Effect of balneological treatments (peloidotherapy and hydrotherapy) on pain, function and quality of life in patients with knee osteoarthritis

Objective: To evaluate the efficacy of balneological treatment applied as a combination of hydrotherapy and peloidotherapy in patients with knee osteoarthritis with clinical scales and to determine its effect on pain, function, and quality of life. Material and Method: Sixty patients diagnosed with knee osteoarthritis according to the criteria of the American College of Rheumatology were divided into two groups by computerized randomization. The patients in the study group were applied full bath for 20 minutes in the hydrotherapy pool at 38°C, and then, medical mud was applied to both knees at 43°C. The patients in the study group received treatment for 10 days, on weekdays for 2 weeks. Balneotherapy was not applied to the patients in the control group. Patients completed the clinical scales of pain (VAS), patient and physician's global assessment (VAS), Lequesne knee index, Western Ontario and McMaster Universities index (WOMAC), and Nottingham Health Profile with the blinded physician before treatment/day 1, end of treatment/day 12 and at 3 months. Routine biochemistry tests were requested from the patients at each control. Results: There was a statistically significant improvement in VAS pain, global assessment scores of patients and physicians compared to baseline, at the end of treatment and at the 3rd month controls in the study group, but no change was observed in the control group. Except for WOMAC stiffness, a statistically significant decrease was observed in the WOMAC subgroups and WOMAC total scores in the study group at the 3rd month controls compared to the baseline, while no significant decrease was observed in the control group. In the Lequesne knee index study group, a statistically significant improvement was observed in the 12th day and 3rd month scores compared to the baseline, while no significant change was observed in the control group. A statistically significant improvement was observed in Nottingham Health Profile (NHP) pain, emotional reactions, physical movement and energy scores in the study group on the 12th day compared to the baseline, and this significant difference continued in the 3rd month except for the energy score. In the control group, no statistically significant change was observed in the 12th day and 3rd month scores compared to the baseline. No statistically significant change was observed in CRP levels in both groups. Conclusion: The positive effect of balneological treatment (hydrotherapy and peloidotherapy) applied to patients with knee osteoarthritis on pain, functional status and quality of life in knee osteoarthritis has been supported by clinical scales, and this combined balneological treatment method is an effective treatment option in knee osteoarthritis. Keywords: Hydrotherapy; Peloidotherapy; Knee Osteoarthritis