07-3 Effect of different 6-day spa therapy courses on the quality of life in the knee osteoarthritis treatment

Abstract

Objectives: In medical spas different spa therapy courses are offered for treating knee osteoarthritis (OA). They contain approximately 10 daily sessions of 2-3 different treatments. During the last two decades, the length of the spa therapy time in Estonia has decreased from 12 days mainly to 6 days due to the changes in the economic situation. Spa therapy courses contain different treatments: massages, thermotherapies, kinesitherapies etc. Last research (Vaht et al. 2008) focused on the effect of 6-days spa therapy course in general. At the beginning and end of spa treatment HAQ-DI, VAS and Lequesne Index were used to assess the clinical status. There were no significant differences between the results of 6- and 12-day spa therapy courses. They both had positive effects by reducing pain and improving clinical status in patients suffering from OA. This study focused on mud therapy and the aim is to compare the therapeutic effect of different spa therapy courses in knee OA.
Materials and methods: 374 patients with knee OA participated voluntarily in this controlled follow-up study, which included different medical spas of Estonia: Spa Hotel Laine, Värska Spa Hotel, Tervis Medical Spa Hotel, Fra Mare Thalasso Spa. Participants fulfilled the criteria of the American College of Rheumatology (ACR) and were at the age between 47-83. The patients with total knee prosthesis, and those who had received thermotherapy in the past three months or had started using analgesics or antidepressants in the past 2 weeks, were excluded.
  The patients were allocated to the groups in order of their admittance:
I - local mud application (40-42°C, 15-20 min, n = 52) or mud bath (41-43°C, 10 min, n = 74); massage therapy (25 min) and kinesitherapy (30 min).
II - herbal bath (37-39°C, 10 min, ) and local mud application (n = 56) or mineral water bath and mud bath (n = 82) and massage.
III - control group - herbal bath (n = 32) or mineral water bath (n = 78), massage therapy and kinesitherapy.
  All therapies were administered once a day and six times a week. All patients were evaluated before and after 6 days of spa treatments and follow-up after 10 weeks of spa treatments (VAS, HAQ-DI, Lequesne Index). Data were analysed using SPSS statistical software.
Results: After 6 days, treatment of all packages reduced pain and diminished the value of Lequesne Index. The follow-up period gave better results for the package where mineral water bath, mud bath and massage therapy were used.
Conclusions: 6-day spa therapy has a good result in the treatment of knee OA reducing pain and improving the quality of life. Better results are achieved when spa therapy course contains two thermal therapies daily in the II group. This work was supported by the Regional Competence Centre Development programme, European Regional Development Fund.