Fazaa A, Souabni L, Ben Abdelghani K, Kassab S, Chekili S, Zouari B, Hajri R, Laatar A, Zakraoui L
Service de rhumatologie, hôpital MongiSlim, 2046 La Marsa, Tunisia; Faculté de médecine de Tunis, Tunis El Manar university, Tunis, Tunisia.
Service de rhumatologie, hôpital MongiSlim, 2046 La Marsa, Tunisia; Faculté de médecine de Tunis, Tunis El Manar university, Tunis, Tunisia.
Ann Phys Rehabil Med. 2014 Dec;57(9-10):561-9. doi: 10.1016/j.rehab.2014.09.007. Epub 2014 Sep 27.
To compare the benefits of a thermal cure and non-thermal rehabilitation in treatment of knee osteoarthritis (KOA).
Randomized therapeutic trial including patients with knee osteoarthritis (American College of Rheumatology criteria). Patients were randomly divided into two groups. Spa treatment consisted of underwater shower, massage-jet showers, hydromassage, pool rehabilitation and peloid therapy. Non-thermal rehabilitation consisted of analgesic physiotherapy, muscle strengthening and group physical rehabilitation. A blinded evaluation was carried out at day 21 and 12months following treatment. It was based on the visual analogic scale of pain (VAS), which represented the primary endpoint.
Two hundred and forty patients were included (February-June 2005). The spa treatment and non-thermal rehabilitation groups included 119 and 121 patients respectively. Two hundred and thirty-three patients completed their treatments. Significant improvement of the visual analogic scale of pain was noted in the thermal cure group (61.6±15 at day 0 versus 46.5±22.4 at 12months, P<0.001), but not in the non-thermal group (64.1±15 at day 0 versus 62±29 at 12months, P=0.68). At day 21, comparison of the two groups revealed no significant difference on the VAS (P=0.08). However, at 12months, the thermal cure group was significantly more improved (P=0.000).
In our study, crenobalneotherapy had resulted, at 12months, in more pronounced long-term improvement of the painful symptoms of KOA than had non-thermal rehabilitation.
比较热疗与非热康复治疗膝关节骨关节炎（KOA）的疗效。
对符合美国风湿病学会标准的膝关节骨关节炎患者进行随机治疗试验。患者被随机分为两组。水疗包括水下淋浴、按摩喷头淋浴、水按摩、泳池康复和泥疗。非热康复包括止痛物理治疗、肌肉强化训练和集体物理康复。在治疗后第21天和12个月进行盲法评估。评估基于疼痛视觉模拟量表（VAS），这是主要终点指标。
共纳入240例患者（2005年2月至6月）。水疗组和非热康复组分别有119例和121例患者。233例患者完成了治疗。热疗组疼痛视觉模拟量表有显著改善（治疗前0天为61.6±15，12个月时为46.5±22.4，P<0.001），而非热疗组无显著改善（治疗前0天为64.1±15，12个月时为62±29，P= 0.68）。在第21天，两组在VAS上的比较无显著差异（P=0.08）。然而，在12个月时，热疗组改善更为显著（P=0.000）。
在我们的研究中，12个月时，温泉浴疗法比非热康复能更显著地长期改善KOA的疼痛症状。
