Effectiveness of balneotherapy in knee osteoarthritis

Aim: We aimed to investigate the effects of balneotherapy on knee osteoarthritis in present randomized controlled single blind clinical trial. Methods: Patients with knee osteoarthritis according to ACR criteria whom admitted to our institute were randomly assigned to two groups, 22 patients in each. Balneotherapy group received a total of 24 mixed thermo mineral baths at 37-38 ° C for 20 minutes in a schedule of 2 weeks, 6 days a week, 2 times a day in Gönen Spas. Patients in the control group were received medical treatment and monitored as outpatients. Study population were administered to pain (VAS), The Western Ontario and McMaster Universities Arthritis Index (WOMAC) and The Health Assessment Questionnaire (HAQ) evaluation before treatment, post treatment and on 4th week after treatment. In addition, 10 step ladder-up and 15 meter walking time was calculated. Results: Significant improvement in Pain (VAS), Pain (WOMAC-A), joint stiffness (WOMAC-B), joint function (WOMAC-C), The Health Assessment Questionnaire (HAQ) and in 10 steps ladder up and down tests achieved in balneotherapy group compared to pretreatment values. 15 meter walking time was improved at 4 week compared to baseline measurements. In control group, there was no significant improvement in the evaluated parameters at 4th week compared to pretreatment evaluation. Conclusion: We conclude that balneotherapy may be effective in improving pain and functional status in patients with knee osteoarthritis. &nbsp

Effect of vitamin D level and polypharmacy on the risk of falls in the elderly

Aim: To investigate the effects of polypharmacy and vitamin D levels on the risk of falls in the elderly. Methods: The prospective study included 201 patients (F/M: 155/46) aged 65 years and older who presented with nonspecific musculoskeletal pain. The demographic and laboratory data of the patients, as well as the results of a single leg stance test (SLST), a timed up and go (TUG) test and levels of vitamin D were recorded. Results: The percentage of patients with polypharmacy is 15.9 percent and 29.4 percent used no medications. The SLST score was the lowest and the TUG test score was significantly higher in the polypharmacy group (p<0.05). Vitamin D levels were significantly higher in patients with normal SLST times than those with abnormal SLST times (p<0.05). The risk of falls was significantly higher among patients with a previous history of a fall (p<0.05). Polypharmacy and the female gender appeared as the most significant factors affecting the risk of falls (p<0.05), while vitamin D level was found to have no effect (p>0.05). Conclusion: Medical therapies for the treatment of diseases in the elderly should have a rational basis, as this may reduce falls, particularly in the elderly population, that can have serious consequences, and may even lead to death

Effect of single or multiple injection of platelet-rich plasma in comparison with hyaluronic acid on knee osteoarthritis

Aim: To compare the effect of administration of 2 different doses of platelet rich plasma (PRP) and a single dose of hyaluronic acid (HA) preparation on pain and daily life activities of knee osteoarthritis (KOA) patients. Method: In this nonrandomized comparative study, three groups of patients who received either a single dose of intraarticular (IA) PRP (PRP1 group), three doses of IA PRP (PRP3 group), or single dose IA HA (HA group) were included. Assessments were before treatment, and in the 3rd week and 6th week after treatment (after the final injection). The pain-visual analog scale (VAS), Euro-Qol (EQ)-5D-3L, EQVAS, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used. Results: In the 3rd week, there were statistically significant differences between the PRP1-HA groups in all parameters except EQ5; between PRP3-HA groups in all parameters except EQ5 and WOMAC stiffness; and between PRP3-PRP1 groups in all parameters except EQVAS, WOMAC pain and WOMAC stiffness. In the 6th week, there were statistically significant differences between the PRP1-HA groups in all parameters except WOMAC stiffness; between PRP3-HA groups in all parameters; and between PRP3-PRP1 groups in all parameters except WOMAC pain. Conclusion: Intraarticular PRP injections (single or three doses) were found to be more beneficial in the short term in terms of pain and functional improvement than HA injection and administration of three consecutive doses of PRP may be more effective compared to single-dose PRP administration in KOA patients

Assessment of the health workers knowledge and belief about rheumatic and musculoskeletal diseases and spa treatments: A descriptive study

To investigate identifying the knowledge levels, behavior attitude and belief levels about rheumatic and musculoskeletal diseases (RMDs) and spa treatments (ST) among health workers in communication with patients and determining target groups for health training. Cross-sectional, descriptive study. Bolu Izzet Baysal Physical Medicine and Rehabilitation Education and Research Hospital and Izzet Baysal Education and Research Hospital 01.04.2019-15.04.2019. 600 participants completed 6 descriptive questions with yes-no answers about demographic characteristics and completed a survey determining knowledge levels about RMDs and ST as correct or incorrect. Though there was statistically significant difference in favor of women about RMDs knowledge level, there was no statistically significant difference between 2 groups for ST knowledge levels. When RMDs and ST knowledge levels are compared, doctors and physiotherapists had statistically similar knowledge levels, with statistically significant level of difference compared to the other groups. Among groups reporting similar opinions about the efficacy of ST, there was no statistically significant difference identified between RMDs knowledge levels, with a statistically significant level of difference identified for ST knowledge levels. Apart from doctors and physiotherapists, 307 other health workers did not have RMDs themselves or in their family, while only 167 had RMDs themselves and 126 stated both they and their family had RMDs. There was a statistically significant difference identified for RMDs knowledge levels. We found that even among the health workers who communicate with patients in hospitals, the level of knowledge with RMDs and ST is very variable. Taking this into account, we believe that all personnel should be provided with supportive scientific information and training in order to ensure that the health workers who are intertwined with the health problems of the individuals reach the correct information. [Med-Science 2019; 8(4.000): 901-7

Effects of Balneotherapy on Serum Levels of Shingosine-1-Phosphate in Patients With Osteoarthritis

Context . Balneotherapy is one of the most commonly used nonpharmacological interventions for osteoarthritis (OA), but its mechanism of action in relieving pain and stiffness and in improving physical function is not well understood. Studies have found that therapy provokes a series of neuroendocrinal reactions with anti-inflammatory and analgesic effects. Sphingosine-1-phosphate (S1P), a bioactive lipid, has been implicated as an important mediator in the maintenance of physiological processes (eg, vascular barrier integrity) and in pathophysiologic processes such as inflammatory conditions. Accordingly, targeting S1P and S1P receptors may offer a potential therapy for arthritis

Balneological outpatient treatment for patients with knee osteoarthritis; an effective non-drug therapy option in daily routine?

This study aims to compare the effects of balneological treatments applied at consecutive and intermittent sessions without interfering with their daily routine in patients with knee osteoarthritis. This is a randomized, controlled, single-blind clinical trial. Fifty patients diagnosed with knee osteoarthritis were included. The patients were divided into two groups. All patients were given a total of ten sessions of balneological treatment consisting of hydrotherapy and mud pack therapy. Group 1 received consecutive treatment for 2 weeks, while group 2 received intermittent treatment for 5 weeks. Local peloid packs at 45 A degrees C were applied for 20 min, after a tap water (38 A degrees C) bath. Evaluations were conducted before, after treatment, and at 12th week of post-treatment by Pain (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Short Form-36 (SF-36). Both balneological treatment regimens of knee osteoarthritis had statistically significant clinical effects as well as effects on the quality of life. Patients' well-being continued at 3 months, except for joint stiffness (WOMAC), role-emotional (SF-36), and vitality (SF-36) in group 1 and for mental health (SF-36) in both groups. Both patient groups had improved compared to baseline. However, at 3 months after the treatment, the well-being of group 2 was unable to be maintained in terms of role-physical (SF-36) parameter, while the well-being of group 1 was unable to be maintained in terms of pain, WOMAC (pain, physical functions, total), and SF-36 (physical functioning, role-physical, pain, role-emotional, and mental health) variables, compared to data obtained immediately after treatment. Our study suggests that traditional and intermittent balneological therapies have similar efficacy in patients with knee osteoarthritis

How does spa treatment affect cardiovascular function and vascular endothelium in patients with generalized osteoarthritis? A pilot study through plasma asymmetric di-methyl arginine (ADMA) and L-arginine/ADMA ratio

The study aims to investigate the effect of spa treatment on vascular endothelium and clinical symptoms of generalized osteoarthritis. Forty generalized osteoarthritis (GOA) patients referred to a government spa hospital, and 40 GOA patients followed on university hospital locomotor system disease ambulatory clinics were included as study and control groups, respectively. Study group received spa treatment including thermal water baths, physical therapy modalities, and exercises. Control group was followed with home exercises for 15 days. Plasma ADMA, L-arginine, L-arginine/ADMA ratio, routine blood analyses, 6-min walking test, including fingertip O-2 saturation, systolic/diastolic blood pressure, and pulse rate, were measured at the beginning and at the end of treatment. Groups were evaluated with VAS pain, patient, and physician global assessment; HAQ; and WOMAC at the beginning, at the end, and after 1 month of treatment. In study group, L-arginine and L-arginine/ADMA ratio showed statistically significant increase after treatment. Plasma ADMA levels did not change. There is no significant difference in intergroup comparison. Study group displayed statistically significant improvements in all clinical parameters. The study showed that spa treatment does not cause any harm to the vascular endothelium through ADMA. Significant increase in plasma L-arginine and L-arginine/ADMA ratio suggests that balneotherapy may play a preventive role on cardiovascular diseases. Balneotherapy provides meaningful improvements on clinical parameters of GOA