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ARIANNE VERHAGEN, SITA BIERMA-ZEINSTRA, JOHAN LAMBECK, JEFFERSON ROSA CARDOSO, ROB de BIE, MAARTEN BOERS, and HENRICA C.W. de VET
ABSTRACT. Methods. We performed a broad search strategy to retrieve eligible studies, selecting randomized controlled trials comparing balneotherapy with any intervention or with no intervention. Two authors independently assessed quality and extracted data. Disagreements were solved by consensus. In the event of clinical heterogeneity or lack of data we refrained from statistical pooling. Results. Seven trials (498 patients) were included in this review: one performed an intention-to-treat analysis, 2 provided data for our own analysis, and one reported a "quality of life" outcome. We found silver-level evidence of mineral baths compared to no treatment (effect sizes 0.34-1.82). Adverse events were not measured or found in included trials. Conclusion. We found silver-level evidence concerning the beneficial effects of mineral baths compared to no treatment. Of all other balneological treatments, no clear effects were found. However, the scientific evidence is weak because of the poor methodological quality and the absence of an adequate statistical analysis and data presentation. (J Rheumatol First Release May 1 2008) Key Indexing Terms:
OSTEOARTHRITIS From the Department of General Practice, Erasmus Medical Centre University, Rotterdam; The Halliwick-Hydrotherapy Institute, VM Malden, The Netherlands; Physical Therapy Department, Universidade Estadual de Londrina, Londrina, Brazil; Department of Epidemiology, Maastricht University, Maastricht; Department of Clinical Epidemiology and Biostatistics, VU University Medical Centre; and EMGO-Institute, VU University Medical Centre, Amsterdam, The Netherlands. A.P. Verhagen, PhD; S.M.A. Bierma-Zeinstra, PhD, Department of General Practice, Erasmus Medical Centre University; J. Lambeck, PT, Halliwick-Hydrotherapy Institute; J.R. Cardoso, PT, Physical Therapy Department, Universidade Estadual de Londrina; R.A. de Bie, PhD, Professor, Department of Epidemiology, Maastricht University; M. Boers, MD, PhD, Professor, Department of Clinical Epidemiology and Biostatistics, VU University Medical Centre; H.C.W. de Vet, PhD, Professor, VU University Medical Centre. Address reprint requests to Dr. A.P. Verhagen, Department of General Practice, Erasmus Medical Centre University, PO Box 2040, 3000 CA Rotterdam, The Netherlands. E-mail: a.verhagen@erasmusmc.nl |
