title: SPA therapy in fibromyalgia: a randomised controlled clinic study.
abstract: OBJECTIVE
  The aim of the present study is to evaluate the effectiveness of spa therapy in the management of fibromyalgia.
  
  
  METHODS
  Thirty women with fibromyalgia were randomly assigned to either a spa therapy group or a control group. The spa therapy group (n = 16) had spa treatment for 2 weeks in addition to their medical treatment. The control group (n = 14) continued to have their medical treatment and/or daily exercises. An investigator who was blinded for the intervention assessed all the patients for 9 months. Improvements in Fibromyalgia Impact Questionnaire (FIQ), pain and number of tender points were primary outcomes. Secondary outcome measures were improvement in sleep disturbance, fatigue, gastrointestinal symptoms, anxiety, Beck Depression Inventory and patient's global evaluation.
  
  
  RESULTS
  the spa group was found to be superior to the control group at the end of intervention in terms of FIQ, pain, tender point count, fatigue and patients' global assessment. This superiority remained for 6 months in FIQ, 1 month in pain and tender point count.
  
  
  CONCLUSIONS
  It was concluded that the addition of spa therapy to medical therapy has both short- and long-term beneficial effects in female patients with fibromyalgia.
authors.affiliation: Department of Medical Ecology and Hydroclimatology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey. donmeza@istanbul.edu.tr
authors.forename: Arif
authors.initials: A
authors.lastname: Dönmez
authors.forename: M Zeki
authors.initials: MZ
authors.lastname: Karagülle
authors.forename: Nuran
authors.initials: N
authors.lastname: Tercan
authors.forename: Mustafa
authors.initials: M
authors.lastname: Dinler
authors.forename: Halim
authors.initials: H
authors.lastname: Işsever
authors.forename: Mine
authors.initials: M
authors.lastname: Karagülle
authors.forename: Mustafa
authors.initials: M
authors.lastname: Turan
mesh_terms: D000328:Adult; D001452:Balneology; D003131:Combined Modality Therapy; D003863:Depression / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D005221:Fatigue / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D059408:Pain Management; D026741:Physical Therapy Modalities; D012720:Severity of Illness Index; D016037:Single-Blind Method; D012893:Sleep Wake Disorders / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome