Department of Physical Medicine and Rehabilitation, Izzet Baysal Physical Medicine and Rehabilitation Training and Research Hospital, Bolu, Turkey.
Department of Medical Ecology and Hydroclimatology, Usak University Faculty of Medicine, Uşak, Turkey.
Int J Biometeorol. 2019 Dec;63(12):1555-1568. doi: 10.1007/s00484-019-01768-0. Epub 2019 Jul 31.
This study aimed to investigate whether balneotherapy (BT) applied in combination with physical therapy (PT) has a more positive effect in patients aged 65 years and older with knee osteoarthritis (KOA) compared to PT alone. A total of 305 individuals were randomized into two groups. Group I was applied PT alone; group II was applied PT + BT. Assessments were made using the Pain (VAS), EQ-5D-3L Scale, Western Ontario And McMaster Universities Osteoarthritis Index (WOMAC), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) Scale, Epworth Sleepiness scale (EPWORTH) and the Outcome Measures in Rheumatology-The Osteoarthritis Research Society International set of responder criteria for osteoarthritis (OMERACT-OARSI) at the beginning (T0) and at the end (T1) of treatment. Statistically significant interactions found between treatment (PT alone or PT + BT) and time (before treatment and after treatment) in terms of Pain-VAS, Pain-WOMAC, Stiffness-WOMAC, Physical Function-WOMAC, Total-WOMAC, EQ-5D, EQ-VAS, FACIT-F, and EPWORTH scores (p < 0.0001 for all). According to OMERACT-OARSI criteria, the responder rate was 89.04% in PT alone group and 98.74% in PT + BT group. Balneotherapy plus physical therapy was more effective than physical therapy alone in KOA patients aged over 65 years. Reducing pain, especially, positively contributes to functionality, quality of life, fatigue and sleepiness of KOA patients.
本研究旨在探讨温泉疗法（BT）联合物理疗法（PT）是否比单独 PT 对 65 岁及以上膝骨关节炎（KOA）患者有更积极的影响。共有 305 人被随机分为两组。组 I 仅接受 PT；组 II 接受 PT+BT。使用疼痛（VAS）、EQ-5D-3L 量表、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、慢性病治疗功能评估-疲劳（FACIT-F）量表、嗜睡量表（EPWORTH）和关节炎结局测量（OMERACT-OARSI）的骨关节炎反应标准进行评估。在治疗开始时（T0）和结束时（T1）。在疼痛 VAS、疼痛 WOMAC、僵硬 WOMAC、身体功能 WOMAC、总 WOMAC、EQ-5D、EQ-VAS、FACIT-F 和 EPWORTH 评分方面，治疗（单独 PT 或 PT+BT）和时间（治疗前和治疗后）之间存在统计学显著交互作用（所有 p<0.0001）。根据 OMERACT-OARSI 标准，单独 PT 组的应答率为 89.04%，PT+BT 组的应答率为 98.74%。在 65 岁以上 KOA 患者中，温泉疗法联合物理疗法比单独物理疗法更有效。特别是减轻疼痛对 KOA 患者的功能、生活质量、疲劳和嗜睡有积极影响。
