy in fibromyalgia: a single blind randomized controlled clinical study. Rheumatol Int. 2012;32(7):1949-1954.
  • 38. Ozkuk K, Uysal B, Ates Z, Okmen BM, Sezer R, Dilek G. The effects of inpatient versus outpatient spa therapy on pain, anxiety, and quality of life in elderly patients with generalized osteoarthritis: a pilot study. Int J Biometeorol. 2018;62(10):1823-1832.

Konvansiyonel Fizik Tedavi Alan Fibromiyalji Hastalarında Balneoterapinin Katkısı

Year 2023, , 19 - 25, 16.04.2023
https://doi.org/10.46332/aemj.941039

Abstract

Amaç: Bu çalışmada, konvansiyonel fizik tedavi alan fibromiyalji hastalarında balneoterapinin fonksiyonel iyileşme, ağrı, uyku ve yaşam kalitesi ile ilaç tüketimi üzerindeki katkısının araştırılması amaçlanmıştır.

Araçlar ve Yöntem: İlk kez fibromiyalji tanısı alan 107 kadın hasta çalışmaya dahil edildi. Hastalar transkutanöz elektriksel sinir stimülasyonu, yüzeyel sıcak ve terapötik ultrason içeren fizik tedavi modaliteleri uygulanan (grup1) ve balneoterapi ile birlikte birinci gruba verilen fizik tedavi modaliteleri uygulanan (grup 2) olmak üzere ikiye ayrıldı. Tüm hastalara 10 seans tedavi programı uygulandı. Tedavi öncesi ve sonrası Fibromiyalji Etki Anketi (FEA), Vizüel analog skala (VAS), Pittsburg Uyku Kalitesi İndeksi (PUKİ), Yaşam kalitesi Kısa Form-36 (KF-36) kullanılarak değerlendirmeler yapıldı. Hastaların tükettikleri toplam parasetamol tablet miktarı da ayrıca kaydedildi.

Bulgular: Her iki grupta, tedavi öncesine göre tedavi sonrası ağrı VAS, FEA ve PUKİ skorlarında anlamlı düzelme saptanırken balneoterapi alan hastalarda daha anlamlı iyileşme saptandı. Balneoterapi grubunda ilaç tüketimi anlamlı miktarda düşük olup KF-36’nın tedavi sonrası ağrı, genel sağlık ve sosyal fonksiyon skorlarında anlamlı iyileşme gözlendi.

Sonuç: Fibromiyalji tedavisinde konvansiyonel fizik modaliteleri ile kombine edilen balneoterapi, hastalarda ağrı, fonksiyonel durum, yaşam ve uyku kalitesi ile ilaç tüketimi üzerinde olumlu katkı sağlayan etkili bir tedavi seçeneği olarak uygulanabilir.

References

  • 1. Evcik D, Ketenci A, Sindel D. The Turkish Society of Physical Medicine and Rehabilitation (TSPMR) guideline recommendations for the management of fibromyalgia syndrome. Turk J Phys Med Rehabil. 2019;65(2):111-123.
  • 2. Şas S, Koçak FA, Tuncay F. Fibromiyalji sendromunda yaşam kalitesinin değerlendirilmesi. Ahi Evran Med J. 2019;3(2):48-53.
  • 3. Sarzi-Puttini P, Giorgi V, Marotto D, Atzeni F. Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment. Nat Rev Rheumatol. 2020;16(11):645-660.
  • 4. Kia S, Choy E. Update on Treatment Guideline in Fibromyalgia Syndrome with Focus on Pharmacology. Biomedicines. 2017;5(2):20.
  • 5. Eroksuz R, Erol Forestier FB, Karaaslan F, et al. Comparison of intermittent and consecutive balneological outpatient treatment (hydrotherapy and peloidotherapy) in fibromyalgia syndrome: a randomized, single-blind, pilot study. Int J Biometeorol. 2020;64(3):513-520.
  • 6. Prabhakar A, Kaiser JM, Novitch MB, Cornett EM, Urman RD, Kaye AD. The Role of Complementary and Alternative Medicine Treatments in Fibromyalgia: a Comprehensive Review. Curr Rheumatol Rep. 2019;21(5):14.
  • 7. Hauser W, Ablin J, Perrot S, Fitzcharles MA. Management of fibromyalgia: practical guides from recent evidence-based guidelines. Pol Arch Intern Med. 2017;127(1):47-56.
  • 8. Bender T, Balint G, Prohaszka Z, Geher P, Tefner IK. Evidence-based hydro- and balneotherapy in Hungary--a systematic review and meta-analysis. Int J Biometeorol. 2014;58(3):311-323.
  • 9. Fioravanti A, Cantarini L, Guidelli GM, Galeazzi M. Mechanisms of action of spa therapies in rheumatic diseases: what scientific evidence is there? Rheumatol Int. 2011;31(1):1-8.
  • 10. Abacı E.A., Balcı N. Bel Ağrıları ve Kaplıca Tedavisi. Turkiye Klinikleri J PM&R-Special Topics. 2018;11 (1):30-36.
  • 11. Özgen M. Fibromiyaljide Kaplıca Tedavisi Turkiye Klinikleri J PM&R-Special Topics. 2018;11(1):37-42.
  • 12. Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2017;76(2):318-328.
  • 13. Ablin J, Fitzcharles MA, Buskila D, Shir Y, Sommer C, Hauser W. Treatment of fibromyalgia syndrome: recommendations of recent evidence-based interdisciplinary guidelines with special emphasis on complementary and alternative therapies. Evid Based Complement Alternat Med. 2013;2013:485272.
  • 14. Clauw DJ. Fibromyalgia: a clinical review. JAMA. 2014;311(15):1547-1555.
  • 15. Wolfe F, Clauw DJ, Fitzcharles MA, et al. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum. 2016;46(3):319-329.
  • 16. Burckhardt CS, Clark SR, Bennett RM. The fibromyalgia impact questionnaire: development and validation. J Rheumatol. 1991;18(5):728-733.
  • 17. Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatol Int. 2000;20(1):9-12.
  • 18. Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983;17(1):45-56.
  • 19. Buysse DJ, Reynolds CF, 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213.
  • 20. Ağargün YM, Kara H, Anlar Ö. Pitsburg Uyku Kalitesi İndeksi’nin geçerliliği ve güvenirliği. Türk Psikiyatri Derg. 1996;7(2):107-111.
  • 21. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical care. 1992;30(6):473-483.
  • 22. Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş A. Kısa form 36 (KF 36)’nın Türkçe versiyonunun güvenirliliği ve geçerliliği. İlaç ve Tedavi Derg. 1995;12(2):102-106.
  • 23. Atzeni F, Gerardi MC, Masala IF, Alciati A, Batticciotto A, Sarzi-Puttini P. An update on emerging drugs for fibromyalgia treatment. Expert Opin Emerg Drugs. 2017;22(4):357-367.
  • 24. Alkan H, Ardıç F. Kaplıca Tedavisinde Etki Mekanizmaları. Turkiye Klinikleri J PM&R-Special Topics. 2018;11(1):10-20.
  • 25. Ardic F, Ozgen M, Aybek H, Rota S, Cubukcu D, Gokgoz A. Effects of balneotherapy on serum IL-1, PGE2 and LTB4 levels in fibromyalgia patients. Rheumatol Int. 2007;27(5):441-446.
  • 26. Cheleschi S, Gallo I, Tenti S. A comprehensive analysis to understand the mechanism of action of balneotherapy: why, how, and where they can be used? Evidence from in vitro studies performed on human and animal samples. Int J Biometeorol. 2020;64(7): 1247-1261.
  • 27. Langhorst J, Musial F, Klose P, Hauser W. Efficacy of hydrotherapy in fibromyalgia syndrome-a meta-analysis of randomized controlled clinical trials. Rheumatology. 2009;48(9):1155-1159.
  • 28. Karagulle M, Kardes S, Karagulle MZ. Real-life effectiveness of spa therapy in rheumatic and musculoskeletal diseases: a retrospective study of 819 patients. Int J Biometeorol. 2017;61(11):1945-1956.
  • 29. Naumann J, Sadaghiani C. Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome: a qualitative systematic review and meta-analysis of randomized controlled trials. Arthritis Res Ther. 2014;16(4):R141.
  • 30. Buskila D, Abu-Shakra M, Neumann L, et al. Balneotherapy for fibromyalgia at the Dead Sea. Rheumatol Int. 2001;20(3):105-108.
  • 31. Evcik D, Kizilay B, Gokcen E. The effects of balneotherapy on fibromyalgia patients. Rheumatol Int. 2002;22(2):56-59.
  • 32. Altan L, Bingol U, Aykac M, Koc Z, Yurtkuran M. Investigation of the effects of pool-based exercise on fibromyalgia syndrome. Rheumatol Int. 2004;24(5): 272-277.
  • 33. Fioravanti A, Manica P, Bortolotti R, Cevenini G, Tenti S, Paolazzi G. Is balneotherapy effective for fibromyalgia? Results from a 6-month double-blind randomized clinical trial. Clin Rheumatol. 2018;37(8): 2203-2212.
  • 34. Kesiktas N, Karagulle Z, Erdogan N, Yazicioglu K, Yilmaz H, Paker N. The efficacy of balneotherapy and physical modalities on the pulmonary system of patients with fibromyalgia. J Back Musculoskelet Rehabil. 2011;24(1):57-65.
  • 35. Cao CF, Ma KL, Li QL, et al. Balneotherapy for Fibromyalgia Syndrome: A Systematic Review and Meta-Analysis. J Clin Med. 2021;10(7):1493.
  • 36. Nguyen M, Revel M, Dougados M. 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. 1997;36 (1):77-81.
  • 37. Ozkurt S, Donmez A, Zeki Karagulle M, Uzunoglu E, Turan M, Erdogan N. Balneotherapy in fibromyalgia: a single blind randomized controlled clinical study. Rheumatol Int. 2012;32(7):1949-1954.
  • 38. Ozkuk K, Uysal B, Ates Z, Okmen BM, Sezer R, Dilek G. The effects of inpatient versus outpatient spa therapy on pain, anxiety, and quality of life in elderly patients with generalized osteoarthritis: a pilot study. Int J Biometeorol. 2018;62(10):1823-1832.
There are 38 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Original Articles
Authors

Engin Taştaban 0000-0001-9094-2904

Ömer Şendur This is me 0000-0002-0718-9438

Publication Date April 16, 2023
Published in Issue Year 2023

Cite

APA Taştaban, E., & Şendur, Ö. (2023). Konvansiyonel Fizik Tedavi Alan Fibromiyalji Hastalarında Balneoterapinin Katkısı. Ahi Evran Medical Journal, 7(1), 19-25. https://doi.org/10.46332/aemj.941039
AMA Taştaban E, Şendur Ö. Konvansiyonel Fizik Tedavi Alan Fibromiyalji Hastalarında Balneoterapinin Katkısı. Ahi Evran Med J. April 2023;7(1):19-25. doi:10.46332/aemj.941039
Chicago Taştaban, Engin, and Ömer Şendur. “Konvansiyonel Fizik Tedavi Alan Fibromiyalji Hastalarında Balneoterapinin Katkısı”. Ahi Evran Medical Journal 7, no. 1 (April 2023): 19-25. https://doi.org/10.46332/aemj.941039.
EndNote Taştaban E, Şendur Ö (April 1, 2023) Konvansiyonel Fizik Tedavi Alan Fibromiyalji Hastalarında Balneoterapinin Katkısı. Ahi Evran Medical Journal 7 1 19–25.
IEEE E. Taştaban and Ö. Şendur, “Konvansiyonel Fizik Tedavi Alan Fibromiyalji Hastalarında Balneoterapinin Katkısı”, Ahi Evran Med J, vol. 7, no. 1, pp. 19–25, 2023, doi: 10.46332/aemj.941039.
ISNAD Taştaban, Engin - Şendur, Ömer. “Konvansiyonel Fizik Tedavi Alan Fibromiyalji Hastalarında Balneoterapinin Katkısı”. Ahi Evran Medical Journal 7/1 (April 2023), 19-25. https://doi.org/10.46332/aemj.941039.
JAMA Taştaban E, Şendur Ö. Konvansiyonel Fizik Tedavi Alan Fibromiyalji Hastalarında Balneoterapinin Katkısı. Ahi Evran Med J. 2023;7:19–25.
MLA Taştaban, Engin and Ömer Şendur. “Konvansiyonel Fizik Tedavi Alan Fibromiyalji Hastalarında Balneoterapinin Katkısı”. Ahi Evran Medical Journal, vol. 7, no. 1, 2023, pp. 19-25, doi:10.46332/aemj.941039.
Vancouver Taştaban E, Şendur Ö. Konvansiyonel Fizik Tedavi Alan Fibromiyalji Hastalarında Balneoterapinin Katkısı. Ahi Evran Med J. 2023;7(1):19-25.

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