ABSTRACT
Title
Effectiveness of SPA Therapy in Knee Osteoarthritis
Authors
M. Costantino1,2,3, A. Filippelli1
1Department of Experimental Medicine–Pharmacological Division, II University of Naples-Italy
2CE.RI.S.T. (Center of Thermal Researches and Studies srl), Naples, Italy
3Association F.I.R.S.Thermae (Interdisciplinary Formation, Research and SPA Sciences), Naples, Italy
1Department of Experimental Medicine–Pharmacological Division, II University of Naples-Italy
2CE.RI.S.T. (Center of Thermal Researches and Studies srl), Naples, Italy
3Association F.I.R.S.Thermae (Interdisciplinary Formation, Research and SPA Sciences), Naples, Italy
Abstract
Objective: The most common type of joint degenerative chronic disease with a high incidence and prevalence in elderly is knee osteoarthritis (KO). The pain and functional disability characterizing the KO are accompanied by psychological distress not always adequately considered. Salus Per Aquam (SPA) therapy as mud-bath treatment could constitute a phase of the therapeutic strategy oriented to a reduction in dosage of polypharmacy with an improvement of the quality of life. Few studies evaluate the impact of mud-bath therapy in KO. The aim of our study was to investigate the effectiveness of SPA therapy on pain, functional disability and psychological distress in knee osteoarthritis.
Patients and Methods. The study population was constituded by 44 subjects (61% women and 39% men; mean age: 58,7 years; age range: 42-76 years) with KO. The investigated subjects were treated with a cycle ( 2 weeks) of mud-bath treatment with sulphur mineral water from Terme of Telese-Impresa A. Minieri SpA (Benevento-Italy). Main outcome measures: 1) Visual Analog Scale (VAS) scores for pain at rest and following functional walking and stepping activities (self-paced walking and stepping); 2) Algofunctional Lequesne index (pain or discomfort, maximum distance walked and activities of daily living); 3) Self-rating Anxiety Scale (SAS) and Self-rating depression Scale (SDS) of Zung; 4) Plasmatic concentration of reactive oxygen metabolites (ROMs) (d-ROMs test-Diacron International Srl – Grosseto - Italy) at baseline and week 2. The results, presented as mean±SD, were compared with the Student “t” test or Wilcoxon test. A p value <0.05 was considered significant.
Results. At week 2 sulphur mud-bath cycle induced a significant (p<0.05) reduction of VAS scores (1,8±1,6-->0,9±1,3), an improvement of quality of life as shown by Lequesne index (pain or discomfort: 3,1±2,0à1,7±1,5; score activities of daily living: 2,8±1,4-->1,8±1,5) and scores of SDS and SAS scales (anxiety:37±3-->29±5 - 46±5-->34±10; depression:35±3-->29±5 - 43±2-->31±9). ROMs plasmatic concentration was significantly (p<0.05) reduced after 2 weeks mud-bath treatment (baseline: 351±36 CARR.U. – 2 week SPA therapy: 320±50 CARR.U.).
Conclusions.The data from this investigation seem to indicate that SPA therapy may be useful
in improving joint function and quality of life in knee osteoarthritis.
Leardini G.et al. (2001). Arthritis Rheum 44:S313
Jordan KM et al. (2003). Ann Rheum Dis 62:1145-55
Costantino M. (2006). Clin Ter 157:525-529
Costantino M, Filippelli A. Clin Ter in press
Patients and Methods. The study population was constituded by 44 subjects (61% women and 39% men; mean age: 58,7 years; age range: 42-76 years) with KO. The investigated subjects were treated with a cycle ( 2 weeks) of mud-bath treatment with sulphur mineral water from Terme of Telese-Impresa A. Minieri SpA (Benevento-Italy). Main outcome measures: 1) Visual Analog Scale (VAS) scores for pain at rest and following functional walking and stepping activities (self-paced walking and stepping); 2) Algofunctional Lequesne index (pain or discomfort, maximum distance walked and activities of daily living); 3) Self-rating Anxiety Scale (SAS) and Self-rating depression Scale (SDS) of Zung; 4) Plasmatic concentration of reactive oxygen metabolites (ROMs) (d-ROMs test-Diacron International Srl – Grosseto - Italy) at baseline and week 2. The results, presented as mean±SD, were compared with the Student “t” test or Wilcoxon test. A p value <0.05 was considered significant.
Results. At week 2 sulphur mud-bath cycle induced a significant (p<0.05) reduction of VAS scores (1,8±1,6-->0,9±1,3), an improvement of quality of life as shown by Lequesne index (pain or discomfort: 3,1±2,0à1,7±1,5; score activities of daily living: 2,8±1,4-->1,8±1,5) and scores of SDS and SAS scales (anxiety:37±3-->29±5 - 46±5-->34±10; depression:35±3-->29±5 - 43±2-->31±9). ROMs plasmatic concentration was significantly (p<0.05) reduced after 2 weeks mud-bath treatment (baseline: 351±36 CARR.U. – 2 week SPA therapy: 320±50 CARR.U.).
Conclusions.The data from this investigation seem to indicate that SPA therapy may be useful
in improving joint function and quality of life in knee osteoarthritis.
Leardini G.et al. (2001). Arthritis Rheum 44:S313
Jordan KM et al. (2003). Ann Rheum Dis 62:1145-55
Costantino M. (2006). Clin Ter 157:525-529
Costantino M, Filippelli A. Clin Ter in press