EVALUATION OF EARLY PERIOD EFFECTIVENESS OF BALNEOTHERAPY IN PATIENTS WITH KNEE OSTEOARTHRITIS

Year 2023, Volume: 24 Issue: 2, 141 - 147, 05.04.2023

Şükrü Sınıcı , Selma Eroğlu , Ümit Dündar

https://doi.org/10.18229/kocatepetip.1027174

Abstract

OBJECTIVE: Balneotherapy is a non-pharmacological method recommended and used in knee osteoarthritis. The aim of this study is to evaluate the early-term effectiveness of the physical therapy program applied together with balneotherapy in patients with knee osteoarthritis.
MATERIAL AND METHODS: Sixty patients diagnosed with primary knee osteoarthritis were included in the study. Randomization was carried out as a balneotherapy group (n=30) and a control group (n =30) by simple randomization method. In Both groups, all of the patients were treated with a fifteen sessions physical therapy program consisting of a hot pack, transcutaneous electrical stimulation, and ultrasound (1 MHz, 1,5 Watt/cm2). Patients in the balneotherapy group were also treated for fifteen sessions balneotherapy program lasting 20 min/day in addition to the physical therapy program. Patients were assessed by Visual Analogue Scale (VAS), WOMAC, and isokinetic muscle testing at the beginning and end of the therapies.
RESULTS: A statistically significant improvement was observed in the mean scores of VAS, all WOMAC scores, and isokinetic test measurements after treatment in both groups (p<0.001). Comparison of the groups by percent changes showed that; VAS (p=0.047), WOMAC pain (p=0.002), WOMAC stiffness (p=0.004), WOMAC function (p=0.001), WOMAC total (p=0.001) differed significantly in favor of balneotherapy group, no significant difference was found in isokinetic muscle strength measurements (p>0.05).
CONCLUSIONS: Balneotherapy combined with a physical therapy program in patients with knee osteoarthritis is effective in reducing pain and increasing physical function in the early period.

Keywords

Balneotherapy, Osteoarthritis of Knee, İsokinetic Test, Physical Therapy

DİZ OSTEOARTRİTİ OLAN HASTALARDA BALNEOTERAPİNİN ERKEN DÖNEM ETKİNLİĞİNİN DEĞERLENDİRİLMESİ

Abstract

AMAÇ: Balneoterapi, diz osteoartritinde önerilen ve kullanılan farmakolojik olmayan bir yöntemdir. Bu çalışmanın amacı diz osteoartritli hastalarda balneoterapiyle birlikte uygulanan fizik tedavi programının erken dönem etkinliğini değerlendirmektir.
GEREÇ VE YÖNTEM: Primer diz osteoartriti tanısı almış 60 hasta çalışmaya dahil edildi ve basit rastgele yöntem ile balneoterapi grubu (n=30) ve kontrol grubu (n=30) olarak randomizasyon yapıldı. Her iki gruptaki hastalar hot pack, transkutanöz elektrik stimülasyonu ve ultrasondan (1 MHz, 1,5 Watt/cm2) oluşan 15 seans fizik tedavi programı ile tedavi edildi. Balneoterapi grubundaki hastalara fizik tedavi programına ek olarak 20 dakika/gün süren on beş seans balneoterapi programı uygulandı. Hastalar tedavilerin başlangıcında ve tedavinin sonunda Vizüel Analog Skalası (VAS), WOMAC ve izokinetik kas testi ile değerlendirildi.
BULGULAR: Her iki grupta tedavi sonrası VAS, tüm WOMAC skorları ve izokinetik test ölçümlerinde istatistiksel olarak anlamlı iyileşme kaydedildi (p<0,001). Gruplar arası değerlendirme parametrelerinin yüzde değişimleri karşılaştırıldığında; balneoterapi grubu lehine VAS (p=0,047), WOMAC ağrı (p=0,002), WOMAC sertlik (p=0,004), WOMAC fonksiyon (p=0,001), WOMAC total (p=0,001) skorlarında anlamlı azalma varken, izokinetik kas gücü ölçümlerinde anlamlı farklılık saptanmadı (p>0,05).
SONUÇ: Diz osteoartriti olan hastalarda fizik tedavi programı ile birlikte uygulanan balneoterapi, erken dönemde ağrıyı azaltmada ve fiziksel fonksiyonu artırmada etkilidir.

Keywords

Balneoterapi, Diz Osteoartriti, İzokinetik Test, Fizik Tedavi

References

• 1. Şahin-Onat Ş, Taşoğlu Ö, Özişler Z, Güneri FD, Özgirgin N. Balneotherapy in the Treatment of Knee Osteoarthritis : A Controlled Study. Arch Rheumatol. 2015;30(4):292–7.
• 2. Branco M, Rego NN, Silva PH, Archanjo IE, Ribeiro MC, Trevisani VF. Bath thermal waters in the treatment of knee osteoarthritis: a randomized controlled clinical trial. Eur J Phys Rehabil Med. 2016;52(4):422–30.
• 3. Evcik D, Kavuncu V, Yeter A, Yigit I. The efficacy of balneotherapy and mud-pack therapy in patients with knee osteoarthritis. Jt Bone Spine. 2007;74(1):60–5.
• 4. Gálvez I, Torres-piles S, Ortega E. Innate / inflammatory bioregulation and clinical effectiveness of whole-body hyperthermia ( balneotherapy ) in elderly patients with osteoarthritis. Int J Hyperth. 2018;35(1):340–7.
• 5. Tenti S, Cheleschi S, Galeazzi M, Fioravanti A. Spa therapy: can be a valid option for treating knee osteoarthritis? Int J Biometeorol. 2014;59:1133–43.
• 6. Ma T, Song X, Ma Y, et al. The effect of thermal mineral waters on pain relief, physical function and quality of life in patients with osteoarthritis A systematic review and meta-analysis. Med (United States). 2021;100(4).
• 7. Cantista P, Maraver F. Balneotherapy for knee osteoarthritis in S. Jorge: a randomized controlled trial. Int J Biometeorol. 2020;64(6):1027–38.
• 8. Güler Uysal F, Başaran S. Knee Osteoarthritis. Türk Fiz Tıp Rehab Derg. 2009;(1):1–17.
• 9. 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. Rheumatol Int. 2012;32(5):1235–44.
• 10. Tüzün EH, Eker L, Aytar A, Daşkapan A, Bayramoğlu M. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthr Cartil. 2005;13(1):28–33.
• 11. Fioravanti A, Karagülle M, Bender T, Karagülle MZ. Balneotherapy in osteoarthritis : Facts , fiction and gaps in knowledge. Eur J Integr Med. 2017;9:148–50.
• 12. Öncel S. The effectıveness of balneotherapy ın preventıon and treatment of osteoarthrıtıs. Türk Geriatr Derg. 2011;14(1):111–7.
• 13. Brosseau L, MacLeay L, Robinson V, et al. Efficacy of balneotherapy for osteoarthritis of the knee: a systematic review. Phys Ther Rev. 2002;7(4):209–22.
• 14. Hizmetli S. Hydroclimatology-Balneotherapy Practices in Elderly Patients. Turk J Phys Med Rehab. 2009;55(2):100–3.
• 15. Yurtkuran M, Yurtkuran M, Alp A, et al. Balneotherapy and tap water therapy in the treatment of knee osteoarthritis. Rheumatol Int. 2006;27(1):19–27.
• 16. Kulisch A, Benko A, Bergmann A, et al. Evaluation of the effect of Lake Heviz thermal mineral water in patients with osteoarthritis of the knee: a randomized, controlled, single-blind, follow-up study. Eur J Phys Rehabil Med. 2014;50(4):373–81.
• 17. Uysal B, Ozkuk K. Effectiveness of balneotherapy in knee osteoarthritis. Exp Biomed Res. 2018;1(2):46–54.
• 18. Peultier-Celli L, Mainard D, Wein F, et al. Comparison of an Innovative Rehabilitation, Combining Reduced Conventional Rehabilitation with Balneotherapy, and a Conventional Rehabilitation after Anterior Cruciate Ligament Reconstruction in Athletes. Front Surg. 2017;4:1–10.