Comparison of Outpatient and Inpatient Spa Therapy

Study Overview
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Brief Summary
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In this study, we aimed to compare the effectiveness of inpatient and outpatient physical therapy modalities and spa combination treatments on pain and functional status in patients with knee osteoarthritis.

Detailed Description
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Osteoarthritis (OA) has an important place in musculoskeletal diseases and is the most common rheumatic joint disorder characterized by progressive cartilage degeneration. Osteoarthritis of the knee is the most common symptomatic osteoarthritis characterized by chronic knee pain, joint stiffness, limited daily activities, and decreased quality of life. In this study, it was aimed to compare the effects of inpatient and outpatient applications of HP, US, TENS, spa combination treatments on pain and functional status in patients with knee osteoarthritis.

Official Title
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Comparison of Outpatient and Inpatient Spa Therapy in Knee Osteoarthritis

Conditions
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Osteoarthritis, Knee

Intervention / Treatment
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* Other: Spa therapy and conventional physical therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients diagnosed with primary knee osteoarthritis Exclusion Criteria: Patients who have secondary knee osteoarthritis due to various diseases Patients with pronounced pathology in the waist, hip and ankle joint, patients with active tumors Patients with febrile infectious disease Having had serious surgical operations in the last 6 months Patients who have undergone and/or have been injected with intraarticular steroid and hyaluronic acid into the knee joint Patients who have received balneotherapy and peloidotherapy in the last one year Patients with decompensated organ failure, those with inflammatory disease, those with pregnancy and breastfeeding People with neurological diseases such as epilepsy, inner ear hearing aids, pacemakers and other individuals with a small metallic implant

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Inpatient group<br>Spa therapy,HP application, deep heater application, and TENS. | Other: Spa therapy and conventional physical therapy<br>* HP application +deep heater application + TENS. HP application: A hotpack wrapped in a towel for 20 minutes will be placed on the knee and surrounding soft tissues. Deep heater application: The application will be performed with a therapeutic ultrasound device at a dose of 1.5watt / cm2 for each string for 6 minutes. TENS application:TENS device with two electrodes surrounding tendon will be performed for 30 minutes at low-frequency current application. Spa therapy: A conventional water bath water at 38 ° C will be applied in the pool for 20 minutes a day.<br>|
| Active Comparator: Outpatient group<br>Spa therapy,HP application, deep heater application, and TENS. | Other: Spa therapy and conventional physical therapy<br>* HP application +deep heater application + TENS. HP application: A hotpack wrapped in a towel for 20 minutes will be placed on the knee and surrounding soft tissues. Deep heater application: The application will be performed with a therapeutic ultrasound device at a dose of 1.5watt / cm2 for each string for 6 minutes. TENS application:TENS device with two electrodes surrounding tendon will be performed for 30 minutes at low-frequency current application. Spa therapy: A conventional water bath water at 38 ° C will be applied in the pool for 20 minutes a day.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Western Ontario and McMaster University (WOMAC) osteoarthritis index | The form consists of three parts (pain, stiffness, and physical function) and 24 questions. High WOMAC values indicate an increase in pain and stiffness and impairment of physical function. | two weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual Analog Scale (VAS) | The patient was asked to mark the severity of his or her pain with active motion on a horizontal line 100 millimeters in length. The intensity of the pain was calculated by measuring the area in which the individual marked between 0 (no pain) and 10 (the most severe pain I felt in my life). | two weeks | 
| Timed Up and Go (TUG) | The patient starts in a seated position and stands up upon therapist's command: walks 3 meters, turns around, walks back to the chair and sits down. The time stops when the patient is seated. The subject is allowed to use an assistive device. | two weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Spa therapy, Electrotherapy, Ultrasound, Hotpack