Evaluation of the therapeutic and the chemical effects of balneological treatment on clinical and laboratory parameters in knee osteoarthritis: a randomized, controlled, single-blinded trial

Comparison of the effectiveness of peloid therapy and kinesiotaping in patients with unilateral plantar fasciitis: A prospective, randomized controlled study

Objectives

This study aimed to compare the efficacy of peloid therapy and kinesiotaping for unilateral plantar fasciitis (PF).

Patients and methods

In the randomized controlled study, a total of 114 patients (89 females, 25 males; mean age: 45.1±8.3 years; range, 27 to 65 years) diagnosed with unilateral PF between January 2021 and March 2023 were randomly divided into three equal groups: the peloid group (peloid therapy and home-based exercise + heel pad), the kinesiotaping group (kinesiotaping and home-based exercise + heel pad), and the control group (home-based exercise + heel pad). Peloid therapy was performed over two weeks for a total of 10 sessions. Kinesiotaping was applied four times over two weeks. Plantar fascia, calf, and Achilles stretching exercises and foot strengthening exercises were performed, and prefabricated silicone heel insoles were used daily for six weeks. Patients were evaluated three times with clinical assessment scales for pain, the Heel Tenderness Index, and the Foot and Ankle Outcome Score before treatment, at the end of treatment, and in the first month after treatment.

Results

Statistically significant improvements were observed for all parameters at the end of treatment and in the first month after treatment compared to the baseline in every group (p<0.001). No superiority was found between the groups.

Conclusion

Peloid therapy or kinesiotaping, given as adjuncts to home-based exercise therapy and shoe insoles in patients with unilateral PF, did not result in additional benefits.

Laboratory features of effects of peloidotherapy and aromatherapy in patients with rheumatoid arthritis

Peloidotherapy and aromatherapy have been used for years in the treatment of numerous inflammatory conditions, including rheumatoid arthritis (RA). The exact mechanism of their action in RA is unclear. The goal of our research is to determine the effect of peloidotherapy and aromatherapy on inflammation parameters in RA patients. Our study included 20 patients of both sexes, with confirmed diagnosis of RA, older than 18 years. Patients were treated during 28 days with combination of peloidotherapy and aromatherapy. Serum samples for detection of levels of inflammation parameters were taken at two intervals: before the start of therapy and at the end of treatment. The results of our study show that there were no significant changes in the parameters of the complete blood count. Nevertheless, a statistically significant decrease in the serum concentration of two markers of inflammation-interleukin-6 (IL-6) and nitrogen-oxide (NO)-was detected. Correlation analyses results say that there is a synchronized drop in the serum concentrations of CRP and the sedimentation rate, and the serum concentrations of fibrinogen and IL-6 are in the same relationship as well as serum levels of IL-6 and NO. Bearing in mind the importance of IL-6 and NO in the pathogenesis of inflammation in RA, we conclude that the application of our therapeutic protocol can be a significant add-on treatment to classic immunomodulators. Due to the small number of study participants, the lack of a control group, and the short follow-up time of patients, additional research is needed.

Comparison of the short-term efficacy of peloid and paraffin treatments on pain and quality of life in the treatment of plantar fasciitis: a randomized controlled study

Although peloid, paraffin, and exercise treatments are effective in patients with plantar fasciitis, there had been no comprehensive and comparative studies of these treatments for plantar fasciitis. The aim of our study was to evaluate the effects of peloid, paraffin, and exercise treatments on pain, functional status, and quality of life in patients with plantar fasciitis. A total of 104 patients, aged 18 years and over, who applied to our clinic with heel pain and were diagnosed with plantar fasciitis according to the American College of Foot and Ankle Surgeons Clinical Consensus Statement: Diagnosis and Treatment of Adult Acquired Infracalcaneal Heel Pain guideline, with pain at the level of 3 and more severe according to the visual analog scale were randomly divided into three groups: the peloid group (peloid therapy and home exercise), the paraffin group (paraffin therapy and home exercise), and the control group (home exercise). Peloid and paraffin applications were applied 5 days a week, a total of 15 sessions in 3 weeks. Participants were evaluated with the visual analog scale, heel tenderness index, and the foot and ankle outcome score before treatment, after treatment, and at the first month after treatment. Compared to pre-treatment evaluation, significant improvements were observed in all parameters after treatment and at the first month controls in all 3 groups (p < 0.05). In the peloidotherapy and paraffin therapy added groups, pain reduction and quality of life increase were higher than the exercise group (p < 0.05). Adding peloidotherapy or paraffin therapy to the home exercise program in the treatment of plantar fasciitis can further reduce pain and improve quality of life.

The Potential Role of Spa Therapy in Managing Frailty in Rheumatic Patients: A Scoping Review

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.

Comparison of the effectiveness of peloid and paraffin treatment for symptomatic hand osteoarthritis in women: a single-blind randomized controlled study

Although peloid and paraffin treatments may have a positive effect in the short term on pain, functional status, hand grip strength, and quality of life in patients with hand osteoarthritis (HOA), there are no comprehensive and comparative studies of these therapies for HOA. The aim of our study was to evaluate the short-term effects of peloid and paraffin treatments in symptomatic HOA patients. Eighty female patients diagnosed with HOA were randomly divided into two equal groups: peloid group (peloid therapy and home exercise) and paraffin group (paraffin therapy and home exercise). Peloid and paraffin applications were performed over 3 weeks for a total of 15 sessions. Patients were evaluated with visual analog scale (VAS)-rest, -activity, and -handgrip for pain, Jamar hand dynamometer for grip strength, Australian/Canadian (AUSCAN) Osteoarthritis Hand Index for function, health assessment questionnaire (HAQ) for physical activity, Beck depression inventory (BDI) for depression, and short form-36 (SF-36) for quality of life. Evaluations were performed before treatment, in the 3rd week, and 1 month after treatment. For all parameters except SF-36, statistically significant improvements were observed in short-term evaluations compared to the baseline in both groups (p = .000). Reductions in HAQ scores in the 3rd week and 1st month (p = .001 and p = .003), and the decrease in BDI scores in the 3rd week (p = .005) was statistically significantly higher in the peloid group. Improvements in some subparameters of the SF-36 were statistically significant in favor of the peloid group. In female patients with HOA, both groups experienced similar positive effects on pain, functional status, and hand grip strength for up to one month, but the peloid group was found to be superior in the short term in terms of physical activity and some quality of life parameters. Peloid therapy can be preferred as a natural and reliable method for symptomatic HOA.

Comparison of the efficacies of peloid therapy and paraffin treatment given as an adjuncts to exercise therapy in patients with hallux rigidus: a randomized, uncontrolled, prospective study

Although it is thought that peloid and paraffin treatments may have positive effect on pain, functional status, and quality of life in patients with hallux rigidus (HR), there are no comprehensive and comparative studies with a high level of evidence. We aimed to compare peloid and paraffin treatments in symptomatic hallux rigidus patients. A total of 113 patients diagnosed with HR between May 2019 and June 2021 were included in the study. After exclusion criteria, the remaining 90 patients were randomly divided into two groups: the peloid therapy group (peloid therapy + home exercise) and the paraffin therapy group (paraffin therapy + home exercise). Peloid and paraffin treatments were applied for 2 weeks (5 days a week for a total of 10 sessions). Patients were evaluated before treatment, at the end of treatment, and one month after treatment. The groups were compared in terms of pain, functional status, quality of life, and joint range of motion. In the final analysis, 40 patients in each treatment group were compared. Statistically significant improvements were achieved for all parameters at the end of treatment and at follow-up, and the treatments were found to be highly effective. As a result of the comparison, the methods were not found to be superior to each other. The present study is the first randomized study comparing peloid therapy and paraffin therapy given as an adjuncts to exercise therapy. Exercise therapy plus peloid and exercise therapy plus paraffin treatments seem to have similar effects on HR; however, controlled trials are necessary for confirmation of our results.