Balneotherapy for rheumatoid arthritis - PubMed (original) (raw)
Review
Balneotherapy for rheumatoid arthritis
A P Verhagen et al. Cochrane Database Syst Rev. 2003.
Update in
- Balneotherapy (or spa therapy) for rheumatoid arthritis.
Verhagen AP, Bierma-Zeinstra SM, Boers M, Cardoso JR, Lambeck J, de Bie R, de Vet HC. Verhagen AP, et al. Cochrane Database Syst Rev. 2015 Apr 11;2015(4):CD000518. doi: 10.1002/14651858.CD000518.pub2. Cochrane Database Syst Rev. 2015. PMID: 25862243 Free PMC article. Review.
Abstract
Background: Balneotherapy (spa therapy) for patients with arthritis is one of the oldest forms of therapy. One of the aims of balneotherapy is to soothe the pain, improve joint motion and as a consequence to relieve people' suffering and make them feel well.
Objectives: To perform a systematic review on the effectiveness of balneotherapy for rheumatoid arthritis.
Search strategy: Using the Cochrane search strategy, studies were found by screening: 1) The MEDLINE CD-ROM database from 1966 to June 2002 and 2) the database from the Cochrane 'Rehabilitation and Related Therapies' Field, the Pedro database up to June 2002. Also, 3) reference checking and 4) personal communications with authors was carried out to retrieve eligible studies. Date of the most recent literature search: June, 2002
Selection criteria: Studies were eligible if they were randomised controlled trials (RCTs) comparing balneotherapy with any other intervention or with no intervention. Included participants all suffered from definite or classical rheumatoid arthritis (RA) as defined by the American Rheumatism Association Criteria (ARA) or by the criteria of Steinbrocker. At least one of the WHO/ILAR core set of endpoints for RA clinical trials had to be among the main outcome measures.
Data collection and analysis: The Delphi list was the criteria list used to assess the components of methodological quality. Two reviewers carried out quality assessment and data extraction of the studies. Disagreements were solved by consensus.
Main results: Six trials, representing 355 people, were included in this review. Most trials reported positive findings (the absolute improvement in measured outcomes ranged from 0 to 44%), but were methodologically flawed to some extent. A 'quality of life' outcome was reported by two trials. None of the trials performed an intention-to-treat analysis and only two performed a comparison of effects between groups. Pooling of the data was not performed; because of heterogeneity of the studies, multiple outcome measurements, and the overall data presentation was too scarce.
Reviewer's conclusions: One cannot ignore the positive findings reported in most trials. However the scientific evidence is insufficient because of the poor methodological quality, the absence of an adequate statistical analysis, and the absence, for the patient, of most essential outcome measures (pain, self assessed function, quality of life). Therefore, the noted "positive findings" should be viewed with caution. Because of the methodological flaws an answer about the apparent effectiveness of balneotherapy cannot be provided at this moment. A large, methodological sound trial is needed.
Update of
- Balneotherapy for rheumatoid arthritis and osteoarthritis.
Verhagen AP, de Vet HC, de Bie RA, Kessels AG, Boers M, Knipschild PG. Verhagen AP, et al. Cochrane Database Syst Rev. 2000;(2):CD000518. doi: 10.1002/14651858.CD000518. Cochrane Database Syst Rev. 2000. PMID: 10796385 Updated. Review.
Similar articles
- Balneotherapy for rheumatoid arthritis and osteoarthritis.
Verhagen AP, de Vet HC, de Bie RA, Kessels AG, Boers M, Knipschild PG. Verhagen AP, et al. Cochrane Database Syst Rev. 2000;(2):CD000518. doi: 10.1002/14651858.CD000518. Cochrane Database Syst Rev. 2000. PMID: 10796385 Updated. Review. - Balneotherapy (or spa therapy) for rheumatoid arthritis.
Verhagen AP, Bierma-Zeinstra SM, Boers M, Cardoso JR, Lambeck J, de Bie R, de Vet HC. Verhagen AP, et al. Cochrane Database Syst Rev. 2015 Apr 11;2015(4):CD000518. doi: 10.1002/14651858.CD000518.pub2. Cochrane Database Syst Rev. 2015. PMID: 25862243 Free PMC article. Review. - Balneotherapy for osteoarthritis.
Verhagen AP, Bierma-Zeinstra SM, Boers M, Cardoso JR, Lambeck J, de Bie RA, de Vet HC. Verhagen AP, et al. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD006864. doi: 10.1002/14651858.CD006864. Cochrane Database Syst Rev. 2007. PMID: 17943920 Review. - Taking baths: the efficacy of balneotherapy in patients with arthritis. A systematic review.
Verhagen AP, de Vet HC, de Bie RA, Kessels AG, Boers M, Knipschild PG. Verhagen AP, et al. J Rheumatol. 1997 Oct;24(10):1964-71. J Rheumatol. 1997. PMID: 9330940 Review. - Balneotherapy for osteoarthritis. A cochrane review.
Verhagen A, Bierma-Zeinstra S, Lambeck J, Cardoso JR, de Bie R, Boers M, de Vet HC. Verhagen A, et al. J Rheumatol. 2008 Jun;35(6):1118-23. Epub 2008 May 1. J Rheumatol. 2008. PMID: 18464302 Review.
Cited by
- Effectiveness of sensorimotor training in patients with rheumatoid arthritis: a randomized controlled trial.
da Silva KN, Teixeira LE, Imoto AM, Atallah AN, Peccin MS, Trevisani VF. da Silva KN, et al. Rheumatol Int. 2013 Sep;33(9):2269-75. doi: 10.1007/s00296-013-2706-3. Epub 2013 Mar 3. Rheumatol Int. 2013. PMID: 23455663 Clinical Trial. - Defining immunological impact and therapeutic benefit of mild heating in a murine model of arthritis.
Lee CT, Kokolus KM, Leigh ND, Capitano M, Hylander BL, Repasky EA. Lee CT, et al. PLoS One. 2015 Mar 20;10(3):e0120327. doi: 10.1371/journal.pone.0120327. eCollection 2015. PLoS One. 2015. PMID: 25793532 Free PMC article. - Effectiveness of aquatic exercise and balneotherapy: a summary of systematic reviews based on randomized controlled trials of water immersion therapies.
Kamioka H, Tsutani K, Okuizumi H, Mutoh Y, Ohta M, Handa S, Okada S, Kitayuguchi J, Kamada M, Shiozawa N, Honda T. Kamioka H, et al. J Epidemiol. 2010;20(1):2-12. doi: 10.2188/jea.je20090030. Epub 2009 Oct 31. J Epidemiol. 2010. PMID: 19881230 Free PMC article. Review. - Infrared sauna in patients with rheumatoid arthritis and ankylosing spondylitis. A pilot study showing good tolerance, short-term improvement of pain and stiffness, and a trend towards long-term beneficial effects.
Oosterveld FG, Rasker JJ, Floors M, Landkroon R, van Rennes B, Zwijnenberg J, van de Laar MA, Koel GJ. Oosterveld FG, et al. Clin Rheumatol. 2009 Jan;28(1):29-34. doi: 10.1007/s10067-008-0977-y. Epub 2008 Aug 7. Clin Rheumatol. 2009. PMID: 18685882 - Effectiveness of spa therapy for patients with chronic low back pain: An updated systematic review and meta-analysis.
Bai R, Li C, Xiao Y, Sharma M, Zhang F, Zhao Y. Bai R, et al. Medicine (Baltimore). 2019 Sep;98(37):e17092. doi: 10.1097/MD.0000000000017092. Medicine (Baltimore). 2019. PMID: 31517832 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical