title: The effect of balneotherapy on pain relief, stiffness, and physical function in patients with osteoarthritis of the knee: a meta-analysis.
abstract: This meta-analysis was performed to determine the effect of balneotherapy on relieving pain and stiffness and improving physical function, compared to controls, among patients with knee osteoarthritis. We searched electronic databases for eligible studies published from 2004 to December 31, 2016, with language restrictions of English or Japanese. We screened publications in Medline, Embase, Cochrane library, and the Japan Medical Abstracts Society Database using two approaches, MeSH terms and free words. Studies that examined the effect of balneotherapy for treating knee osteoarthritis of a ≥2-week duration were included. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were used as the outcome measure. A total of 102 publications were assessed according to the exclusion criteria of the study; eight clinical trial studies, which comprised a total of 359 cases and 375 controls, were included in this meta-analysis. The meta-analysis analyzed improvement in WOMAC score at the final follow-up visit, which varied from 2 to 12 months post-intervention. Our meta-analysis indicates that balneotherapy was clinically effective in relieving pain and stiffness, and improving function, as assessed by WOMAC score, compared to controls. However, there was high heterogeneity (88 to 93%). It is possible that balneotherapy may reduce pain and stiffness, and improve function, in individuals with knee osteoarthritis, although the quality of current publications contributes to the heterogeneity observed in this meta-analysis.
authors.affiliation: Rehabilitation Division, Tottori University Hospital, 36-1 Nishicho, Yonago City, Tottori, 683-8504, Japan. h.matsumoto@med.tottori-u.ac.jp.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Matsumoto
authors.affiliation: Rehabilitation Division, Tottori University Hospital, 36-1 Nishicho, Yonago City, Tottori, 683-8504, Japan.|Faculty of Medicine, School of Health Science, Tottori University, 86 Nishicho, Yonago City, Tottori, 683-8503, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hagino
authors.affiliation: Faculty of Medicine, School of Health Sciences, Gunma University, 3-39-15 Showa-machi, Maebashi City, Gunma, 371-8514, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Hayashi
authors.affiliation: Gunma University Initiative for Advanced Research, 3-39-15 Showa-machi, Maebashi City, Gunma, 371-8514, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Ideno
authors.affiliation: Rehabilitation Division, Tottori University Hospital, 36-1 Nishicho, Yonago City, Tottori, 683-8504, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Wada
authors.affiliation: Center for Sport Science and Health Promotion, Department of Rehabilitation for the Movement Functions, National Rehabilitation Center for Persons with Disabilities, 4-1 Namiki, Tokorozawa City, Saitama, 359-0042, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Ogata
authors.affiliation: Graduate School International University of Health and Welfare, 4F, Aoyama 1-Chome Tower, 1-3-3 Minami-Aoyama, Minatoku, Tokyo, 107-0062, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Akai
authors.affiliation: Department of Orthopaedic Surgery, Mitsui Memorial Hospital, 1 Izumicho-kanda, Chiyodaku, Tokyo, 101-8643, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Seichi
authors.affiliation: Nagano University of Health & Medicine, 11-1 Imaibara, Nakashimacho, Nagano City, Nagano, 381-2227, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Iwaya
mesh_terms: D001452:Balneology / Q000379:methods*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000628:therapy*; D059408:Pain Management / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology*; D016896:Treatment Outcome
keywords: Balneotherapy; Meta-analysis; Osteoarthritis of the knee