Article

OBJECTIVE: To compare the benefits of a thermal cure and non-thermal
rehabilitation in treatment of knee osteoarthritis (KOA). METHODS: Randomized
therapeutic trial including patients with knee osteoarthritis (American College
of Rheumatology criteria). Patients were randomly divided into two groups. Spa
treatment consisted of underwater shower, massage-jet showers, hydromassage, pool
rehabilitation and peloid therapy. Non-thermal rehabilitation consisted of
analgesic physiotherapy, muscle strengthening and group physical rehabilitation.
A blinded evaluation was carried out at day 21 and 12months following treatment.
It was based on the visual analogic scale of pain (VAS), which represented the
primary endpoint. RESULTS: Two hundred and forty patients were included
(February-June 2005). The spa treatment and non-thermal rehabilitation groups
included 119 and 121 patients respectively. Two hundred and thirty-three patients
completed their treatments. Significant improvement of the visual analogic scale
of pain was noted in the thermal cure group (61.6+/-15 at day 0 versus
46.5+/-22.4 at 12months, P<0.001), but not in the non-thermal group (64.1+/-15 at
day 0 versus 62+/-29 at 12months, P=0.68). At day 21, comparison of the two
groups revealed no significant difference on the VAS (P=0.08). However, at
12months, the thermal cure group was significantly more improved (P=0.000).
CONCLUSION: In our study, crenobalneotherapy had resulted, at 12months, in more
pronounced long-term improvement of the painful symptoms of KOA than had
non-thermal rehabilitation.
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Langue : ANGLAIS ; FRANCAIS