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Zhang R, Lei YJ, Wen SY, Pang J, Cao YL, Zhang M, Zhan HS, Lin X, Chen B. Effect of Shi-Style Steaming and Bathing Decoction in Patients with Knee Osteoarthritis: Study Protocol for a Randomized Placebo-Controlled Trial. J Pain Res 2024; 17:2851-2860. [PMID: 39253736 PMCID: PMC11382682 DOI: 10.2147/jpr.s466741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 08/27/2024] [Indexed: 09/11/2024] Open
Abstract
Purpose To prove more accurately that Chinese herbal bath therapy may be a safe, effective, simple alternative treatment modality for knee OA, we designed a randomized, double-blind, placebo-controlled trial to explore the effectiveness of SSBD for the relief of pain, daily activities, and quality of life in patients with knee OA. Patients and Methods A single-center, 52-week, randomized controlled trial of SSBD versus placebo is being performed. A total of 200 patients with symptomatic knee OA will be randomly allocated to the SSBD treatment or placebo intervention group for 4 weeks. The two groups of patients are allowed to steam and bathe their knees once every other day, using one packet of SSBD each time, for 30 minutes, 3 times a week, for a total of 4 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale at 4 weeks is the primary outcome measure, and the secondary outcomes include WOMAC stiffness and function scores, the Lysholm knee scale score, quality of life, the Brief Pain Inventory score, the Patient's Global Impressions of Improvement Scale score and the Clinical Global Impressions of Severity scale score. The safety of the herbal medications will also be evaluated. Conclusion We will discuss whether SSBD has greater advantages in terms of efficacy, safety, and patient overall perception than does placebo control in middle-aged and elderly patients with knee OA. The findings may provide new and valuable information about the efficacy and safety of Chinese herbal bath therapy in the treatment of knee osteoarthritis.
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Affiliation(s)
- Ran Zhang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
- Institute of Orthopedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Ya-Jie Lei
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
- Institute of Orthopedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Sheng-Yue Wen
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
- Institute of Orthopedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Jian Pang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
- Institute of Orthopedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Yue-Long Cao
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
- Institute of Orthopedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Min Zhang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
- Institute of Orthopedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Hong-Sheng Zhan
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
- Institute of Orthopedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Xun Lin
- Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Bo Chen
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
- Institute of Orthopedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China
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Boopalan D, Vijayakumar V, Kalidas S, Ravi P, Balakrishnan A, Shanmugam P, Arumugam V, Kuppusamy M, Karuppasamy G. Effect of local mud application in patients with knee osteoarthritis - A systematic review and meta-analysis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024:10.1007/s00484-024-02725-2. [PMID: 38916766 DOI: 10.1007/s00484-024-02725-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 06/09/2024] [Accepted: 06/11/2024] [Indexed: 06/26/2024]
Abstract
Mud therapy is a safe, cost-effective approach for Knee Osteoarthritis (OA), promoting healing through warmth and minerals, providing pain relief, and improving function. The main objective of the current review is to assess the effectiveness of local mud application for pain management in patients with Knee OA. The published papers were obtained from PubMed, Embase, Scopus, Cochrane Library, ClinicalTrails.gov, Web of Science, and references from relevant systematic reviews from 1990 January to February 2023. Trials meeting the predefined criteria were included in this meta-analysis. The main focus of this study was to assess pain as a primary outcome measure. R software version 4.3.1 and Cochrane Risk of Bias Tool 1 were used to derive meta-analysis and risk of bias in the included studies. A meta-analysis was performed using the fixed-effects model to obtain a summary of treatment effects, which calculated the effect size (standardized mean difference; SMD) along with a 95% Confidence Interval (CI).In the current meta-analysis, a total of ten studies with 560 Knee OA patients were included. Findings demonstrated significant effects of local mud application on pain (SMD: -0.36, 95% CI: -0.56, -0.16), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale (SMD: -0.49, 95% CI: -0.68, -0.29) for individuals suffering from Knee OA. The current study identified compelling evidence to support the recommendation of mud application as an effective intervention for individuals with Knee OA. While local mud application may serve as a supplementary therapy alongside conventional medical approaches for improved Knee OA management, additional high-quality randomized controlled trials are required to validate these findings.
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Affiliation(s)
- Deenadayalan Boopalan
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Venugopal Vijayakumar
- Department of Yoga, Govt. Yoga & Naturopathy Medical College & Hospital, The Tamilnadu Dr. MGR Medical University, Chennai, India
| | - Shantichitra Kalidas
- Department of English, Faculty of Science and Humanities, SRM Institute of Science and Technology, Kattankulathur, Tamilnadu, India
| | - Poornima Ravi
- Department of Clinical Research, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Arthi Balakrishnan
- Department of Naturopathy, International Institute of Yoga and Naturopathy Medical Sciences, The Tamil Nadu Dr. MGR Medical University, Chengalpattu, 603001, Tamil Nadu, India
| | - Poonguzhali Shanmugam
- Department of community medicine, Govt. Yoga & Naturopathy Medical College & Hospital, The Tamilnadu Dr, MGR Medical University, Chennai, India
| | - Velan Arumugam
- Department of Yoga, International Institute of Yoga and Naturopathy Medical sciences, The Tamil Nadu Dr. MGR Medical University, Chengalpattu, 603001, Tamil Nadu, India
| | - Maheshkumar Kuppusamy
- Department of Physiology, Government Yoga and Naturopathy Medical College & Hospital, The Tamilnadu Dr.MGR Medical University, Chennai, Tamil Nadu, India.
| | - Govindasamy Karuppasamy
- Department of Physical Education and Sports Sciences, College of Science and Humanities, SRM Institute of Science and Technology, Kattankulathur, Tamilnadu, India
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Mondal H, Komarraju S, D S, Muralidharan S. Naturopathic Interventions for Reduction of Perceived Pain in Patients Suffering from Arthritis: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e54589. [PMID: 38524044 PMCID: PMC10958190 DOI: 10.7759/cureus.54589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 03/26/2024] Open
Abstract
Arthritis affects millions of lives with its pervasive effects on physical health and quality of life. Addressing the complexities of managing symptoms such as swelling, inflammation, and pain requires prolonged treatment. Naturopathy is a treatment method that enhances the body's innate ability to restore optimal health through a holistic approach including natural products and lifestyle modifications. This systematic review addresses the intersection of naturopathy and arthritis treatment to provide current evidence about its potential benefits. Four databases (PubMed, AYUSH Research Portal, Web of Science, and Google Scholar) were searched with the keywords "Naturopathy" AND "Arthritis". Randomized, non-randomized, and cross-over studies in English were included. Studies reporting perceived pain using a visual analogue scale (VAS) were selected for meta-analysis. A total of 15 studies were included in the systematic review. The studies were from Denmark, Egypt, France, Hungary, Israel, Italy, Spain, and Turkey, and the study periods ranged from 1992 to 2017. They suggested that naturopathic treatment modalities like exercise, mud compress, sand bath, or hydrotherapy may be used in addition to conventional modes of treatment for added benefit. There was a diversity of naturopathic treatment modalities and outcome evaluation methods. Most studies used mud compress or mud baths with reported improvement of symptoms. The meta-analysis of 10 studies (11 sets of data) showed a significant improvement in pain measured by VAS. The studies included in the review have a high level of heterogenicity. There is a need for more studies and uniform assessment methods with standardization of interventions for robust evidence. More clinical trials from countries where naturopathy is approved treatment modalities are needed.
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Affiliation(s)
- Himel Mondal
- Physiology, All India Institute of Medical Sciences, Deoghar, Deoghar, IND
| | | | - Sathyanath D
- Naturopathy and Yoga, National Institute of Naturopathy, Pune, IND
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Koru H, Yilmaz H, Yilmaz R, Karpuz S. Comparison of the efficiency of peloidotherapy and extracorporeal shock wave therapies in patients diagnosed with lateral epicondylitis: a prospective, randomized, controlled study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:101-108. [PMID: 37934301 DOI: 10.1007/s00484-023-02574-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/10/2023] [Accepted: 10/27/2023] [Indexed: 11/08/2023]
Abstract
Various treatment methods are used in the management of lateral epicondylitis (LE); however, there is no universally accepted standard treatment approach. The aim of this study is to compare the effects of peloidotherapy and extracorporeal shock wave therapy (ESWT) on pain, functional status, and quality of life in the treatment of LE. The study was designed as a hospital-based, prospective randomized controlled trial. Ninety patients, with a mean age of 47.30±7.95 (range, 18 to 65 years), diagnosed with chronic (3 months) unilateral LE were included in the study. The patients were randomly divided into two groups. The peloidotherapy group received 15 sessions of peloid therapy for 3 weeks, 5 days a week, while the ESWT group received three sessions of ESWT (1.8 bar, 10.0 Hz, 2000 impulses) for 3 weeks, once a week. The patients were evaluated before treatment, at the end of the treatment, and one month after the treatment. The groups were compared in terms of pain, quality of life, functional status, and handgrip strength. At the end of the treatment and one-month follow-up, statistically significant improvements were observed in all parameters. This study is the first randomized trial comparing peloidotherapy to ESWT as an adjunct to exercise therapy in LE. Both ESWT and peloidotherapy, when added to exercise therapy, showed positive short-term effects on pain, quality of life, functional status, and handgrip strength in primary conservative treatment of chronic LE (p<0.001), and no superiority was found between them in terms of efficacy. Peloidotherapy or ESWT may be preferred in the treatment of lateral epicondylitis, depending on the patient's condition. Peloidotherapy appears to be more advantageous due to its lower side effects and painless nature. ClinicalTrials.gov ID: NCT04748406.
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Affiliation(s)
- Hasan Koru
- Department of Physical Medicine and Rehabilitation, Konya Beyhekim Training and Research Hospital, University of Health Sciences, Devlethane Street No:2/A, 42060, Selcuklu, Konya, Turkey.
| | - Halim Yilmaz
- Department of Physical Medicine and Rehabilitation, Konya Beyhekim Training and Research Hospital, University of Health Sciences, Devlethane Street No:2/A, 42060, Selcuklu, Konya, Turkey
| | - Ramazan Yilmaz
- Department of Physical Medicine and Rehabilitation, Konya Beyhekim Training and Research Hospital, University of Health Sciences, Devlethane Street No:2/A, 42060, Selcuklu, Konya, Turkey
| | - Savaş Karpuz
- Department of Physical Medicine and Rehabilitation, Konya Beyhekim Training and Research Hospital, University of Health Sciences, Devlethane Street No:2/A, 42060, Selcuklu, Konya, Turkey
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Maccarone MC, Scanu A, Coraci D, Masiero S. The Potential Role of Spa Therapy in Managing Frailty in Rheumatic Patients: A Scoping Review. Healthcare (Basel) 2023; 11:1899. [PMID: 37444733 PMCID: PMC10340743 DOI: 10.3390/healthcare11131899] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
Frailty is not limited to the elderly, as patients with rheumatic diseases can also experience this condition. The present scoping review aimed to investigate the possibility of using the health resort setting as an alternative location for managing rheumatic patients with frailty. The research resulted in finding several in vitro, in vivo, and clinical studies, resulting in evidence supporting the effectiveness of spa treatments in reducing pain, improving function, and managing comorbidity in rheumatic diseases. Additionally, spa treatments were demonstrated to modulate the MAPK/ERK pathway and the NF-kB pathway's activation and to reduce proinflammatory molecules' secretion in rheumatic diseases, thus suggesting their potential effective role in the regulation of inflammaging in frailty. Moreover, the health resort setting may offer potential resources to reduce risk factors, such as drug consumption, inactivity, and disease severity, and may serve as a setting for developing prevention protocols for frailty. Future research should explore innovative approaches, such as exercise training and early diagnostics, for the overall management of frailty in rheumatic patients in the spa setting.
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Affiliation(s)
- Maria Chiara Maccarone
- Department of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Via Giustiniani 2, 35128 Padua, Italy;
| | - Anna Scanu
- Neurorehabilitation Unit, Department of Neuroscience, University of Padua, 35128 Padua, Italy; (A.S.); (D.C.)
- Department of Women’s and Children’s Health, University of Padua, 35128 Padua, Italy
| | - Daniele Coraci
- Neurorehabilitation Unit, Department of Neuroscience, University of Padua, 35128 Padua, Italy; (A.S.); (D.C.)
| | - Stefano Masiero
- Department of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Via Giustiniani 2, 35128 Padua, Italy;
- Neurorehabilitation Unit, Department of Neuroscience, University of Padua, 35128 Padua, Italy; (A.S.); (D.C.)
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Karaarslan F, Yılmaz H, Akkurt HE, Kaya FM, Şafak Yılmaz E. Comparison of the efficacy of mud-pack and hot-pack treatments in chronic non-specific neck pain: A single-blind, randomized-controlled study. Turk J Phys Med Rehabil 2022; 68:381-390. [PMID: 36475098 PMCID: PMC9706788 DOI: 10.5606/tftrd.2022.8575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 10/27/2021] [Indexed: 11/25/2022] Open
Abstract
Objectives This study aims to compare the short-term efficacy of mud-pack (MP) and hot-pack (HP) treatments with the same temperature and duration on sleep, function, depression, and quality of life for chronic non-specific neck pain (CNNP) patients. Patients and methods Between December 2018 and September 2019, a total of 70 patients with CNNP diagnosis (12 males, 58 females; mean age: 50.2±9.4 years; range, 24 to 65 years) were included. The patients were divided into two groups. The MP group (n=35) had a total of 15 sessions of MP for 20 min + transcutaneous electrical nerve stimulation (TENS) for 20 min + home exercise (HE) on five days per week for three weeks. The HP group (n=35) had 15 similar sessions of HP for 20 min + TENS for 20 min + HE. The patients were assessed with the Visual Analog Scale (VAS-pain), VAS physician's and patient's global assessments, modified Neck Disability Index (mNDI), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and Short Form-36 (SF-36) measures before treatment, at the end of post-treatment third week and one month later. Results In the MP group, there were statistically significant improvements in all parameters at the end of treatment three-week and one-month follow-up (p<0.05), apart from SF-36 Vitality/Energy (SF-36V/E) at the end of treatment and SF-36 General Health (SF-36GH) at one month. In the HP group, there were statistically significant improvements observed for all parameters (p<0.05), apart from the SF-36 Physical Role and SF-36GH at the end of treatment third week and SF-36V/E at the first-month assessment. The VAS-pain(p<0.001), mNDI (p=0.019), BDI (p=0.002), SF-36GH (p<0.001), SF-36V/E (p<0.001) and SF-36 mental health (p<0.001) showed statistically significantly superior improvements in the MP group (p<0.05). Conclusion In CNNP patients, both MP and HP treatments are effective. However, MP therapy has more positive effects on pain, function, depression, and quality of life parameters. The MP treatment may be used in addition to TENS treatment for CNNP patients.
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Affiliation(s)
- Fatih Karaarslan
- Department of Medical Ecology and Hydroclimatology, University of Health Sciences, Gülhane Faculty of Medicine, Ankara, Türkiye
| | - Halim Yılmaz
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Konya Training and Research Hospital, Konya, Türkiye
| | - Halil Ekrem Akkurt
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Konya Training and Research Hospital, Konya, Türkiye
| | - Fatih Muhammed Kaya
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Konya Training and Research Hospital, Konya, Türkiye
| | - Esra Şafak Yılmaz
- Department of Medical Informatic, University of Health Sciences, Gülhane Faculty of Medicine, Ankara, Türkiye
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D'Angelo D, Coclite D, Napoletano A, Fauci AJ, Latina R, Gianola S, Castellini G, Salomone K, Gambalunga F, Sperati F, Iacorossi L, Iannone P. The efficacy of balneotherapy, mud therapy and spa therapy in patients with osteoarthritis: an overview of reviews. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:1255-1271. [PMID: 33740137 DOI: 10.1007/s00484-021-02102-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 02/16/2021] [Accepted: 02/20/2021] [Indexed: 06/12/2023]
Abstract
Osteoarthritis is a degenerative disease considered a leading cause of functional disability. Its treatment is based on a combination of pharmacological and non-pharmacological interventions, but the role of these latter is still debated. This overview of systematic reviews aimed at evaluating the short-term efficacy of different thermal modalities in patients with osteoarthritis. We searched PubMed, Scopus, CINHAL, Web of Science, ProQuest and the Cochrane Database of Systematic Reviews from inception until October 2020, with no language restrictions. We selected the following outcomes a priori: pain, stiffness and quality of life. Seventeen systematic reviews containing 27 unique relevant studies were included. The quality of the reviews ranged from low to critically low. Substantial variations in terms of interventions studied, comparison groups, population, outcomes and follow-up between the included SRs were found. From a re-analysis of primary data, emerged that balneotherapy was effective in reducing pain and improving stiffness and quality of life, mud therapy significantly reduced pain and stiffness, and spa therapy showed pain relief. However, the evidence supporting the efficacy of different thermal modalities could be seriously flawed due to methodological quality and sample size, to the presence of important treatment variations, and to the high level of heterogeneity and the absence of a double-blind design. There is some encouraging evidence that deserves clinicians' consideration, suggesting that thermal modalities are effective on a short-term basis for treating patients with AO.
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Affiliation(s)
- Daniela D'Angelo
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, Via Giano della Bella, 34, 00162, Rome, Italy
| | - Daniela Coclite
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, Via Giano della Bella, 34, 00162, Rome, Italy
| | - Antonello Napoletano
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, Via Giano della Bella, 34, 00162, Rome, Italy
| | - Alice Josephine Fauci
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, Via Giano della Bella, 34, 00162, Rome, Italy
| | - Roberto Latina
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, Via Giano della Bella, 34, 00162, Rome, Italy
| | - Silvia Gianola
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Greta Castellini
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Katia Salomone
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, Via Giano della Bella, 34, 00162, Rome, Italy
| | | | - Francesca Sperati
- Biostatistics and Bioinformatic Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Laura Iacorossi
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, Via Giano della Bella, 34, 00162, Rome, Italy.
| | - Primiano Iannone
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, Via Giano della Bella, 34, 00162, Rome, Italy
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Maraver F, Armijo F, Fernandez-Toran MA, Armijo O, Ejeda JM, Vazquez I, Corvillo I, Torres-Piles S. Peloids as Thermotherapeutic Agents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041965. [PMID: 33670514 PMCID: PMC7934683 DOI: 10.3390/ijerph18041965] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/11/2021] [Accepted: 02/14/2021] [Indexed: 11/24/2022]
Abstract
The use of peloids as heat-providing therapeutic systems dates back to antiquity. Such systems consist of a liquid phase and an organic or inorganic solid phase. The latter facilitates the handling, preparation and stability of the solid–liquid system, modifying its organoleptic and phy-sicochemical properties, and improves its efficacy and tolerance. Peloids enable the application of heat to very specific zones and the release of heat at a given rate. The aims of this work are to study 16 reference peloids used in medical spa centers as thermo-therapeutic agents as well as to propose nine raw materials as a solid phase for the preparation of peloids. The physical properties studied are the centesimal composition, the instrumental texture and the thermal parameters. In conclusion, the peloids of the medical spas studied are used as thermotherapeutic agents in the treatment of musculoskeletal disorders, especially in knee osteoarthritis and to a lesser extent in back pain and psoriatic arthropathy. The clinical experience in these centers shows that the main effects of the application of their peloids are the reduction of pain, an increase in the joint’s functional capacity and an improvement in the quality of life. As thermotherapeutic agents, all the peloids of the me-dical spas studied and the pastes (raw materials with distilled water) examined showed a heat flow rate of up to four times lower than that shown by the same amount of water. The raw materials studied can be used as solid phases for the preparation of peloids with mineral waters.
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Affiliation(s)
- Francisco Maraver
- Medical Hydrology Group, Department of Radiology, Rehabilitation & Physiotherapy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (F.A.); (J.M.E.); (I.V.)
- Professional School of Medical Hydrology, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain;
- Correspondence:
| | - Francisco Armijo
- Medical Hydrology Group, Department of Radiology, Rehabilitation & Physiotherapy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (F.A.); (J.M.E.); (I.V.)
- Professional School of Medical Hydrology, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain;
| | | | - Onica Armijo
- La Paz University Hospital, Universidad Autonoma de Madrid, Paseo de la Castellana 261, 28046 Madrid, Spain;
| | - Jose Manuel Ejeda
- Medical Hydrology Group, Department of Radiology, Rehabilitation & Physiotherapy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (F.A.); (J.M.E.); (I.V.)
| | - Iciar Vazquez
- Medical Hydrology Group, Department of Radiology, Rehabilitation & Physiotherapy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (F.A.); (J.M.E.); (I.V.)
- Geological Survey of Spain (IGME), Calle de la Calera 1, 28760 Madrid, Spain
| | - Iluminada Corvillo
- Professional School of Medical Hydrology, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain;
| | - Silvia Torres-Piles
- Research Group in Immunophysiology, Department of Medical-Surgical Therapy, Faculty of Medicine, University of Extremadura, Avda. Elvas s/n, 06071 Badajoz, Spain;
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NACAKOĞLU İ, KAYA E. Kaplıca Tedavisinin Romatizmal Hastalıklarda İlaç Terkine Olan Etkileri. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2020. [DOI: 10.30934/kusbed.558889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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10
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Bernetti A, Mangone M, Alviti F, Paolucci T, Attanasi C, Murgia M, Di Sante L, Agostini F, Vitale M, Paoloni M. Spa therapy and rehabilitation of musculoskeletal pathologies: a proposal for best practice in Italy. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:905-914. [PMID: 31129759 DOI: 10.1007/s00484-019-01731-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/08/2019] [Accepted: 05/08/2019] [Indexed: 05/12/2023]
Abstract
Spa therapy is a heterogeneous collection of treatments and methods based on natural resources. It is often considered as an option in the common therapeutic approach to many musculoskeletal disorders, as well as respiratory, vascular, and dermatological disorders. The objective of this paper is to highlight possible interactions between rehabilitation and spa medicine in the field of musculoskeletal disorders, through an analysis of the scientific literature, in order to give the practitioner the ability to integrate good clinical practice in the field of rehabilitation through practical application involving spa therapies. The literature search was conducted using Medline, PEDro, Cochrane Database, and Google Scholar. Only studies published in English and works concerning the implementation of spa thermal treatment in neuro-musculoskeletal diseases were included. Specifically, the publications analyzed dealt with the treatment of diseases such as arthritis, rheumatic arthritis, ankylosing spondylitis, and low back pain through the use of thermal spa therapies. In conjunction with its widespread use in clinical practice, many studies in the literature suggest the effectiveness of crenobalneotherapy for a number of musculoskeletal disorders, generally those which are chronic and debilitating, finding significant clinical improvement both in terms of pain and functional limitations. Some of the guidelines formulated by national and international bodies on the treatment of specific diseases, such as the Italian Rheumatology Society (SIR) and the Osteoarthritis Research Society International (OARSI) guidelines, recognize the value of thermal medicine as a complement, but not a replacement, for conventional therapy (pharmacological or not).
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Affiliation(s)
- Andrea Bernetti
- Department of Physical Medicine and Rehabilitation, Sapienza University, Piazzale Aldo Moro 5, 00185, Rome, Italy.
| | - Massimiliano Mangone
- Department of Physical Medicine and Rehabilitation, Sapienza University, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Federica Alviti
- Department of Physical Medicine and Rehabilitation, Sapienza University, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Teresa Paolucci
- Complex Unit of Physical Medicine and Rehabilitation, Policlinico Umberto I Hospital, Rome, Italy
| | - Carmine Attanasi
- Department of Physical Medicine and Rehabilitation, Sapienza University, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Massimiliano Murgia
- Complex Unit of Physical Medicine and Rehabilitation, Policlinico Umberto I Hospital, Rome, Italy
| | - Luca Di Sante
- Complex Unit of Physical Medicine and Rehabilitation, Policlinico Umberto I Hospital, Rome, Italy
| | - Francesco Agostini
- Department of Physical Medicine and Rehabilitation, Sapienza University, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Marco Vitale
- Dipartimento di Scienze Biomediche, Biotecnologiche e Traslazionali, Unità di Anatomia e Istologia, Università degli Studi di Parma, Parma, Italy
| | - Marco Paoloni
- Department of Physical Medicine and Rehabilitation, Sapienza University, Piazzale Aldo Moro 5, 00185, Rome, Italy
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Király M, Kővári E, Hodosi K, Bálint PV, Bender T. The effects of Tiszasüly and Kolop mud pack therapy on knee osteoarthritis: a double-blind, randomised, non-inferiority controlled study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:943-950. [PMID: 31377868 PMCID: PMC7266795 DOI: 10.1007/s00484-019-01764-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/29/2019] [Accepted: 07/12/2019] [Indexed: 05/05/2023]
Abstract
The aim of this non-inferiority study was to evaluate and compare the effects of Tiszasüly and Kolop mud pack therapy on pain, function and quality of life in patients with knee osteoarthritis. In this double-blind, randomised, follow-up study, 60 patients with knee osteoarthritis were treated with either Tiszasüly hot mud pack (group 1) or with Kolop hot mud pack (group 2) on 10 occasions for 2 weeks (10 working days). One hundred millimetre visual analogue scale (VAS) for knee pain, the Western Ontario and McMaster Universities Arthritis Index (WOMAC), the Knee injury and Osteoarthritis Outcome Score (KOOS), the Lequesne Index for physical function and EuroQoL-5D for quality-of-life measurements were recorded at baseline, at the end of treatment (week 2) and 3 months later (week 12). In both groups, all measured parameters improved significantly from the baseline until the end of treatment and during the follow-up period (p < 0.05). There were no significant differences between the groups in terms of the WOMAC, KOOS, EQ-5D and Lequesne Index at any visits. Knee pain improved in both groups at week 2 and week 12; the only significant difference visible between the groups was at the end of the treatment in favour of the Tiszasüly mud pack group (p = 0.009). Tiszasüly and Kolop mud packs both have a favourable effect on knee pain, physical function and quality of life in patients with knee osteoarthritis. Our results proved non-inferiority of Tiszasüly mud pack.
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Affiliation(s)
- Márta Király
- Petz Aladár County Teaching Hospital, Híd u.2., Győr, H-9025, Hungary
- Doctoral School of Clinical Medicine, University of Szeged, Korányi fasor 6., Szeged, H-6720, Hungary
| | - Eszter Kővári
- School of PhD Studies, Semmelweis University, Üllői út 26., Budapest, H-1085, Hungary
| | - Katalin Hodosi
- Medical and Health Science Center, University of Debrecen, Nagyerdei körút 98., Debrecen, H-4012, Hungary
| | - Péter V Bálint
- 3rd Rheumatology Department, National Institute of Rheumatology and Physiotherapy, Frankel L. u. 25-29., Budapest, H-1023, Hungary
| | - Tamás Bender
- Polyclinic of Hospitaller Brothers of St. John of God, Árpád fejedelem útja 7., Budapest, H-1023, Hungary.
- Department of Orthopedics, Faculty of Medicine, Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary.
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Effects of Balneotherapy in Jeju Magma-Seawater on Knee Osteoarthritis Model. Sci Rep 2020; 10:6620. [PMID: 32313003 PMCID: PMC7171195 DOI: 10.1038/s41598-020-62867-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 03/10/2020] [Indexed: 12/14/2022] Open
Abstract
Balneotherapy is a common non-pharmacological treatment for osteoarthritis (OA), however, the efficacy is controversial in knee OA. Jeju magma-seawater (JMS) has high contents of various minerals, which has anti-inflammatory and antioxidant properties via an oral route. Thus, we examined the effects of JMS bathing on knee OA and the combination effects with diclofenac sodium as an anti-inflammatory drug. Knee OA was induced by transection of the anterior cruciate ligament and the partial meniscectomy in rat. The rats were administered subcutaneously saline or diclofenac sodium in saline, followed by bathing in thermal distilled water or JMS for 8 weeks. The model represented the characteristic changes of the cartilage degradation, osteophyte formation and synovial inflammation, and the relevant symptoms of the joint swelling and stiffness. However, the JMS bathing reduced the joint thickness and improved the mobility. It also contributed to a well-preserved tissue supported by increases in bone mineral density of the joint and decreases in Mankin scores in the cartilages. The effects involved anti-inflammation, chondroprotection, anti-apoptosis, and chondrogenesis. Overall, the JMS bathing in combination with diclofenac sodium showed a similar trend associated with synergic effects. It suggests that JMS bathing can be promising for a clinical use in knee OA.
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Mud Therapy Combined with Core Exercise for Chronic Nonspecific Low Back Pain: A Pilot, Single-Blind, Randomized Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:7547452. [PMID: 32328139 PMCID: PMC7157804 DOI: 10.1155/2020/7547452] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 01/08/2020] [Indexed: 11/17/2022]
Abstract
Background Low back pain (LBP) is common in the elderly and an appropriate intervention for LBP management should be investigated. The aim of this study is to investigate the potential of mud-heat intervention combined with core exercise as an alternative intervention for relieving pain and improving motor function in individuals with nonspecific chronic LBP. Methods Thirty-one individuals with chronic nonspecific LBP were randomly allocated to either the intervention group (n = 16) or the control group (n = 15). The intervention group used a mud pack for 30 min and performed a core-exercise program for 50 min twice a day for 4 days (8 sessions). The control group performed the core-exercise program only, at the same time point as the intervention group. Pain intensity was assessed using a 100 mm visual analog scale and a pain pressure threshold (PPT) as the primary outcomes. The secondary outcome measures included functional disability by LBP (Oswestry Disability Index), muscle properties, and static/dynamic balance. Results There was a significant group difference in pain intensity at rest (p=0.048) and in the PPT at the two sites assessed (2 cm lateral to L3 spinous process, p=0.045; 2 cm lateral to L5 spinous process, p=0.015). No group differences were found in terms of muscle properties. Compared to core exercise only, moor-heat therapy and core exercise showed a significant improvement in static balance (p=0.026) and dynamic balance (p=0.019). Conclusion Mud therapy combined with core exercise is effective in relieving pain and improving motor function in patients with chronic nonspecific LBP. Further research is needed to underpin these preliminary results.
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Hou C, Liang L, Chu X, Qin W, Li Y, Zhao Y. The short-term efficacy of mud therapy for knee osteoarthritis: A meta-analysis. Medicine (Baltimore) 2020; 99:e19761. [PMID: 32332614 PMCID: PMC7220793 DOI: 10.1097/md.0000000000019761] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The objective of this review is to systematically evaluate the short-term efficacy of mud therapy in the treatment of knee osteoarthritis (KOA).Randomized controlled trials, in which treatment of KOA is mud therapy, were included by systematically searching the PubMed, Embase, and the Cochrane Library databases.According to inclusion criteria and searching method, 11 articles, containing a total of 1106 patients, were included in the study. Our results showed significant differences in visual analog scale pain score and Western Ontario and McMaster Universities Osteoarthritis Index (pain, stiffness, function). In addition, the heterogeneity of study included is lower (I < 25%).According to the results of this meta-analysis, mud therapy can effectively alleviate the pain and improve joint function for KOA.
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Affiliation(s)
- Chengzhi Hou
- Orthopedic Department, Wangjing Hospital, China Academy of Chinese Medical Sciences
| | - Long Liang
- Orthopedic Department, Wangjing Hospital, China Academy of Chinese Medical Sciences
| | - Xuelei Chu
- Beijing University of Chinese Medicine, Beijing, China
| | - Weikai Qin
- Orthopedic Department, Wangjing Hospital, China Academy of Chinese Medical Sciences
| | - Yongyao Li
- Orthopedic Department, Wangjing Hospital, China Academy of Chinese Medical Sciences
| | - Yong Zhao
- Orthopedic Department, Wangjing Hospital, China Academy of Chinese Medical Sciences
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15
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Alfieri FM, Barros MCC, Carvalho KCD, Toral I, Silva CFD, Vargas e Silva NCDO. Geotherapy combined with kinesiotherapy is efficient in reducing pain in patients with osteoarthritis. J Bodyw Mov Ther 2020; 24:77-81. [DOI: 10.1016/j.jbmt.2019.05.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 05/24/2019] [Indexed: 11/28/2022]
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16
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Effects of balneotherapy and spa therapy on quality of life of patients with knee osteoarthritis: a systematic review and meta-analysis. Rheumatol Int 2018; 38:1807-1824. [DOI: 10.1007/s00296-018-4081-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 06/06/2018] [Indexed: 12/25/2022]
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17
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Morer C, Roques CF, Françon A, Forestier R, Maraver F. The role of mineral elements and other chemical compounds used in balneology: data from double-blind randomized clinical trials. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:2159-2173. [PMID: 28849535 DOI: 10.1007/s00484-017-1421-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 07/28/2017] [Accepted: 07/31/2017] [Indexed: 05/21/2023]
Abstract
The aims of this study were to conduct a systematic literature review on balneotherapy about the specific therapeutic role of mineral elements and other chemical compounds of mineral waters and derivate peloids/muds and to discuss the study methods used to evaluate it (in musculoskeletal conditions). We searched Medline by PubMed using the following key words: "spa therapy" "balneotherapy" "mud" "peloid" "mud pack Therapy" in combination with "randomized controlled trial" "double blind trial." We also reviewed the reference list of articles retrieved by the Medline search. We selected the double-blind randomized clinical trials that assessed the effects of mineral water or mud treatments compared to tap water, attenuated peloid/mud therapy or similar treatments without the specific minerals or chemical compounds of the treatment group ("non-mineral"). We evaluated the internal validity and the quality of the statistical analysis of these trials. The final selection comprised 27 double-blind randomized clinical trials, 20 related to rheumatology. A total of 1118 patients with rheumatological and other musculoskeletal diseases were evaluated in these studies: 552 of knee osteoarthritis, 47 of hand osteoarthritis, 147 chronic low back pain, 308 of reumathoid arthritis, and 64 of osteoporosis; 293 of these participants were assigned to the experimental groups of knee osteoarthritis, 24 in hand osteoarthritis, 82 of low back pain, 152 with reumathoid arthritis, and 32 with osteoporosis. They were treated with mineral water baths and/or mud/peloid (with or without other forms of treatment, like physical therapy, exercise…). The rest were allocated to the control groups; they received mainly tap water and/or "non-mineral" mud/peloid treatments. Mineral water or mud treatments had better and longer improvements in pain, function, quality of life, clinical parameters, and others in some rheumatologic diseases (knee and hand osteoarthritis, chronic low back pain, rheumatoid arthritis, and osteoporosis) compared to baseline and non-mineral similar treatments. Internal validity and other limitations of the study's methodology impede causal relation of spa therapy on these improvements. Randomized clinical trials are very heterogeneous. Double-blind randomized clinical trials seem to be the key for studying the role of mineral elements and other chemical compounds, observing enough consistency to demonstrate better and longer improvements for mineral waters or derivate compared to tap water; but due to heterogeneity and gaps on study protocol and methodology, existing research is not sufficiently strong to draw firm conclusions. Well-designed studies in larger patients' population are needed to establish the role of minerals and other chemical compounds in spa therapy.
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Affiliation(s)
- Carla Morer
- Department of Physical Medicine and Rehabilitation. Medical Hydrology, Faculty of Medicine, Universidad Complutense de Madrid, Plaza Ramon y Cajal, s/n, 28040, Madrid, Spain
- Institut Català de la Salut, EAP 8B Porta, Centro Atención Primaria Rio de Janeiro, UTAC Muntanya, Barcelona, Spain
| | | | - Alain Françon
- Aix-les-Bains Rheumatologic and Thermal Research Center, 15 Avenue Charles de Gaulle, 73100, Aix-les-Bains, France
| | - Romain Forestier
- Aix-les-Bains Rheumatologic and Thermal Research Center, 15 Avenue Charles de Gaulle, 73100, Aix-les-Bains, France
| | - Francisco Maraver
- Department of Physical Medicine and Rehabilitation. Medical Hydrology, Faculty of Medicine, Universidad Complutense de Madrid, Plaza Ramon y Cajal, s/n, 28040, Madrid, Spain.
- Professional School of Medical Hydrology, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain.
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Ökmen BM, Eröksüz R, Altan L, Aksoy MK. Efficacy of peloid therapy in patients with chronic lateral epicondylitis: a randomized, controlled, single blind study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:1965-1972. [PMID: 28620677 DOI: 10.1007/s00484-017-1386-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 05/02/2017] [Accepted: 05/27/2017] [Indexed: 06/07/2023]
Abstract
The aim of this study was to assess the effect of peloid on pain, functionality, daily life activities, and quality of life of lateral epicondylitis (LE) patients. In this randomized, controlled, single-blind study, 75 patients who were diagnosed with chronic LE were enrolled to the study. Patients were randomized into two groups using the random number table. The patients in the first group (group 1) (n = 33), were given lateral epicondylitis band (LEB) (during the day for 6 weeks) + peloid therapy (five consecutive days a week for 2 weeks), and the second group (group 2) (n = 32), received LEB treatment alone. The patients were assessed by using Patient Rated Tennis Elbow Evaluation (PRTEE) and Nottingham Health Profile (NHP). The data were obtained before treatment (W0), immediately after treatment (W2), and 1 month after treatment (W6). In analysis of the collected data, the Wilcoxon signed rank test for intra-group comparisons and Mann-Whitney U test for comparisons between groups were used. Both in groups 1 and 2, there was a statistically significant improvement in all the evaluation parameters at W2 and W6 when compared to W0 (p < 0.05). In comparison of difference scores between groups, although there was no statistically significant difference between the two groups at W2 when compared to W0 (p > 0.05), a statistically significant difference was found in favor of group 1 for all the evaluation parameters at W6 (p < 0.05). Our results have shown that peloid treatment could be effective in providing improvement in pain relief, function, daily life activities, and quality of life in LE patients.
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Affiliation(s)
- Burcu Metin Ökmen
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
| | - Rıza Eröksüz
- Department of Medical Ecology and Hydroclimatology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
- Department of Physical Medicine and Rehabilitation, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Meliha Kasapoğlu Aksoy
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
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Zrubka Z, Rencz F, Závada J, Golicki D, Rupel VP, Simon J, Brodszky V, Baji P, Petrova G, Rotar A, Gulácsi L, Péntek M. EQ-5D studies in musculoskeletal and connective tissue diseases in eight Central and Eastern European countries: a systematic literature review and meta-analysis. Rheumatol Int 2017; 37:1957-1977. [PMID: 28849432 DOI: 10.1007/s00296-017-3800-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/17/2017] [Indexed: 02/05/2023]
Abstract
EQ-5D is becoming the preferred instrument to measure health-state utilities involved in health technology assessment. The objective of this study is to assess the state of EQ-5D research in musculoskeletal disorders in 8 Central and Eastern European countries and to provide a meta-analysis of EQ-5D index scores. Original research articles published in any language between Jan 2000 and Sept 2016 were included, if they reported any EQ-5D outcome from at least two musculoskeletal patients from Austria, Bulgaria, the Czech Republic, Hungary, Poland, Romania, Slovakia, or Slovenia. Risk of bias was assessed with the Cochrane Collaboration's tool. Twenty-nine articles (5992 patients) were included on rheumatoid arthritis (n = 7), osteoporosis (n = 5), chronic pain (n = 5), osteoarthritis (n = 4), ankylosing spondylitis (n = 2), psoriatic arthritis (n = 2), total hip replacement (n = 2), and scleroderma (n = 2). Low back pain was under-represented, while studies in neck pain, systemic lupus erythematosus, gout, and childhood disorders were lacking. EQ-5D index scores were reported in 24 studies, while the version of the instrument and the value-set was not specified in 41% and 46% of the articles, respectively. Meta-analysis was performed on 24 disease states involving 6876 observation points. Intervention effect was reported in 22 subgroups, out of which risk of bias was low in 41%. This review provides recommendations to improve reporting standards of EQ-5D results and highlights potential areas for future research. Coordinated research in conditions with greatest public health impact as well as a development of a regional value-set could provide locally relevant health-state utilities that are transferable among countries within the region.
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Affiliation(s)
- Zsombor Zrubka
- Doctoral School of Business and Management, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary
- Sandoz Hungária Kft, Bartók Béla u. 43-47, 1134, Budapest, Hungary
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary
| | - Jakub Závada
- Institute of Rheumatology, Na Slupi 4, Prague, 128 00, Czech Republic
| | - Dominik Golicki
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, ul. Banacha 1b, 02-097, Warsaw, Poland
| | | | - Judit Simon
- Department of Health Economics, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1 1090, Vienna, Austria
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary
| | - Guenka Petrova
- Department of Social Pharmacy and Pharmacoeconomics, Faculty of Pharmacy, Medical University, Sofia, Bulgaria
| | - Alexandru Rotar
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 22660, 1100 DD, Amsterdam, The Netherlands
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary.
- Department of Rheumatology, Flór Ferenc County Hospital, Semmelweis tér 1, 2143, Kistarcsa, Hungary.
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The effect of balneotherapy on pain relief, stiffness, and physical function in patients with osteoarthritis of the knee: a meta-analysis. Clin Rheumatol 2017; 36:1839-1847. [DOI: 10.1007/s10067-017-3592-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 02/18/2017] [Accepted: 02/23/2017] [Indexed: 10/20/2022]
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Uzunoglu E, Yentur S, Kayar AH, Turan M, Donmez A, Direskeneli GS, Erdogan N. Effect of mild heat stress on heat shock protein 70 in a balneotherapy model. Eur J Integr Med 2017. [DOI: 10.1016/j.eujim.2016.11.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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22
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Fioravanti A, Karagülle M, Bender T, Karagülle MZ. Balneotherapy in osteoarthritis: Facts, fiction and gaps in knowledge. Eur J Integr Med 2017. [DOI: 10.1016/j.eujim.2017.01.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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23
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Gungen GO, Ardic F, Findikoglu G, Rota S. Effect of mud compress therapy on cartilage destruction detected by CTX-II in patients with knee osteoarthritis. J Back Musculoskelet Rehabil 2016; 29:429-38. [PMID: 26406208 DOI: 10.3233/bmr-150629] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND/OBJECTIVE The aim of this study is to investigate the effect of mud compress (MC) therapy compared to hot pack (HP) therapy on cartilage destruction and subchondral bone alterations detected by urine levels of C telopeptide fragment of collagen type-II (uCTX-II) in patients with knee osteoarthritis (OA). METHODS Fifty-nine patients between 49-74 years of age with bilateral knee OA divided into 2 groups. Twenty-five patients (16 females, 9 males) and 34 patients (22 females, 13 males) were given HP versus local natural organic and mineral-rich MC therapy respectively for 2 weeks as a total of 12 sessions. uCTX-II, Visual Analog Scale (VAS), 15 m walking time, Western Ontario and McMaster Universities multifunctional (WOMAC) index were measured at baseline, after-treatment and 3 months after treatment. RESULTS uCTX-II level did not show any difference between the two groups, however it decreased significantly in MC and HP groups 3 months after treatment (p< 0.017). WOMAC stiffness sore was significantly lower in MC group 3 months after treatment (p< 0.05). Both MC and HP therapies lowered VAS, WOMAC total and subscores significantly up to 3 months (p< 0.017). CONCLUSIONS HP and MC therapies for OA of knee are not superior to one another with respect to the level of uCTX-II. MC may probably decrease the ongoing cartilage destruction and related subchonral bone interactions earlier compared to HP treatment in patients with knee OA as evidenced by decreased uCTX-II levels after-treatment.
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Affiliation(s)
- Gonca Odemis Gungen
- Denizli Governmental Hospital, Clinic of Physical Medicine and Rehabilitation, Denizli, Turkey
| | - Fusun Ardic
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Pamukkale, Denizli, Turkey
| | - Gulin Findikoglu
- Department of Biochemistry, Faculty of Medicine, University of Pamukkale, Denizli, Turkey
| | - Simin Rota
- Department of Biochemistry, Faculty of Medicine, University of Pamukkale, Denizli, Turkey
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Rencz F, Gulácsi L, Drummond M, Golicki D, Prevolnik Rupel V, Simon J, Stolk EA, Brodszky V, Baji P, Závada J, Petrova G, Rotar A, Péntek M. EQ-5D in Central and Eastern Europe: 2000-2015. Qual Life Res 2016; 25:2693-2710. [PMID: 27472992 DOI: 10.1007/s11136-016-1375-6] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Cost per quality-adjusted life year data are required for reimbursement decisions in many Central and Eastern European (CEE) countries. EQ-5D is by far the most commonly used instrument to generate utility values in CEE. This study aims to systematically review the literature on EQ-5D from eight CEE countries. METHODS An electronic database search was performed up to 1 July 2015 to identify original EQ-5D studies from the countries of interest. We analysed the use of EQ-5D with respect to clinical areas, methodological rigor, population norms and value sets. RESULTS We identified 143 studies providing 152 country-specific results with a total sample size of 81,619: Austria (n = 11), Bulgaria (n = 6), Czech Republic (n = 18), Hungary (n = 47), Poland (n = 51), Romania (n = 2), Slovakia (n = 3) and Slovenia (n = 14). Cardiovascular (21 %), neurologic (17 %), musculoskeletal (15 %) and endocrine, nutritional and metabolic diseases (13 %) were the most frequently studied clinical areas. Overall, 112 (78 %) of the studies reported EQ VAS results and 86 (60 %) EQ-5D index scores, of which 27 (31 %) did not specify the applied tariff. Hungary, Poland and Slovenia have population norms. Poland and Slovenia also have a national value set. CONCLUSIONS Increasing use of EQ-5D is observed throughout CEE. The spread of health technology assessment activities in countries seems to be reflected in the number of EQ-5D studies. However, improvement in informed use and methodological quality of reporting is needed. In jurisdictions where no national value set is available, in order to ensure comparability we recommend to apply the most frequently used UK tariff. Regional collaboration between CEE countries should be strengthened.
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Affiliation(s)
- Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, H-1093, Hungary.,Semmelweis University Doctoral School of Clinical Medicine, Üllői út 26., Budapest, H-1085, Hungary
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, H-1093, Hungary.
| | - Michael Drummond
- Centre for Health Economics, University of York, Heslington, York, YO10 5DD, UK
| | - Dominik Golicki
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Poland, ul. Banacha 1b, 02-097, Warsaw, Poland
| | | | - Judit Simon
- Department of Health Economics, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria
| | - Elly A Stolk
- Institute of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, H-1093, Hungary
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, H-1093, Hungary
| | - Jakub Závada
- Institute of Rheumatology, 1st Faculty of Medicine, Charles University, Na Slupi 4, 128 00, Prague, Czech Republic
| | - Guenka Petrova
- Department of Social Pharmacy and Pharmacoeconomics, Faculty of Pharmacy, Medical University, Sofia, Bulgaria
| | - Alexandru Rotar
- Department of Social Medicine, University of Amsterdam, Meibergdreef 9, 22660, 1100 DD, Amsterdam, The Netherlands
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, H-1093, Hungary
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Forestier R, Erol Forestier FB, Francon A. Spa therapy and knee osteoarthritis: A systematic review. Ann Phys Rehabil Med 2016; 59:216-226. [DOI: 10.1016/j.rehab.2016.01.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/19/2016] [Accepted: 01/25/2016] [Indexed: 11/24/2022]
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Comment on: Clinical Efficacy of Mudpack Therapy in Treating Knee Osteoarthritis: A Meta-analysis of Randomized Controlled Studies. Am J Phys Med Rehabil 2016; 96:e9-e10. [PMID: 27196383 DOI: 10.1097/phm.0000000000000551] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Clinical Efficacy of Mudpack Therapy in Treating Knee Osteoarthritis: A Meta-Analysis of Randomized Controlled Studies. Am J Phys Med Rehabil 2016. [PMID: 26203645 PMCID: PMC4704659 DOI: 10.1097/phm.0000000000000354] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Supplemental digital content is available in the text. Objective The objective of this study was to evaluate the clinical efficacy of mudpack therapy for the treatment of knee osteoarthritis and identify the likely factors associated with the high heterogeneity of combined studies. Design The Medline, Embase, and Cochrane Library databases were systematically searched for randomized controlled trials in which mudpack therapy was used to treat knee osteoarthritis. Results Ten publications that reported the results from a total of 1010 subjects were included in this meta-analysis. Meta-analysis of improvement in joint function at the final follow-up visit suggested, given that the follow-up time was less than 4 mos, that the combined effect size of four studies was −0.30 (−0.62 to 0.02) and the difference did not reach the level of statistical significance. When the follow-up time reached 4 mos, the combined effect size was −1.10 (−2.07 to −0.14) and the difference was significant. The I2 values of the two groups were 21.4% and 93.8%. Conclusion Functional improvement of the knee joint in patients treated with mudpack therapy was not significantly different from that of control subjects at the end of the 4-mo follow-up. The quality of current publications was a factor causing heterogeneity.
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Roques CF, Queneau P. Médecines thermales et douleurs des lombalgies chroniques, gonarthrose ou fibromyalgie. BULLETIN DE L ACADEMIE NATIONALE DE MEDECINE 2016. [DOI: 10.1016/s0001-4079(19)30733-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Fioravanti A, Bacaro G, Giannitti C, Tenti S, Cheleschi S, Gui Delli GM, Pascarelli NA, Galeazzi M. One-year follow-up of mud-bath therapy in patients with bilateral knee osteoarthritis: a randomized, single-blind controlled trial. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:1333-43. [PMID: 25516113 DOI: 10.1007/s00484-014-0943-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 11/17/2014] [Accepted: 11/25/2014] [Indexed: 05/21/2023]
Abstract
The objective of this prospective parallel randomized single-blind study was to assess that a cycle of mud-bath therapy (MBT) provides any benefits over usual treatment in patients with bilateral knee osteoarthritis (OA). Patients with symptomatic primary bilateral knee OA, according to ACR criteria, were included in the study and randomized to one of two groups: one group received a cycle of MBT at spa center of Chianciano Terme (Italy) in addition to the usual treatment, and one group continued their regular care routine alone. Clinical assessments were performed 7 days before enrollment (screening visit), at the time of enrollment (basal time), after 2 weeks, and after 3, 6, 9, and 12 months after the beginning of the study. All assessments were conducted by two researchers blinded to treatment allocation. The primary efficacy outcomes were the global pain score evaluated by Visual Analog Scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) subscore for physical function (W-TPFS). Of the 235 patients screened, 103 met the inclusion criteria: 53 patients were included in the MBT group and 50 in the control group. In the group of patients treated with MBT, we observed a statistically significant (p < 0.001) reduction of VAS and W-TPFS score at the end of the treatment; this improvement was significant (p < 0.05) also at 3 months of follow-up. The control group did not show significant differences between baseline time and all other times. The differences between one group were significant for both primary parameters already from the 15th day and persisted up to the 9th month. This beneficial effect was confirmed by the significant reduction of symptomatic drug consumption. Tolerability of MBT seemed to be good, with light and transitory side effects. Our results confirm that a cycle of MBT added to usual treatment provides a beneficial effect on the painful symptoms and functional capacities in patients with knee OA that lasts over time. Mud-bath therapy can represent a useful backup to pharmacologic treatment of knee OA or a valid alternative for patients who do not tolerate pharmacological treatments.
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Affiliation(s)
- A Fioravanti
- Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico "Le Scotte," Viale Bracci 1, 53100, Siena, Italy,
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Tenti S, Cheleschi S, Galeazzi M, Fioravanti A. Spa therapy: can be a valid option for treating knee osteoarthritis? INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:1133-1143. [PMID: 25339582 DOI: 10.1007/s00484-014-0913-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 10/01/2014] [Accepted: 10/06/2014] [Indexed: 05/28/2023]
Abstract
Osteoarthritis (OA) continues to be one of the leading causes of 'years lived with disability' worldwide. Symptomatic knee OA is highly prevalent among people aged 50 years and over and is destined to become an ever more important healthcare problem. Current management of knee OA includes non-pharmacological and pharmacological treatments. Spa therapy is one of the most commonly used non-pharmacological approaches for OA in many European countries, as well as in Japan and Israel. Despite its long history and popularity, spa treatment is still the subject of debate and its role in modern medicine continues to be unclear. The objective of this review is to summarize the currently available information on clinical effects and mechanisms of action of spa therapy in knee OA. Various randomized controlled clinical trials (RCTs) were conducted to assess the efficacy and tolerability of balneotherapy and mud-pack therapy in patients with knee OA. Data from these clinical trials support a beneficial effect of spa therapy on pain, function and quality of life in knee OA that lasts over time, until 6-9 months after the treatment. The mechanisms by which immersion in mineral or thermal water or the application of mud alleviate suffering in OA are not fully understood. The net benefit is probably the result of a combination of factors, among which the mechanical, thermal and chemical effects are most prominent. In conclusion, spa therapy seems to have a role in the treatment of knee OA. Additional RCTs and further studies of mechanisms of action with high methodological quality are necessary to prove the effects of spa therapy.
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Affiliation(s)
- Sara Tenti
- Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, Policlinico "Le Scotte", University of Siena, Viale Bracci 1, 53100, Siena, Italy
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Thermalisme et douleur chronique en rhumatologie : revue des essais cliniques randomisés (ECR) et des méta-analyses. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s11724-015-0410-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Gerencsér G, Szendi K, Berényi K, Varga C. Can the use of medical muds cause genotoxicity in eukaryotic cells? A trial using comet assay. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2015; 37:63-70. [PMID: 25063339 DOI: 10.1007/s10653-014-9630-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 06/24/2014] [Indexed: 05/21/2023]
Abstract
Despite the lack of knowledge of their exact effects, peloids (natural muds) are widely applied in clinical treatment and prevention of different diseases, especially in rheumatic and gynecological disorders or skin diseases. Primarily we have information on their inorganic components, but only limited data are available on the organic components and nothing on their mechanism of chemical action. The objective of the present study was to detect the DNA-damaging effects (possible genotoxic effect) of peloid samples using the single-cell comet assay on Long Evans rat lymphocytes, human lymphocytes, and Eisenia fetida coelomocytes. Rat and human lymphocytes were exposed to the in toto peloid samples, in vitro. The Eisenia cells were extracted from the coelom of animals kept in the intact peloid sample. An indicator derived from the DNA fluorescence intensity was used in the statistical evaluation. The predominantly organic (Hévíz) sample showed a significant alteration from the negative control in several cases, while the inorganic (Kolop) applied did not. A higher quantity of organic compounds may have an important role in the emergence of DNA damage. The results revealed that medical muds have not only positive health effects but can also contain substances with potential human toxicity risk. Our research provides essential steps towards the creation of a toxicity profile and the possible safe use of peloids as medicinal therapy.
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Affiliation(s)
- Gellért Gerencsér
- Department of Environmental Health, Institute of Public Health Medicine, University of Pécs, Szigeti Str. 12, 7624, Pecs, Hungary,
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Abstract
This article on physiotherapy presents some current evidence stating the strengths and weaknesses of the physiotherapeutic procedures. In the area of physiotherapy empirical data obtained during decades were overtaken by evidence from current studies. The author points out the great problem of physiotherapy, namely the heterogeneity of the applied parameters. Knowledge of current evidence may be very important and helpful for the physicians, but the author proposes, from the practical point of view, that physiotherapeutical procedures based on exprience and used for many years should not be entirely neglected. Nowadays physiotherapy plays an important role in the treament of locomotor diseases but its use is increasing in other fields of medicine, as well.
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Affiliation(s)
- Tamás Bender
- Budai Irgalmasrendi Kórház Központi Fizioterápiás Osztály Budapest Árpád fejedelem u. 7. 1023
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