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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
Kulisch A, Benko A, Bergmann A, Gyarmati N, Horvath H, Kranicz A, Mando ZS, Matan A, Nemeth A, Szakal E, Szanto D, Szekeres L, Bender T
European Journal of Physical and Rehabilitation Medicine 2014 Aug;50(4):373-381
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Osteoarthritis is the most frequent joint disease and is a leading cause of pain and locomotor disability in elderly people. The treatment of osteoarthritis includes non-pharmacological, pharmacological, and surgical therapies. Silver level evidence has been found concerning balneotherapy in osteoarthritis. AIM OF THE STUDY: The aim of this study was to evaluate how Lake Heviz thermal mineral water therapy influences pain, knee function, and quality of life in patients with knee osteoarthritis, compared to the control group. STUDY DESIGN: randomized, controlled, single-blind, follow-up study. SETTING: Spa Heviz and St. Andrew Hospital for Rheumatic Diseases POPULATION: This study included 77 outpatients between 45 and 75 years of age with mild to moderate osteoarthritis of the knee meeting the American College of Rheumatology classification criteria. METHODS: Patients were randomized into two groups. In group I (n = 38), subjects bathed in Lake Heviz and in group II (N.= 39), patients were treated in a pool full of tap water. Water temperature was 34 degreesC for both groups. Participants underwent 30-minute therapy sessions, five times a week for three weeks. Outcome measures were pain visual analogue scale scores, active flexion degree, knee circumference, stair-climb time, Western Ontario and McMaster Universities osteoarthritis index (WOMAC), and EuroQoL Group 5-Dimension Self-Report Questionnaire score (EQ-5D). Study parameters were recorded at baseline, immediately after treatment, and after 15 weeks. RESULTS: Comparison of the two groups revealed a statistically significant difference in pain visual analogue scale scores (p < 0.01), active flexion degree (p < 0.01), physical function components of WOMAC (p < 0.05), and EQ-5D scores (p < 0.05) even after 15 weeks. CONCLUSIONS: Balneotherapy improved pain, function as well as the quality of life in patients with knee osteoarthritis. CLINICAL REHABILITATION IMPACT: Balneotherapy is a potentially useful treatment modality for patients with knee osteoarthritis.

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