title: Spa therapy for generalized osteoarthritis: an open, observational, preliminary study.
abstract: OBJECTIVE
  Open, prospective study to evaluate the effect of spa therapy on generalized osteoarthritis (GOA).
  
  
  METHODS
  Patients diagnosed as GOA were recruited from a private outpatient clinic. The treatment protocol was designed with 6 different spa modalities, 3 for each consecutive day, during 18 days. Interventions were Berthollet's technique (local mineral water cloud application), peloidotherapy, hydrotherapy, under water /standard (dry) massage, supervised water exercise, bath in hydro-massage pool, bath in tub with hydro-jets, free immersion in mineral water pool. The primary outcome was a clinically relevant improvement in 50% of patients at the end of the treatment. Statistical analyses were based on intention-to-treat method. Health care providers were blinded to the study.
  
  
  RESULTS
  Ninety nine patients were included between March 7th-April 29th 2011 and all were analyzed for the primary outcome. Clinically relevant improvement was observed in 61% of the patients at the end of the treatment, and 68% at the 8th month. Patient acceptable symptom state was achieved in 33% of the patients at the 3rd week and 75% at the 8th month and Outcome Measures in Rheumatology-Osteoarthritis Research Society International Criteria (OMERACT-OARSI criteria) response in 41% of the patients at the 3rd week and 19% at the 8th month. Improvement was also observed in other judgment criteria evaluating pain, function and quality of life and continued until the 8th month for some of the parameters. No serious adverse effect was observed.
  
  
  CONCLUSIONS
  Spa treatment may improve the clinical status of patients with GOA and seems to be well tolerated.
authors.affiliation: Istanbul Physical Therapy Rehabilitation Training and Research Hospital, Istanbul, Turkey.
authors.forename: Fatma Begüm
authors.initials: FB
authors.lastname: Erol
authors.affiliation: Centre de recherche rhumatologique et thermale, Aix-Les-Bains, France.
authors.forename: Romain J
authors.initials: RJ
authors.lastname: Forestier
authors.affiliation: Ankara Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkey.
authors.forename: Fulya Demircioğlu
authors.initials: FD
authors.lastname: Güneri
authors.affiliation: Istanbul University, Istanbul Medical FacultyMedical Ecology and Hydroclimatology Department, Istanbul, Turkey.
authors.forename: M Zeki
authors.initials: MZ
authors.lastname: Karagülle
authors.affiliation: Istanbul University, Istanbul Medical FacultyMedical Ecology and Hydroclimatology Department, Istanbul, Turkey.
authors.forename: Nergis
authors.initials: N
authors.lastname: Erdoğan
mesh_terms: D000368:Aged; D001452:Balneology / Q000379:methods*; D005260:Female; D006801:Humans; D006875:Hydrotherapy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008900:Mineral Waters / Q000627:therapeutic use; D010003:Osteoarthritis / Q000473:pathology / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D008900:Mineral Waters