To evaluate the effects of spa therapy on knee and hip osteoarthritis by studying patients given the same treatment on two different occasions.
A prospective study of two medically-supervised, 3-week spa therapy courses performed at an interval of about 1 year in 51 consecutive patients with knee and/or hip osteoarthritis, most of whom were overweight (mean body mass index, 30 +/- 5 kg/m2). Mean age was 66 years. Study data were collected over a 17-month period.
Lequesne's algofunctional index was significantly improved 5 and 8 months after the first course (by 1.74 +/- 2.2, P < 0.0001; and by 0.89 +/- 2.4, P = 0.017; respectively) and 5 months after the second course (by 1.26 +/- 3, P = 0.008). Walking distance showed comparable improvements. The decrease in medication use was not significant. No significant differences were found between the effects of the two courses after 20 days and 5 months. The advantages and drawbacks of the repeated treatment design used in this study are discussed.
Although some sources of bias could not be eliminated, our data suggest that spa therapy may be effective in knee and hip osteoarthritis. The repeated treatment design may prove useful for evaluating treatments to which patients cannot be blinded.