The effect of balneotherapy to levels of leptin, adiponectin and COMP in patients with knee osteoarthritis

Background: Osteoarthritis is the most common type of arthritis and the major cause of chronic musculoskeletal pain and mobility disability in elderly. Balneotherapy is one ot the most commonly used non-pharmacological approaches for knee osteoarthritis. The aim of this study was to determine the effect of balneotherapy in patients with knee osteoarthritis functionally and also on serum leptin, adiponectin and COMP levels which probably influenced by this modalities. Material-Methods: The prospective trial was conducted in physical medicine and rehabilitation clinics in our university. Seventy patients between the age of 35-75 who were diagnosed as osteoarthritis according to ACR criteria were enrolled into this study. OA grading was performed by using the Kellgren-Lawrence criteria. Patients fullfiling the inclusion criteria were recieve either daily hot pack or balneotherapy as indicated. Patients were assessed at the beginning and at the end of the study for clinical and biochemical parameters. All patients were thought home exercises programme and preventive measures. The main outcome of the patients for pain and function were evaluated by VAS; WOMAC and 6 minute walk test. Serum levels of leptin, adiponectin and COMP were measured. Results : There were no statistically significant differences in the tested variables between the groups. There was a positive weak linear relation between leptin and COMP levels; HDL and adipokin levels before the therapy. There was also a positive moderate linear relation between BMI and COMP levels. At the end of the therapy VAS, WOMAC and 6 minute walk test in either groups were improved significantly with respect to prior to therapy.( p<0,05 ). When we compare before and after test variables balneotherapy group (gr.2) change percentage ratios of VAS, WOMAC, 6 minute walk test were significantly higher with respect to group 1 (p<0,05). Conclusions: Balneotherapy is an efficent therapeutic modality in knee OA. The positive affect of balneotherapy may partly due to obesity related hormones and catilage reorganizsation of the knee joint. Futher and long fallow-up studies needed for investigation of effects of balneotherapy on functions and serum biomarkers of the knee osteoarthritis