Evaluation of the effectiveness of balneological therapy (hydrotherapy and peloidotherapy) in osteoarthritis patients with comorbidity, a randomized controlled clinical study

Objective: To evaluate the efficacy of balneological treatment (hydrotherapy and peloidotherapy) in patients with multiple-joint osteoarthritis (hand or hip in addition to knee) and comorbidity (hypertension, obesity and/or diabetes). Method: In this randomized controlled trial, 58 patients were randomly assigned to two groups. The treatment group received hydrotherapy (36-380C) for 20 minutes, and then peloidotherapy is applied on painful joints at 42-430C for 20 minutes, on weekdays for 2 weeks. The control group continued usual medical treatment. Patients were evaluated at baseline, and 1 and 3 months after the treatment with pain (Visual Analog Scale, VAS), patient and physician global assessment (VAS), European quality of life (EQ5D-3L), Western Ontario and McMaster Universities (WOMAC) knee (pain, stiffness, physical function), Duruöz Hand index (DHI), WOMAC Hip (pain, stiffness, physical function), and Australian/Canadian osteoarthritis hand index (AUSCAN). Results: All patients had knee osteoarthritis in addition to hand osteoarthritis (36 patients, 68%) and hip osteoarthritis (17 patients, 32%). All patients had comorbidity(ies) (71% of patients had hypertension, 62% had obesity and 41% had diabetes mellitus). There was a statistically significant difference in the treatment group compared to the control group in all parameters at 1 and 3 months except Womac-hip pain (p=0.304) and EQ5D (p=0.054) scores at 1 month. Conclusion: Balneological treatment (hydrotherapy and peloidotherapy) is an effective treatment option to reduce pain, improve the functional state and the quality of life in patients with multiple-joint osteoarthritis and comorbidity. KeyWords: Balneological treatment; Hydrotherapy; Peloidotherapy; Osteoarthritis; Comorbidity.