Article

OBJECTIVE: To determine whether the addition of spa therapy to home exercises
provides any benefit over exercises and the usual treatment alone in the
management of generalised osteoarthritis associated with knee osteoarthritis.
This study was a post-hoc subgroup analysis of our randomised
multicentre trial (www.clinicaltrial.gov: NCT00348777). Participants who met the
inclusion criteria of generalized osteoarthritis (Kellgren, American College of
Rheumatology, or Dougados criteria) were extracted from the original randomised
controlled trial. They had been randomised using Zelen randomisation. The
treatment group received 18days of spa treatment in addition to a home exercise
programme. Main outcome was number of patients achieving minimal clinically
important improvement at six months (MCII) (>/=-19.9mm on the VAS pain scale
and/or >/=-9.1 points in a WOMAC function subscale), and no knee surgery.
Secondary outcomes included the "patient acceptable symptom state" (PASS) defined
as VAS pain </=32.3mm and/or WOMAC function subscale </=31 points. RESULTS: From
the original 462 participants, 214 patients could be categorized as having
generalised osteoarthritis. At sixth month, 182 (88 in control and 94 in SA
group) patients, were analysed for the main criteria. MCII was observed more
often in the spa group (n=52/94 vs. 38/88, P=0.010). There was no difference for
the PASS (n=19/88 vs. 26/94, P=0.343). CONCLUSIONS: This study indicates that spa
therapy with home exercises may be superior to home exercise alone in the
management of patients with GOA associated with knee OA.
CI - Copyright (c) 2014 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS ; FRANCAIS