Mud‐Bath Therapy in Addition to Usual Care in Bilateral Knee Osteoarthritis: An Economic Evaluation Alongside a Randomized Controlled Trial

Ciani, Oriana; Pascarelli, Nicola Antonio; Giannitti, Chiara; Gargiulo, Mauro; Meregaglia, Michela; Fattore, Giovanni; Fioravanti, Antonella

doi:10.1002/acr.23116

Cited by 37 publications

(24 citation statements)

References 37 publications

(44 reference statements)

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“…Nowadays, several human in vivo studies demonstrated the efficacy of BT [ 1 – 3 , 9 , 48 , 49 ]. Randomized controlled clinical trials investigated OA of the knee [ 50 , 51 ], hip [ 52 ], or shoulder [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

Investigation of Lake Hévíz Mineral Water Balneotherapy and Hévíz Mud Treatment in Murine Osteoarthritis and Rheumatoid Arthritis Models

Tékus

Borbély

Kiss

et al. 2018

Evidence-Based Complementary and Alternative Medicine

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Arthritic diseases are the most frequent causes of chronic pain and disability. Rheumatoid arthritis (RA) is an autoimmune disease characterized by synovial inflammation and progressive structural joint damage. Osteoarthritis is a degenerative process of the articular cartilage associated with hypertrophic changes in the bone. The aim of the present study was to investigate the anti-inflammatory and analgesic effects of Hévíz thermal water and mud in monosodium iodoacetate- (MIA-) (25 mg/ml, 20 μl i.a.) induced osteoarthritis and Complete Freund's adjuvant- (CFA-) (1 mg/ml, 50–50 μl s.c) induced rheumatoid arthritis murine models. The mechanonociceptive threshold of female NMRI mice (n=6– 8 mice/ group) was measured by aesthesiometry, and paw volume was monitored with plethysmometry, knee joint diameter with digital micrometer, and dynamic weight bearing on the hind limbs with a Bioseb instrument. Periarticular bone destruction was assessed by SkyScan 1176 in vivo micro-CT. Inflammatory cytokines were detected by ELISA in plasma samples. Treatments (30 min, every working day) with tap water, sand, and a combined therapy of tap water and sand served as controls. Hévíz medicinal water and combined treatment with water and mud significantly decreased the mechanical hyperalgesia and knee oedema in MIA-induced osteoarthritis model. However, balneotherapy did not influence mechanical hyperalgesia, weight bearing, or oedema formation induced by CFA. Neither medicinal water nor mud treatment ameliorated deep structural damage of the bones or the joints in the animal models. On the basis of the present findings, we conclude that balneotherapy is an effective complementary treatment to reduce the pain sensation and swelling in degenerative joint diseases such as osteoarthritis. Our experimental data are in agreement with the previous human studies that also confirmed antinociceptive and anti-inflammatory effects of thermal water and Hévíz mud treatments.

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Section: Discussionmentioning

confidence: 99%

Investigation of Lake Hévíz Mineral Water Balneotherapy and Hévíz Mud Treatment in Murine Osteoarthritis and Rheumatoid Arthritis Models

Tékus

Borbély

Kiss

et al. 2018

Evidence-Based Complementary and Alternative Medicine

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“…Balneotherapy with mud application is a well-tolerated, costeffective, thermal treatment frequently used for rheumatic diseases, especially knee OA, reinforcing the suitability of this therapy in health systems [21]. The clinical effectiveness of this therapy in OA has been largely demonstrated by numerous investigations [29,30], including studies from our group in the same spa center as the present investigation [14,19].…”

Section: Discussionmentioning

confidence: 61%

“…Several studies have reported the beneficial effects of balneotherapy [15][16][17][18], and particularly mud therapy, on function, perceived pain, analgesic drug consumption, and quality of life in patients with OA, suggesting that they are effective and safe alternatives in the clinical management of this pathology [14,19,20]. Moreover, this strategy is also costeffective, making it a relevant part of the public health systems of many countries within and outside Europe [21,22]. However, despite the evidence of clinical and symptomatic benefits of these therapies, their role in modern medicine is still under discussion [16], mainly because the biological and physiological mechanisms underlying these benefits have not yet been completely elucidated.…”

Section: Introductionmentioning

confidence: 99%

Innate/inflammatory bioregulation and clinical effectiveness of whole-body hyperthermia (balneotherapy) in elderly patients with osteoarthritis

Gálvez

Torres-Piles

Ortega

2018

International Journal of Hyperthermia

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Objectives: Balneotherapy with mud application (mud therapy) is a common hydrothermal intervention for the treatment and rehabilitation of elderly patients with osteoarthritis, leading to anti-inflammatory effects. The main purpose of this investigation was to study a role for regulatory T cells in these anti-inflammatory effects. The second objective was to assess whether the neutrophil-mediated innate response is affected by these anti-inflammatory effects. Methods: Thirty-six elderly patients with knee osteoarthritis underwent a 10-day cycle of balneotherapy at a spa center. They received daily sessions of whole-body mud therapy at 40-42 C, using mineral-medicinal water and mud. IL-8 and TGF-b serum concentrations, percentage of circulating CD4 þ CD25 þ FOXP3 þ and CD8 þ CD28regulatory T cells, and neutrophil phagocytic capacity were evaluated at baseline and at the end of the intervention. Clinical assessments included knee flexion and extension angle, pain, stiffness, physical function and health-related quality of life. Results: All clinical outcomes significantly improved. Circulating concentrations of IL-8 and TGF-b decreased, which correlated with decreased pain and improved knee flexion, respectively. Percentage of CD4 þ regulatory T cells decreased, whereas CD8 þ regulatory T cells increased. Neutrophil functional capacity increased. Conclusions: Balneotherapy with mud application was effective in the management of osteoarthritis symptoms. The anti-inflammatory effect mediated by cytokines contributed to the improvement in pain and joint function; and changes in the circulating percentage of regulatory T cells seem to be involved in the anti-inflammatory effects. Improvement in neutrophil function after mud therapy reflects an optimal bioregulatory effect on the inflammatory and innate responses.

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“…Ciani et al 69 performed a cost-effectiveness analysis of mudbath therapy alongside a RCT. They found that health related quality of life was significantly improved in the group which received mud-bath therapy compared to the group which received usual care alone.…”

Section: Balneotherapymentioning

confidence: 99%

Osteoarthritis year in review 2017: rehabilitation and outcomes

Schiphof

Driest

Runhaar

2018

Osteoarthritis and Cartilage

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Mud‐Bath Therapy in Addition to Usual Care in Bilateral Knee Osteoarthritis: An Economic Evaluation Alongside a Randomized Controlled Trial

Abstract: The results of this cost-effectiveness analysis support the use of MBT as midterm complementary therapy in the management of knee OA.

Cited by 37 publications

References 37 publications

Investigation of Lake Hévíz Mineral Water Balneotherapy and Hévíz Mud Treatment in Murine Osteoarthritis and Rheumatoid Arthritis Models

Investigation of Lake Hévíz Mineral Water Balneotherapy and Hévíz Mud Treatment in Murine Osteoarthritis and Rheumatoid Arthritis Models

Innate/inflammatory bioregulation and clinical effectiveness of whole-body hyperthermia (balneotherapy) in elderly patients with osteoarthritis

Osteoarthritis year in review 2017: rehabilitation and outcomes

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