title: Comparing the efficacy of mature mud pack and hot pack treatments for knee osteoarthritis.
abstract: OBJECTIVE
  The objective of this study is to compare the efficacy of mature mud pack and hot pack therapies on patients with knee osteoarthritis.
  
  
  METHODS
  This study was designed as a prospective, randomized-controlled, and single-blinded clinical trial. Twenty-seven patients with clinical and radiologic evidence of knee osteoarthritis were randomly assigned into two groups and were treated with mature mud packs (n 15) or hot packs (n=12). Patients were evaluated for pain [based on the visual analog scale (VAS)], function (WOMAC, 6 min walking distance), quality of life [Short Form-36 (SF-36)], and serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and insulin-like growth factor-1 (IGF-1) at baseline, post-treatment, and 3 and 6~months after treatment.
  
  
  RESULTS
  The mud pack group shows a significant improvement in VAS, pain, stifness, and physical function domains of WOMAC. The difference between groups of pain and physical activity domains is significant at post-treatment in favor of mud pack. For a 6 min walking distance, mud pack shows significant improvement, and the difference is significant between groups in favor of mud pack at post-treatment and 3 and 6 months after treatment. Mud pack shows significant improvement in the pain subscale of SF-36 at the third month continuing until the sixth month after the treatment. Significant improvements are found for the social function, vitality/energy, physical role disability, and general health subscales of SF-36 in favor of the mud pack compared with the hot pack group at post-treatment. A significant increase is detected for IGF-1 in the mud pack group 3 months after treatment compared with the baseline, and the difference is significant between groups 3 months after the treatment.
  
  
  CONCLUSIONS
  Mud pack is a favorable option compared with hotpack for pain relief and for the improvement of functional conditions in treating patients with knee osteoarthritis.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Pamukkale University, Denizli, Turkey.
authors.forename: Ayşe
authors.initials: A
authors.lastname: Sarsan
authors.forename: Nuray
authors.initials: N
authors.lastname: Akkaya
authors.forename: Merih
authors.initials: M
authors.lastname: Ozgen
authors.forename: Necmettin
authors.initials: N
authors.lastname: Yildiz
authors.forename: Nilgun Simsir
authors.initials: NS
authors.lastname: Atalay
authors.forename: Fusun
authors.initials: F
authors.lastname: Ardic
mesh_terms: D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D015850:Interleukin-6 / Q000097:blood; D008875:Middle Aged; D009094:Mud Therapy / Q000379:methods*; D020370:Osteoarthritis, Knee / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D016037:Single-Blind Method; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D007334:Insulin-Like Growth Factor I