Effect of balneotherapy on temporospatial gait characteristics of patients with osteoarthritis of the knee

Abstract

Effects of balneotherapy on gait properties of patients with osteoarthritis of the knee were investigated prospectively. A total of 30 patients with knee osteoarthritis received balneotherapy consisting of two daily thermomineral water baths for 2 weeks. Patients were evaluated using gait analysis and clinical scores, both within 2 weeks, before and after spa treatment. Patients were walking faster in their control analyses (0.81 +/- 0.21 to 0.89 +/- 0.19 m/s; P = 0.017), with a shorter mean stance time (63.0 +/- 3.3 to 61.8 +/- 2.5% stride; P = 0.007), an increased cadence (96 +/- 13.1 to 100 +/- 11.9 steps/min; P = 0.094) and stride length (996 +/- 174 to 1,058 +/- 142 mm; P = 0.017). Balneotherapy also resulted in a significant decrease in Lequesne knee osteoarthritis index (12.1 +/- 3.7 to 10.0 +/- 3.3 points; P = 0.003), VAS for pain (58 +/- 25 to 33 +/- 15; P = 0.0001), VAS for patients' (56 +/- 24 to 29 +/- 19; P < 0.001) and investigator's global assessment (55 +/- 20 to 26 +/- 15; P < 0.0001) and WOMAC score (2.1 +/- 0.7 to 1.6 +/- 0.8; P = 0.0004). Balneotherapy has positive effects on gait properties and clinical health quality parameters of patients with knee osteoarthritis in short-term evaluations.

Balneotherapy in the Treatment of Knee Osteoarthritis: A Controlled Study

“…[24][25][26][27][28] Our study is also in accordance with previous balneotherapy studies in terms of improved clinical criteria such as pain, functional outcome, and walking speed. 16,26,28 Improved WOMAC scores were also similar with other studies. 29,30 On the other hand, Bálint et al 27 reported that the W-TSS did not improve and concluded that this was a result of the insensitivity of W-TSS to change.…”

“…In addition, hot bath causes elevation of beta-endorphin and stress hormone levels, exerting a direct analgesic effect. [16][17][18] Heat induces sedation and muscle relaxation and increases mobility. Maintenance of the analgesic effect is also due to muscle relaxation.…”

Intraarticular injection of hyaluronan prevents cartilage erosion, periarticular fibrosis and mechanical allodynia and normalizes stance time in murine knee osteoarthritis

“…In this case, the increase results directly from the fact that during voluntary locomotion, OA patients walk more slowly than normal controls [44]. This does not, of course, exclude the possibility that OA patients have a higher percentage stance time than normal individuals at the same walking speed.…”

Evidence-Based Recommendations for the Management of Knee Osteoarthritis: A Consensus Report of the Turkish League Against Rheumatism

“…A trial performed in Gönen/Balıkesir demonstrated that 20 minutes of treatment duration applied twice daily for two weeks improved walking time as well as the general health quality in patients with knee OA (LOE III). [52] Any patient directed to balneotherapy should be informed concerning its potential effects, especially the "thermal crisis", of this treatment option. The presence of a PM&R specialist in balneotherapy centers may decrease such potential adverse events.…”