title: Balneotherapy for osteoarthritis. A cochrane review.
abstract: OBJECTIVE
  Balneotherapy (or spa therapy, mineral baths) for patients with arthritis is one of the oldest forms of therapy. We assessed effectiveness of balneotherapy for patients with osteoarthritis (OA).
  
  
  METHODS
  We performed a broad search strategy to retrieve eligible studies, selecting randomized controlled trials comparing balneotherapy with any intervention or with no intervention. Two authors independently assessed quality and extracted data. Disagreements were solved by consensus. In the event of clinical heterogeneity or lack of data we refrained from statistical pooling.
  
  
  RESULTS
  Seven trials (498 patients) were included in this review: one performed an intention-to-treat analysis, 2 provided data for our own analysis, and one reported a "quality of life" outcome. We found silver-level evidence of mineral baths compared to no treatment (effect sizes 0.34-1.82). Adverse events were not measured or found in included trials.
  
  
  CONCLUSIONS
  We found silver-level evidence concerning the beneficial effects of mineral baths compared to no treatment. Of all other balneological treatments, no clear effects were found. However, the scientific evidence is weak because of the poor methodological quality and the absence of an adequate statistical analysis and data presentation.
authors.affiliation: Department of General Practice, Erasmus Medical Centre University, Rotterdam, The Netherlands. a.verhagen@erasmusmc.nl
authors.forename: Arianne
authors.initials: A
authors.lastname: Verhagen
authors.forename: Sita
authors.initials: S
authors.lastname: Bierma-Zeinstra
authors.forename: Johan
authors.initials: J
authors.lastname: Lambeck
authors.forename: Jefferson Rosa
authors.initials: JR
authors.lastname: Cardoso
authors.forename: Rob
authors.initials: R
authors.lastname: de Bie
authors.forename: Maarten
authors.initials: M
authors.lastname: Boers
authors.forename: Henrica C W
authors.initials: HC
authors.lastname: de Vet
mesh_terms: D001452:Balneology; D019317:Evidence-Based Medicine; D006801:Humans; D010003:Osteoarthritis / Q000628:therapy*