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Spa therapy for elderly: a retrospective study of 239 older patients with osteoarthritis

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Abstract

Very few studies tested the effectiveness of spa therapy in older patients with osteoarthritis. Therefore, we aimed to evaluate the short-term effects of spa therapy in patients aged 65 years and older with generalized, knee, hip, and cervical and lumbar spine osteoarthritis. In an observational retrospective study design at the Medical Ecology and Hydroclimatology Department of Istanbul Medical Faculty, we analyzed the records of 239 patients aged over 65 years with the diagnosis of all types of osteoarthritis who were prescribed a spa therapy course in some spa resorts in Turkey between 7 March 2002 and 31 December 2012. They travelled to a spa resort where they stayed at a thermal spa hotel and followed the usual therapy packages for 2 weeks. Patients were assessed by an experienced physician within a week before the spa journey and within a week after the completion of the spa therapy. Compared with baseline in whole sample, statistically significant improvements were observed in pain (visual analog scale, VAS), patient and physician global assessments (VAS), Health Assessment Questionnaire disability index (HAQ-DI), Lequesne algofunctional index (LAFI) for knee, Western Ontario and McMaster Universities index (WOMAC), Waddell disability index (WDI), and Neck Pain and Disability Scale (NPAD). According to Outcome Measures in Rheumatology—Osteoarthritis Research Society International (OMERACT-OARSI) Set of Responder Criteria, responder rate were 63.8 % (51/80) in generalized, 52 % (13/25) in knee, 50 % (2/4) in hip, 66.7 % (8/12) in lumbar, and 100 % (6/6) in cervical osteoarthritis subgroups. Spa therapy improved pain and physical functional status in older patients with osteoarthritis, especially generalized osteoarthritis and multiple joint osteoarthritis with involvement of knee. This improvement was clinically important in majority of the patients. To confirm the results of this preliminary study, there is a need of a randomized controlled clinical study comparing spa therapy with usual care in the elderly population with osteoarthritis.

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Abbreviations

OA:

Osteoarthritis

OARSI:

Osteoarthritis Research Society International

VAS:

Visual analog scale

HAQ-DI:

Health Assessment Questionnaire disability index

LAFI:

Lequesne algofunctional index

WOMAC:

Western Ontario and McMaster Universities index

WDI:

Waddell disability index

NPAD:

Neck Pain and Disability Scale

PGA:

Patient global assessments

MDGA:

Physician global assessments

OMERACT:

Outcome Measures in Rheumatology

SD:

Standard deviation

SPSS:

Statistical Package for the Social Sciences

EULAR:

European League Against Rheumatism

TLAR:

Turkish League Against Rheumatism

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Authors and Affiliations

  1. Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, Tıbbi Ekoloji ve Hidroklimatoloji A.B.D. İstanbul Tıp Fakültesi Fatih/Capa, İstanbul, 34093, Turkey

    Mine Karagülle, Sinan Kardeş, Hatice Gürdal & Müfit Zeki Karagülle

  2. Department of Biostatistics, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey

    Rian Dişçi

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  1. Mine Karagülle
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  2. Sinan Kardeş
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  4. Hatice Gürdal
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  5. Müfit Zeki Karagülle
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Correspondence to Mine Karagülle.

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Karagülle, M., Kardeş, S., Dişçi, R. et al. Spa therapy for elderly: a retrospective study of 239 older patients with osteoarthritis. Int J Biometeorol 60, 1481–1491 (2016). https://doi.org/10.1007/s00484-016-1138-7

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  • DOI: https://doi.org/10.1007/s00484-016-1138-7

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