https://doi.org/10.4081/reumatismo.2021.1394

Efficacy of mud plus bath therapy as compared to bath therapy in osteoarthritis of hands and knees: a pilot single-blinded randomized controlled trial

Vol. 73 No. 3 (2021)
Submitted: 9 January 2021
Accepted: 30 September 2021
Published: 22 November 2021
Knee osteoarthritis, hand osteoarthritis, mud therapy, bath therapy.
Abstract Views: 5430
PDF: 899
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

C. Benini
camilla.benini@yahoo.it
https://orcid.org/0000-0002-8082-5023
Rheumatology Unit, University of Verona, Italy.
G. Rubino
Terme di Pejo, Peio Fonti, Trento, Italy.
G. Paolazzi
https://orcid.org/0000-0001-5623-7953
Rheumatology Complex Hospital Unit, S. Chiara Hospital, Trento, Italy.
G. Adami
Rheumatology Unit, University of Verona, Italy.
C. Caimmi
https://orcid.org/0000-0002-0524-8959
Rheumatology Unit, University of Verona, Italy.
O. Viapiana
Rheumatology Unit, University of Verona, Italy.
D. Gatti
https://orcid.org/0000-0002-7471-3076
Rheumatology Unit, University of Verona, Italy.
M. Rossini
https://orcid.org/0000-0001-9692-2293
Rheumatology Unit, University of Verona, Italy.

The primary objective of this study was to assess the efficacy of mud plus bath therapy in comparison to bath therapy alone in hand and knee osteoarthritis (HOA and KOA). We conducted a single-blinded randomized controlled trial (RCT). Patients were randomly assigned to either mud plus bath therapy (group 1) or balneotherapy (group 2). The primary outcome was a change in AUSCAN questionnaire for HOA and in WOMAC for KOA at month 12. Evaluations were performed at baseline (B), immediately after the interventions (week 2, W2) and after 3 (M3), 6 (M6), 9 (M9) and 12 (M12) months. 37 patients with KOA and 52 with HOA were randomized in the study. In HOA patients, AUSCAN pain improved more in group 1 compared to group 2 at M3, M6 and M12 (p<0.001, p=0.001 and p=0.038, respectively). AUSCAN stiffness improved more in group 1 at M3 (p=0.001). AUSCAN function improved more at M3, M6, M9 and M12 (p=0.001, p=0.001, p=0.014 and p=0.018, respectively). Regarding, KOA, WOMAC function decreased more prominently in group 1 compared to group 2 at M9 (p=0.007). The absolute values of WOMAC function at M6 and M9 were lower in group 1 compared to group 2 (p=0.029 and p=0.001, respectively). WOMAC pain absolute values were lower in group 1 at W2 (p=0.044) and at M9 (p=0.08). We conducted a RCT on the efficacy of mud plus balneotherapy over balneotherapy alone in HOA and KOA. We found that mud plus balneotherapy was more effective than balneotherapy alone on clinical outcomes of HOA. Differences in clinical outcomes of KOA were not significant, yet numerically higher.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatolo-gy/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Rheumatol Hoboken NJ 2020;72:220-33. DOI: https://doi.org/10.1002/art.41142
Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ 2003;81:646-56.
Arden N, Nevitt MC. Osteoarthritis: epidemiology. Best Pract Res Clin Rheumatol 2006;20:3-25. DOI: https://doi.org/10.1016/j.berh.2005.09.007
Oliveria SA, Felson DT, Reed JI, et al. Incidence of symptomatic hand, hip, and knee osteoar-thritis among patients in a health maintenance organization. Arthritis Rheum 1995;38:1134-41. DOI: https://doi.org/10.1002/art.1780380817
Dahaghin S, Bierma-Zeinstra SMA, Ginai AZ, et al. Prevalence and pattern of radiographic hand osteoarthritis and association with pain and disability (the Rotterdam study). Ann Rheum Dis 2005;64:682-7. DOI: https://doi.org/10.1136/ard.2004.023564
Guccione AA, Felson DT, Anderson JJ, et al. The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health 1994;84:351-8. DOI: https://doi.org/10.2105/AJPH.84.3.351
Jordan KM, Arden NK, Doherty M, et al. EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 2003;62:1145-55. DOI: https://doi.org/10.1136/ard.2003.011742
Hochberg MC, Altman RD, April KT, et al. American College of Rheumatology 2012 recom-mendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res 2012;64:465-74. DOI: https://doi.org/10.1002/acr.21596
Zhang W, Doherty M, Leeb BF, et al. EULAR evidence based recommendations for the man-agement of hand osteoarthritis: report of a Task Force of the EULAR Standing Committee for Interna-tional Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 2007;66:377-88. DOI: https://doi.org/10.1136/ard.2006.062091
Cozzi F, Ciprian L, Carrara M, et al. Balneotherapy in chronic inflammatory rheumatic diseases-a narrative review. Int J Biometeorol 2018;62:2065-71. DOI: https://doi.org/10.1007/s00484-018-1618-z
Verhagen AP, Bierma-Zeinstra SMA, Boers M, et al. Balneotherapy for osteoarthritis. Cochrane Database Syst Rev 2007;(4):CD006864. DOI: https://doi.org/10.1002/14651858.CD006864
Gutenbrunner C, Bender T, Cantista P, Karagülle Z. A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology. Int J Biometeorol 2010;54:495-507. DOI: https://doi.org/10.1007/s00484-010-0321-5
Loi A, Lisci S, Denotti A, Cauli A. Bone mineral density in women on long-term mud-bath ther-apy in a Salus per Aquam (SPA) environment. Reumatismo. 2013;65:121-5. DOI: https://doi.org/10.4081/reumatismo.2013.121
Altman R, Alarcón G, Appelrouth D, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum 1990;33:1601-10. DOI: https://doi.org/10.1002/art.1780331101
Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16:494-502. DOI: https://doi.org/10.1136/ard.16.4.494
Bellamy N, Buchanan WW, Goldsmith CH, et al. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 1988;15:1833-40.
Salaffi F, Leardini G, Canesi B, et al. Reliability and validity of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index in Italian patients with osteoarthritis of the knee. Osteoarthritis Cartilage. 2003;11:551-60. DOI: https://doi.org/10.1016/S1063-4584(03)00089-X
Bellamy N, Campbell J, Haraoui B, et al. Clinimetric properties of the AUSCAN Osteoarthritis Hand Index: an evaluation of reliability, validity and responsiveness. Osteoarthritis Cartilage. 2002;10:863-9. DOI: https://doi.org/10.1053/joca.2002.0838
Detert J, Klaus P, Listing J, et al. Hydroxychloroquine in patients with inflammatory and erosive osteoarthritis of the hands (OA TREAT): study protocol for a randomized controlled trial. Trials. 2014;15:412. DOI: https://doi.org/10.1186/1745-6215-15-412
Bellamy N, Hochberg M, Tubach F, Martin-Mola E, Awada H, Bombardier C, et al. Develop-ment of multinational definitions of minimal clinically important improvement and patient acceptable symptomatic state in osteoarthritis. Arthritis Care Res. 2015;67:972-80. DOI: https://doi.org/10.1002/acr.22538
Ranza R, Marchesoni A, Calori G, et al. The Italian version of the Functional Disability Index of the Health Assessment Questionnaire. A reliable instrument for multicenter studies on rheumatoid ar-thritis. Clin Exp Rheumatol. 1993;11:123-8.
Gandini F, Giannitti C, Fattore G, et al. Validation of an Italian version of the functional index for hand osteoarthritis (FIHOA). Mod Rheumatol. 2012;22:758-65. DOI: https://doi.org/10.3109/s10165-011-0579-4
Apolone G, Mosconi P. The Italian SF-36 Health Survey: translation, validation and norming. J Clin Epidemiol. 1998;51:1025-36. DOI: https://doi.org/10.1016/S0895-4356(98)00094-8
Zhang W, Robertson J, Jones AC, et al. The placebo effect and its determinants in osteoarthritis: meta-analysis of randomised controlled trials. Ann Rheum Dis. 2008;67:1716-23. DOI: https://doi.org/10.1136/ard.2008.092015
D’Angelo D, Coclite D, Napoletano A, et al. The efficacy of balneotherapy, mud therapy and spa therapy in patients with osteoarthritis: an overview of reviews. Int J Biometeorol. 2021 [Epub ahead of print]. DOI: https://doi.org/10.1007/s00484-021-02102-3
Cantista P, Maraver F. Balneotherapy for knee osteoarthritis in S. Jorge: a randomized controlled trial. Int J Biometeorol. 2020;64:1027-38. DOI: https://doi.org/10.1007/s00484-020-01911-2
Horváth K, Kulisch Á, Németh A, Bender T. Evaluation of the effect of balneotherapy in patients with osteoarthritis of the hands: a randomized controlled single-blind follow-up study. Clin Rehabil. 2012;26:431-41. DOI: https://doi.org/10.1177/0269215511425961
Kovács C, Pecze M, Tihanyi Á, et al. The effect of sulphurous water in patients with osteoarthri-tis of hand. Double-blind, randomized, controlled follow-up study. Clin Rheumatol 2012;31:1437-42. DOI: https://doi.org/10.1007/s10067-012-2026-0
Fioravanti A, Bacaro G, Giannitti C, et al. One-year follow-up of mud-bath therapy in patients with bilateral knee osteoarthritis: a randomized, single-blind controlled trial. Int J Biometeorol. 2015;59:1333-43. DOI: https://doi.org/10.1007/s00484-014-0943-0
Gyarmati N, Kulisch Á, Németh A, et al. Evaluation of the effect of hévíz mud in patients with hand osteoarthritis: a randomized, controlled, single-blind follow-up study. Isr Med Assoc J IMAJ. 2017;19:177-82.
Fraioli A, Serio A, Mennuni G, et al. A study on the efficacy of treatment with mud packs and baths with Sillene mineral water (Chianciano Spa Italy) in patients suffering from knee osteoarthritis. Rheumatol Int. 2011;31:1333-40. DOI: https://doi.org/10.1007/s00296-010-1475-5
Fraioli A, Mennuni G, Fontana M, et al. Efficacy of Spa therapy, mud-pack therapy, balneother-apy, and mud-bath therapy in the management of knee osteoarthritis. A systematic review. BioMed Res Int. 2018;2018:1042576. DOI: https://doi.org/10.1155/2018/1042576
Cantarini L, Leo G, Giannitti C, et al. Therapeutic effect of spa therapy and short wave therapy in knee osteoarthritis: a randomized, single blind, controlled trial. Rheumatol Int. 2007;27:523-9. DOI: https://doi.org/10.1007/s00296-006-0266-5
Fioravanti A, Iacoponi F, Bellisai B, et al. Short- and long-term effects of spa therapy in knee osteoarthritis. Am J Phys Med Rehabil. 2010;89:125-32. DOI: https://doi.org/10.1097/PHM.0b013e3181c1eb81
Odabasi E, Turan M, Erdem H, Tekbas F. Does mud pack treatment have any chemical effect? A randomized controlled clinical study. J Altern Complement Med N Y N. 2008;14:559-65. DOI: https://doi.org/10.1089/acm.2008.0003
Király M, Kővári E, Hodosi K, et al. The effects of Tiszasüly and Kolop mud pack therapy on knee osteoarthritis: a double-blind, randomised, non-inferiority controlled study. Int J Biometeorol. 2020;64:943-50. DOI: https://doi.org/10.1007/s00484-019-01764-4
Zivná H, Maric L, Gradosová I, et al The effect of mud-bath therapy on bone status in rats dur-ing adjuvant subchronic arthritis. Acta Medica (Hradec Kralove). 2012;55:133-7. DOI: https://doi.org/10.14712/18059694.2015.51

How to Cite

Benini, C., Rubino, G., Paolazzi, G., Adami, G., Caimmi, C., Viapiana, O., … Rossini, M. (2021). Efficacy of mud plus bath therapy as compared to bath therapy in osteoarthritis of hands and knees: a pilot single-blinded randomized controlled trial. Reumatismo, 73(3). https://doi.org/10.4081/reumatismo.2021.1394

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.