title: [Knee osteoarthritis and SPA therapy: assessment of joint function and quality of life].
abstract: OBJECTIVE
  In industrialized countries the increase in life expectancy of the population has led to an increase in chronic diseases such as osteoarthritis (OA). Knee osteoarthritis for the high disability and psychological stress, not considered adequately, has negative impact on the quality of life. In this pathology SPA therapy, in particular the sulphur mud-bath therapy, can provide a stage of the therapeutic strategy. However, studies on the impact of SPA therapy on the quality of life in knee osteoarthritis are insufficient. The aim research was to evaluate the effectiveness of SPA therapy on chronic pain, joint function and psychological distress that characterize knee osteoarthritis.
  
  
  METHODS
  The study has been performed on 44 subjects affected by knee Osteoarthritis, being 27 (61%) women and 17 (39%) men (mean age: 58±8.7 years, age range: 42-76 years). The investigated subjects were treated with a cycle of a combination of daily locally applied mud-packs and bicarbonate-sulphurous mineral bath water from Terme of Telese SpA (Benevento-Italy). At the beginning and at the end of the Spa therapy was evaluated the level of pain (using VAS scale), the degree of knee flexion (using goniometer), the level of anxiety and depression (using SDS Zung Test and SAS Zung test) and the impact of sulphurous mud-bath treatment on quality of life (using the algofunctional Lequesne indice).
  
  
  RESULTS
  At the end of Spa therapy the results of our study have shown a significant (p<0.05) reduction of the pain (1.8±1.6 → 0,9±1,3) and a significant (p<0.01) increase of the knee flexion (79°±22 → 91.3°±19) with an improved quality of life.
  
  
  CONCLUSIONS
  The data from this investigation seem to indicate that the SPA therapy may be useful in improving joint function and quality of life in knee osteoarthritis.
authors.affiliation: Associazione F.I.R.S.Thermae, Divisione Idrologia Medica, Terme di Telese, Benevento, Italy. segreteria@firsthermae.org
authors.forename: M
authors.initials: M
authors.lastname: Costantino
authors.forename: A
authors.initials: A
authors.lastname: Filippelli
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life