DİZ OSTEOARTRİTİNDE BALNEOLOJİK TEDAVİNİN AĞRI, FONKSİYON VE YAŞAM KALİTESİNE ETKİSİNİN DEĞERLENDİRİLMESİ: RANDOMİZE, KONTROLLÜ, TEK KÖR BİR ÇALIŞMA

Year 2024, Volume: 87 Issue: 2, 165 - 175, 27.03.2024

Nur Gökçe Aydın , Mine Karagülle , Elif Nur Koçak , Müfit Zeki Karagülle

https://doi.org/10.26650/IUITFD.1398666

Abstract

Amaç: Bu çalışmada balneolojik tedavinin diz osteoartritli hastalarda etkinliğinin klinik ölçeklerle değerlendirilmesi ve ağrı, fonksiyon ve yaşam kalitesi üzerine etkisinin belirlenmesi amaçlandı.
Gereç ve Yöntem: Diz osteoartriti tanısı almış 32 hasta, randomizasyonla iki gruba ayrıldı. Çalışma grubundaki hastalara, hidroterapi havuzunda 38°C'de 20 dakika tam banyo uygulandı, ardından tıbbi çamur her iki dize de 43°C'de uygulandı. İkinci grup özel bir tedavi almadı ve rutin tedavilerine devam etti (kontrol grubu). Hastalar, tedavi öncesi/1. gün, tedavi sonu/12. gün ve 3. ayda kör bir hekimle klinik ölçekleri tamamladı.
Bulgular: Çalışma grubunda WOMAC toplam, VAS ağrı, hasta ve hekim global değerlendirme skorlarında, başlangıca göre, tedavi sonu ve üçüncü ay kontrollerinde istatistiksel olarak anlamlı bir iyileşme gözlendi. Çalışma grubunda Lequesne Diz İndeksi başlangıca göre 12. gün ve üçüncü ay skorlarında istatistiksel olarak anlamlı bir iyileşme gözlendi. Nottingham Sağlık Profili ağrı, duygusal reaksiyonlar, fiziksel hareket ve enerji skorlarında, çalışma grubunda 12. günde başlangıca istatistiksel olarak anlamlı bir iyileşme gözlendi ve bu anlamlı fark üçüncü ayda da enerji skoru dışında devam etti. Kontrol grubunda herhangi bir değişiklik gözlemlenmedi.
Sonuç: Balneolojik tedavinin diz osteoartritinde ağrı, fonksiyonel durum ve yaşam kalitesi üzerinde olumlu etkileri gösterilmiştir.

Keywords

Hidroterapi, peloidoterapi, diz osteoartriti, balneoterapi

EVALUATION OF BALNEOLOGICAL TREATMENT ON PAIN, FUNCTION, AND QUALITY OF LIFE IN KNEE OSTEOARTHRITIS: A RANDOMIZED, CONTROLLED, SINGLE-BLINDED TRIAL

Abstract

Objective: The study aimed to evaluate the efficacy of balneological treatment in patients with knee osteoarthritis using clinical scales and to determine its effect on pain, function, and quality of life.
Material and Method: Thirty-two patients with knee osteoarthritis were divided into two randomization groups. The patients in the study group were given a full bath for 20 min in the hydrotherapy pool at 38°C. Then, medical mud was applied to both knees at 43°C. The second group was not given any specific treatment and continued to receive routine treatment (control group). Patients completed the clinical scales with the blinded physician before treatment/day 1 (baseline), at the end of treatment/day 12, and 3 months.
Result: At the end of treatment, WOMAC total, VAS pain, and global assessment scores of patients and physicians were statistically significant improved compared with baseline and thirdmonth controls in the study group. A statistically significant improvement occurred in the 12-d and 3-month Lequesne knee index scores compared with the baseline in the study group. A statistically significant improvement was observed in Nottingham Health Profile pain, emotional reactions, physical movement, and energy scores in the study group on day 12 compared with baseline, and this significant difference continued in the third month for all scores, excluding the energy score. No change was observed in the control group.
Conclusion: The positive effects of balneological treatment on pain, functional status, and quality of life in knee osteoarthritis have been demonstrated.

Keywords

Hydrotherapy, peloidotherapy, knee osteoarthritis, balneotherapy

References

• Robinson WH, Lepus CM, Wang Q, Raghu H, Mao R, Lindstrom TM, et al. Low-grade inflammation as a key mediator of the pathogenesis of osteoarthritis. Nat Rev Rheumatol 2016;12(10):580-92. [CrossRef] google scholar
• Hall M, Van Der Esch M, Hinman RS, Peat G, De Zwart A, Quicke JG, et al. How does hip osteoarthritis differ from knee osteoarthritis? Osteoarthritis Cartilage 2022;30(1):32-41. [CrossRef] google scholar
• Hawker GA, King LK. The Burden of Osteoarthritis in Older Adults. Clin Geriatr Med 2022;38(2):181-92. [CrossRef] google scholar
• Abhishek A, Doherty M. Diagnosis and clinical presentation of osteoarthritis. Rheum Dis Clin North Am 2013;39(1):45-66. [CrossRef] google scholar
• Antonelli M, Donelli D, Fioravanti A. Effects of balneotherapy and spa therapy on quality of life of patients with knee osteoarthritis: a systematic review and meta-analysis. Rheumatol Int 2018;38(10):1807-24. [CrossRef] google scholar
• Kocyigit BF. Spa therapy: a geriatric perspective. AAEE 2023;2(1):45-8. [CrossRef] google scholar
• Gâlvez I, Torres-Piles S, Ortega-Rincon E. Balneotherapy, Immune System, and Stress Response: A Hormetic Strategy? Int J Mol Sci 2018;19(6):1687. [CrossRef] google scholar
• Tognolo L, Coraci D, Fioravanti A, Tenti S, Scanu A, Magro G, et al. Clinical Impact of Balneotherapy and Therapeutic Exercise in Rheumatic Diseases: A Lexical Analysis and Scoping Review. Applied Sciences 2022;12(15):7379. [CrossRef] google scholar
• Maccarone MC, Scanu A, Coraci D, Masiero S. The Potential Role of Spa Therapy in Managing Frailty in Rheumatic Patients: A Scoping Review. Healthcare 2023;11(13):1899. [CrossRef] google scholar
• Gâlvez I, Fioravanti A, Ortega E. Spa therapy and peripheral serotonin and dopamine function: a systematic review. Int J Biometeorol 2024;68(1):153-61. [CrossRef] google scholar
• Fioravanti A, Giannitti C, Bellisai B, Iacoponi F, Galeazzi M. Efficacy of balneotherapy on pain, function and quality of life in patients with osteoarthritis of the knee. Int J Biometeorol 2011;56(4):583-90. [CrossRef] google scholar
• Alkan H, Ardıç F. Güncel Kılavuzlar Eşliğinde Osteoartritte Non-Farmakolojik Tedavi, In: Hepgüler AS, Osteoartrit. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p.70-7. google scholar
• Fioravanti A, Iacoponi F, Bellisai B, Cantarini L, Galeazzi M. Short-and long-term effects of spa therapy in knee osteoarthritis. Am J Phys Med Rehabil 2010;89(2):125-32. [CrossRef] google scholar
• Dilekçi E, Özkuk K, Kaki B. Effect of balneotherapy on pain and fatigue in elderly with knee osteoarthritis receiving physical therapy: a randomized trial. Int J Biometeorol 2019;63(12):1555-68. [CrossRef] google scholar
• Karagülle M, Karagülle MZ, Karagülle O, Dönmez A, Turan M. A 10-day course of SPA therapy is beneficial for people with severe knee osteoarthritis. Clin Rheumatol 2007;26(12):2063-71. [CrossRef] google scholar
• Özkuk K, Gürdal H, Karagülle M, Barut Y, Eröksüz R, Karagülle MZ. Balneological outpatient treatment for patients with knee osteoarthritis; an effective non-drug therapy option in daily routine? Int J Biometeorol 2017;61(4):719-28. [CrossRef] google scholar
• Özkuk K, Uysal B. Is the duration of spa cure treatment important in knee osteoarthritis? A randomized controlled study. Complement Med Res 2019;26(4):258-64. [CrossRef] google scholar
• Matsumoto H, Hagino H, Hayashi K, Ideno Y, Wada T, Ogata T, et al. The effect of balneotherapy on pain relief, stiffness, and physical function in patients with osteoarthritis of the knee: a meta-analysis. Clin Rheumatol 2017;36(8):1839-47. [CrossRef] google scholar
• Raza HMA, Krutulyte G, Rimdeikiene I, Savickas R. Efficacy of balneotherapy and mud therapy in patients with knee osteoarthritis: a systematic literature review. Akt Rheumatol 2021;46(02):187-97. [CrossRef] google scholar
• D’Angelo D, Coclite D, Napoletano A, Fauci AJ, Latina R, Gianola S, et al. The efficacy of balneotherapy, mud therapy and spa therapy in patients with osteoarthritis: an overview of reviews. Int J Biometeorol 2021;65(7):1255-71. [CrossRef] google scholar
• Cheleschi S, Tenti S, Seccafico I, Gâlvez I, Fioravanti A, Ortega E. Balneotherapy year in review 2021: focus on the mechanisms of action of balneotherapy in rheumatic diseases. Environ Sci Pollut Res Int 2022;29(6):8054-73. [CrossRef] google scholar
• Fioravanti A, Bacaro G, Giannitti C, Tenti S, Cheleschi S, Pascarelli N, et al. One-year follow-up of mud-bath therapy in patients with bilateral knee osteoarthritis: a randomized, single-blind controlled trial. Int J Biometeorol 2015;59(9):1333-43. [CrossRef] google scholar
• Fraioli A, Serio A, Mennuni G, Ceccarelli F, Petraccia L, Fontana M, et al. A study on the efficacy of treatment with mud packs and baths with Sillene mineral water (Chianciano Spa Italy) in patients suffering from knee osteoarthritis. Rheumatol Int 2011;31(10):1333-40. [CrossRef] google scholar
• Maccarone MC MG, Solimene U, Scanu A, Masiero S. From in vitro research to real life studies: an extensive narrative review of the effects of balneotherapy on human immune response. Sport Sci Health 2021;17(4):817-35. [CrossRef] google scholar
• Güngen G, Ardic F, Fındıkoğlu G, Rota S. The effect of mud pack therapy on serum YKL-40 and hsCRP levels in patients with knee osteoarthritis. R Rheumatol Int 2012;32(5):1235-44. [CrossRef] google scholar
• Silva J, Martins J, Nicomedio C, Gonçalves C, Palito C, Gonçalves R, et al. A Novel Approach to Assess Balneotherapy Effects on Musculoskeletal Diseases— An Open Interventional Trial Combining Physiological Indicators, Biomarkers, and Patients’ Health Perception. Geriatrics 2023;8(3):55. [CrossRef] google scholar