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Balneotherapy for rheumatoid arthritis
A P Verhagen1, S M A Bierma-Zeinstra, J R Cardoso
1Department of General Practice, Erasmus MC, P.O. Box 1738, 3000 DR Rotterdam, Netherlands.
The Cochrane Database of Systematic Reviews
|October 30, 2003
Summary
Balneotherapy shows some positive findings for rheumatoid arthritis (RA) symptom relief, but evidence is insufficient due to poor study quality. More rigorous trials are needed to confirm balneotherapy
Area of Science:
- Rheumatology
- Physical Medicine and Rehabilitation
- Evidence-Based Medicine
Background:
- Balneotherapy, an ancient spa therapy, is used to alleviate pain and improve joint mobility in arthritis patients.
- Its application aims to reduce suffering and enhance the well-being of individuals with arthritic conditions.
Purpose of the Study:
- To systematically review the existing scientific literature on the effectiveness of balneotherapy for rheumatoid arthritis (RA).
Main Methods:
- A comprehensive search strategy was employed, including MEDLINE and the Cochrane 'Rehabilitation and Related Therapies' Field database up to June 2002.
- Eligible studies were randomized controlled trials (RCTs) involving patients with rheumatoid arthritis (RA), comparing balneotherapy to other interventions or placebo.
- Methodological quality was assessed using the Delphi list, with data extraction performed by two independent reviewers.
Main Results:
- Six trials involving 355 participants were included in the review.
- Most trials reported positive outcomes for balneotherapy, with improvements ranging from 0% to 44%, but these studies were often methodologically flawed.
- Key limitations included a lack of intention-to-treat analysis, insufficient group comparisons, and scarce data presentation, precluding data pooling.
Conclusions:
- While positive findings exist, the scientific evidence for balneotherapy's effectiveness in rheumatoid arthritis (RA) is currently insufficient due to poor methodological quality and inadequate statistical analysis.
- Essential outcome measures such as pain, function, and quality of life were often missing or poorly reported.
- Further high-quality, methodologically sound randomized controlled trials are necessary to definitively determine the efficacy of balneotherapy for RA.