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Effects of balneotherapy and spa therapy on quality of life of patients with knee osteoarthritis: a systematic review and meta-analysis

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Abstract

Knee osteoarthritis (OA) is a degenerative disease which is expected to become one of the leading causes of disability by the next years. This work aims to assess if balneotherapy and spa therapy can significantly improve Quality of Life (QoL) of patients with knee OA. Medline via PubMed, Scopus, Web of Science, Cochrane Library, and PEDro were systematically searched for articles about trials involving patients with knee OA and measuring the effects of balneotherapy and spa therapy on study participants’ QoL with validated scales. A qualitative and quantitative syntheses were performed. Seventeen studies were considered eligible and included in the systematic review. Fourteen trials reported significant improvements in at least one QoL item after treatment. Ten studies were included in quantitative synthesis. When comparing balneological interventions with standard treatment, results favored the former in terms of long-term overall QoL [ES = − 1.03 (95% CI − 1.66 to − 0.40)]. When comparing balneological interventions with sham interventions, results favored the former in terms of long-term pain improvement [ES = − 0.38 (95% CI − 0.74 to − 0.02)], while no significant difference was found when considering social function [ES = − 0.16 (95% CI − 0.52 to 0.19)]. In conclusion, even though limitations must be considered, evidence shows that BT and spa therapy can significantly improve QoL of patients with knee OA. Moreover, reduction of drug consumption and improvement of algofunctional indexes may be other beneficial effects. Further investigation is needed because of limited available data.

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Authors and Affiliations

  1. Terme di Monticelli, Via delle Terme, 43022, Monticelli Terme, Parma, Italy

    Michele Antonelli

  2. Department of Medicine and Surgery, Institute of Public Health, University of Parma, Via Volturno 39, 43125, Parma, Italy

    Michele Antonelli

  3. Alta Intensità Medica, Department of Internal Medicine, Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy

    Davide Donelli

  4. Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 1, 53100, Siena, Italy

    Antonella Fioravanti

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  1. Michele Antonelli
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Contributions

Conception or design of the work: MA, DD, and AF. Data collection: MA and DD. Data analysis and interpretation: MA, DD, and AF. Drafting the article: MA, DD, and AF. Critical revision of the article: MA, DD, and AF. Final approval of the version to be published: MA, DD, and AF.

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Correspondence to Michele Antonelli.

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Antonelli Michele, Donelli Davide, and Fioravanti Antonella declare that they have no conflict of interest.

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Antonelli, M., Donelli, D. & Fioravanti, A. Effects of balneotherapy and spa therapy on quality of life of patients with knee osteoarthritis: a systematic review and meta-analysis. Rheumatol Int 38, 1807–1824 (2018). https://doi.org/10.1007/s00296-018-4081-6

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