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Comparing the efficacy of mature mud pack and hot pack treatments for knee osteoarthritis
Sarsan A, Akkaya N, Ozgen M, Yildiz N, Atalay NS, Ardic F
Journal of Back and Musculoskeletal Rehabilitation 2012;25(3):193-199
clinical trial
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: The objective of this study is to compare the efficacy of mature mud pack and hot pack therapies on patients with knee osteoarthritis. DESIGN: This study was designed as a prospective, randomized-controlled, and single-blinded clinical trial. Twenty-seven patients with clinical and radiologic evidence of knee osteoarthritis were randomly assigned into two groups and were treated with mature mud packs (n = 15) or hot packs (n = 12). Patients were evaluated for pain (based on the visual analog scale (VAS)), function (WOMAC, 6 min walking distance), quality of life (Short Form-36 (SF-36)), and serum levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and insulin-like growth factor-1 (IGF-1) at baseline, post-treatment, and 3- and 6-months after treatment. RESULTS: The mud pack group shows a significant improvement in VAS, pain, stifness, and physical function domains of WOMAC. The difference between groups of pain and physical activity domains is significant at post-treatment in favor of mud pack. For a 6 min walking distance, mud pack shows significant improvement, and the difference is significant between groups in favor of mud pack at post-treatment and 3 and 6 months after treatment. Mud pack shows significant improvement in the pain subscale of SF-36 at the third month continuing until the sixth month after the treatment. Significant improvements are found for the social function, vitality/energy, physical role disability, and general health subscales of SF-36 in favor of the mud pack compared with the hot pack group at post-treatment. A significant increase is detected for IGF-1 in the mud pack group 3 months after treatment compared with the baseline, and the difference is significant between groups 3 months after the treatment. CONCLUSION: Mud pack is a favorable option compared with hotpack for pain relief and for the improvement of functional conditions in treating patients with knee osteoarthritis.

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