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Ankilozan Spondilitli Hastalarda Balneoterapinin Etkinliği ve İnflamasyona Etkisi, Pilot Çalışma

Yıl 2020, Cilt: 3 Sayı: 3, 84 - 92, 31.12.2020
https://doi.org/10.33713/egetbd.657871

Öz

Amaç: Bu çalışmada, balneoterapinin, ankilozan spondilitli hastalarda hastalık aktivitesi, ağrı, yaşam kalitesine ve inflamasyona etkisini araştırmak.
Gereç ve Yöntem: Bu çalışma prospektif, kontrollü, tek kör bir çalışma olarak planlandı. Toplam 60 hasta iki gruba ayrıldı. I. gruptaki hastalara balneoterapi uygulandı. Kontrol grubuna ek bir tedavi uygulanmadı. Tüm hastalar günlük rutin yaşam tarzlarına ve farmakolojik tedavilerine devam etti. Hastalar tedavinin başlangıcında ve tedavinin sonunda (21. gün) Ağrı VAS, Hasta Global VAS, BASFI, BASDAI, ASQoL, WBC, ESR ve CRP ile değerlendirildi.
Bulgular: Her iki grupta da; tedavi öncesine göre tedavi sonunda BASFI de, balneoterapi grubunda ağrı (VAS), hastanın global değerlendirmesi (VAS), ASQoL ve BASDAIde istatistiksel olarak anlamlı iyileşme tespit edildi.
Gruplar arası karşılaştırmada tedavi öncesi verilerde ağrı (VAS), hastanın global değerlendirmesi (VAS), BASFI ve BASDAI de istatistiksel olarak anlamlı fark varken, tedavi sonrası iki grup arasında ağrı (VAS) hariç diğer verilerde istatistiksel anlamlı fark yoktu.
Fark skorları karşılaştırıldığında ise ağrı (VAS), hastanın global değerlendirmesi (VAS), ASQoL, BASFI ve BASDAIde istatistiksel olarak anlamlı değişim varken WBC, ESR ve CRP arasında istatistiksel olarak anlamlı fark saptanmadı.
Sonuç: Ankilozan Spondilitli hastalarda balneoterapi iyi tolere edilebilir ve uygun hastalarda farmakolojik tedaviler ile birlikte uygulanması tedavinin yararlı etkilerini artırabilir.

Destekleyen Kurum

yok

Kaynakça

  • Kim TJ, Kim TH. Clinical spectrum of ankylosing spondylitis in Korea. Joint Bone Spine 2010;77:235-40
  • Çağlar N, Burnaz Ö, Akın T, Özgönenel L, Çetin E, Aytekin E, et al. Ankilozan spondilitli hastalara ait demografik veriler, klinik özellikler ve medikal tedavileri. İstanbul Tıp Dergisi 2011;12:19-2
  • Van der Heijde D, Ramiro S, Landewé R, et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Annals of the Rheumatic Diseases 2017;76:978-991.
  • Bodur H, et al. Turkish League Against Rheumatism Consensus Report: Recommendations For Management of Axial Spondyloarthritis. Arch Rheumatol. 2018 14;33(1):1-16.
  • Gutenbrunner C, Bender T, Cantista P, Karagülle Z. A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology. Int J Biometeorol 2010;54(5):495-507. doi: 10.1007/s00484-010-0321-5.
  • Tenti S, Fioravanti A, Guidelli GM, Pascarelli NA, Cheleschi S. New evidence on mechanisms of action of spa therapy in rheumatic diseases. TANG 2014;4(1):3.1-3.8. DOI: 10.5667/tang.2013.0029
  • Fioravanti, A., Karagülle, M., Bender, T., & Karagülle, M. Z. Balneotherapy in osteoarthritis: Facts, fiction and gaps in knowledge. European Journal of Integrative Medicine 2017;9:148-150. DOI: 10.1016/j.eujim.2017.01.001
  • Koyuncu E, Okmen BM, Ozkuk K, Tasoglu O, Ozgirgin N. The effectiveness of balneotherapy in chronic neck pain. Clin Rheumatol 2016;35:2549–2555. https://doi.org/10.1007/s10067-016-3199-8
  • Özkuk K, Gurdal H, Karagulle M, Barut Y, Eroksuz R, Karagulle MZ Balneological outpatient treatment for patients with knee osteoarthritis; an effective non-drug therapy option in daily routine? Int J Biometeorol 2017;61:719–728. https://doi.org/10.1007/s00484-016-1250-8
  • Özkuk, K., Uysal, B., Ateş, Z. et al. The effects of inpatient versus outpatient spa therapy on pain, anxiety, and quality of life in elderly patients with generalized osteoarthritis: a pilot study Int J Biometeorol 2018;62:1823-1832. https://doi.org/10.1007/s00484-018-1584-5
  • Karagülle M, Kardeş S, Karagülle MZ Real-life effectiveness of spa therapy in rheumatic and musculoskeletal diseases: a retrospective study of 819 patients. Int J Biometeorol 2017;61(11):1945-1956. doi: 10.1007/s00484-017-1384-3
  • Forestier R, Erol-Forestier FB, Francon A Current role for spa therapy in rheumatology. Joint Bone Spine 2017;84:9–13
  • Gallagher EJ, Liebman M, Bijur PE Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med 2001;38(6):633-638 DOI: 10.1067/mem.2001.118863
  • Yanık, B., Gürsel, Y.K., Kutlay, Ş. et al. Adaptation of the Bath Ankylosing Spondylitis Functional Index to the Turkish population, its reliability and validity: functional assessment in AS. Clin Rheumatol 2005;24(1):41-47 https://doi.org/10.1007/s10067-004-0968-6
  • Akkoc, Y., Karatepe, A. G., Akar, S., Kirazli, Y., Akkoc, N. A Turkish version of the bath ankylosing spondylitis disease activity index: reliability and validity. Rheumatology international 2005;25(4), 280-284 https://doi.org/10.1007/s00296-003-0432-y
  • Doward, L. C., Spoorenberg, A., Cook, S. A., Whalley, D., Helliwell, P. S., Kay, et al. Development of the ASQoL: a quality of life instrument specific to ankylosing spondylitis. Annals of the rheumatic diseases 2003;62(1), 20-6. doi: [10.1136/ard.62.1.20]
  • Ciprian L, Lo Nigro A, RizzoMet al The effects of combined spa therapy and rehabilitation on patients with ankylosing spondylitis being treated with TNF inhibitors. Rheumatol Int 2013;33:241–245
  • Özkuk, K, Gürdal, H, Karagülle, M, Karagülle, M. Diz Osteoartirtli Hastaların Balneolojik Tedavilerinde Süreye Alternatif Bir Yaklaşım. Ege Tıp Bilimleri Dergisi 2018;1 (1):1-6. Retrieved from http://dergipark.gov.tr/egetbd/issue/37116/423237
  • Karagülle M, Kardeş S, Karagülle MZ Long-term efficacy of spa therapy in patients with rheumatoid arthritis. Rheumatol Int 2018;38:353–362
  • Özkuk K, Dilekçi E. The effects of balneotherapy in elderly patients with chronic low back pain treated with physicaltherapy: a pilot study. J Ist Faculty Med 2019;82(4):186-92. doi: 10.26650/IUITFD.2019.0025
  • Codish S, Dobrovinsky S, Abu Shakra M, Flusser D, Sukenik S Spa therapy for ankylosing spondylitis at the Dead Sea. Isr Med Assoc J 2005;7:443–44
  • Yurtkuran M, Ay A, Karakoc Y Improvement of the clinical outcome in ankylosing spondylitis by balneotherapy. Joint Bone Spine 2005;72:303–308
  • Altan L, Bingol U, Aslan M, Yurtkuran M The effect of balneotherapy on patients with ankylosing spondylitis. Scand J Rheumatol 2006;35:283–289
  • van Tubergen A, Landewé R, van der Heijde D, Hidding A, Wolter N, Asscher M, Falkenbach A, Genth E, Thè HG, van der Linden S Combined spa-exercise therapy is effective in patients with ankylosing spondylitis: a randomized controlled trial. Arthritis Rheum 2001;45:430–438
  • Fioravanti A, Cantarini L, Guidelli GM, Galeazzi M Mechanisms of action of spa therapies in rheumatic diseases: what scientific evidence is there? Review. Rheumatol Int. 2011;31:1–8
  • Morer C, Roques CF, Françon A et al. The role of mineral elements and other chemical compounds used in balneology: data from double-blind randomized clinical trials. Int J Biometeorol 2017;61: 2159-73. https://doi.org/10.1007/s00484-017-1421-2
  • Bender T, Karagülle Z, Bálint GP et al. Hydrotherapy, balneotherapy and spa treatment in pain management. Rheumatol Int 2005;25(3):220-4 https://doi.org/10.1007/s00296-004-0487-4
  • Guidelli GM, Tenti S, De Nobili E, Fioravanti A Fibromyalgia syndrome and spa therapy: myth or reality? Clin Med Insights Arthritis Musculoskelet Disord 2012;5:19–26
  • Gálvez, I., Torres-Piles, S., & Ortega-Rincón, E. Balneotherapy, Immune System, and Stress Response: A Hormetic Strategy?. International journal of molecular sciences 2018;19(6), 1687. doi:10.3390/ijms19061687
  • Oláh M., Koncz A., Fehér J., Kálmánczhey J., Oláh C., Balogh S., Nagy G., Bender T. The effect of balneotherapy on C-reactive protein, serum cholesterol, triglyceride, total antioxidant status and HSP-60 levels. Int. J. Biometeorol 2010;54:249–254. doi: 10.1007/s00484-009-0276-6.

The Effectiveness of Balneotherapy in Patients with Ankylosing Spondylitis and Its Effect on Inflammation, A Pilot Study

Yıl 2020, Cilt: 3 Sayı: 3, 84 - 92, 31.12.2020
https://doi.org/10.33713/egetbd.657871

Öz

Objective: This study aimed to investigate whether balneotherapy triggers inflammation and improves the disease activity, pain and quality of life in patients with ankylosing spondylitis
Materials and Method: This study was planned as a prospective, controlled, single-blind study. A total of 60 patients were divided into two groups. Group I was treated balneotherapy. No additional treatment was applied to the control group. All the patients continued their daily routine lifestyles and pharmacological treatments. Assessments were made using the Pain VAS, Patient Global VAS, BASFI, BASDAI, ASQoL, WBC, ESR and CRP at the beginning of treatment and at the end of treatment (day 21).
Results: Compared to the pre-treatment period, there was a statistically significant improvement in both groups’ pain at the end of the treatment in BASFI, in the Balneotherapy group (VAS), in the patient’s global assessment (VAS), in ASQoL and BASDAI. A comparison between groups before treatment revealed that there was a statistically significant difference in terms of pain (VAS), patient’s global assessment (VAS), BASFI and BASDAI whereas, after treatment, there was no statistically significant difference in the data except pain (VAS).A comparison of difference scores revealed that there was a statistically significant change in pain (VAS), patient’s global assessment (VAS), ASQoL, BASFI and BASDAI whereas there was no statistically significant difference between WBC, ESR and CRP.
Conclusion: Balneotherapy is well tolerated and balneotherapy combined with pharmacological treatment may improve the beneficial effects of treatment in ankylosing spondylitis patients.

Kaynakça

  • Kim TJ, Kim TH. Clinical spectrum of ankylosing spondylitis in Korea. Joint Bone Spine 2010;77:235-40
  • Çağlar N, Burnaz Ö, Akın T, Özgönenel L, Çetin E, Aytekin E, et al. Ankilozan spondilitli hastalara ait demografik veriler, klinik özellikler ve medikal tedavileri. İstanbul Tıp Dergisi 2011;12:19-2
  • Van der Heijde D, Ramiro S, Landewé R, et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Annals of the Rheumatic Diseases 2017;76:978-991.
  • Bodur H, et al. Turkish League Against Rheumatism Consensus Report: Recommendations For Management of Axial Spondyloarthritis. Arch Rheumatol. 2018 14;33(1):1-16.
  • Gutenbrunner C, Bender T, Cantista P, Karagülle Z. A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology. Int J Biometeorol 2010;54(5):495-507. doi: 10.1007/s00484-010-0321-5.
  • Tenti S, Fioravanti A, Guidelli GM, Pascarelli NA, Cheleschi S. New evidence on mechanisms of action of spa therapy in rheumatic diseases. TANG 2014;4(1):3.1-3.8. DOI: 10.5667/tang.2013.0029
  • Fioravanti, A., Karagülle, M., Bender, T., & Karagülle, M. Z. Balneotherapy in osteoarthritis: Facts, fiction and gaps in knowledge. European Journal of Integrative Medicine 2017;9:148-150. DOI: 10.1016/j.eujim.2017.01.001
  • Koyuncu E, Okmen BM, Ozkuk K, Tasoglu O, Ozgirgin N. The effectiveness of balneotherapy in chronic neck pain. Clin Rheumatol 2016;35:2549–2555. https://doi.org/10.1007/s10067-016-3199-8
  • Özkuk K, Gurdal H, Karagulle M, Barut Y, Eroksuz R, Karagulle MZ Balneological outpatient treatment for patients with knee osteoarthritis; an effective non-drug therapy option in daily routine? Int J Biometeorol 2017;61:719–728. https://doi.org/10.1007/s00484-016-1250-8
  • Özkuk, K., Uysal, B., Ateş, Z. et al. The effects of inpatient versus outpatient spa therapy on pain, anxiety, and quality of life in elderly patients with generalized osteoarthritis: a pilot study Int J Biometeorol 2018;62:1823-1832. https://doi.org/10.1007/s00484-018-1584-5
  • Karagülle M, Kardeş S, Karagülle MZ Real-life effectiveness of spa therapy in rheumatic and musculoskeletal diseases: a retrospective study of 819 patients. Int J Biometeorol 2017;61(11):1945-1956. doi: 10.1007/s00484-017-1384-3
  • Forestier R, Erol-Forestier FB, Francon A Current role for spa therapy in rheumatology. Joint Bone Spine 2017;84:9–13
  • Gallagher EJ, Liebman M, Bijur PE Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med 2001;38(6):633-638 DOI: 10.1067/mem.2001.118863
  • Yanık, B., Gürsel, Y.K., Kutlay, Ş. et al. Adaptation of the Bath Ankylosing Spondylitis Functional Index to the Turkish population, its reliability and validity: functional assessment in AS. Clin Rheumatol 2005;24(1):41-47 https://doi.org/10.1007/s10067-004-0968-6
  • Akkoc, Y., Karatepe, A. G., Akar, S., Kirazli, Y., Akkoc, N. A Turkish version of the bath ankylosing spondylitis disease activity index: reliability and validity. Rheumatology international 2005;25(4), 280-284 https://doi.org/10.1007/s00296-003-0432-y
  • Doward, L. C., Spoorenberg, A., Cook, S. A., Whalley, D., Helliwell, P. S., Kay, et al. Development of the ASQoL: a quality of life instrument specific to ankylosing spondylitis. Annals of the rheumatic diseases 2003;62(1), 20-6. doi: [10.1136/ard.62.1.20]
  • Ciprian L, Lo Nigro A, RizzoMet al The effects of combined spa therapy and rehabilitation on patients with ankylosing spondylitis being treated with TNF inhibitors. Rheumatol Int 2013;33:241–245
  • Özkuk, K, Gürdal, H, Karagülle, M, Karagülle, M. Diz Osteoartirtli Hastaların Balneolojik Tedavilerinde Süreye Alternatif Bir Yaklaşım. Ege Tıp Bilimleri Dergisi 2018;1 (1):1-6. Retrieved from http://dergipark.gov.tr/egetbd/issue/37116/423237
  • Karagülle M, Kardeş S, Karagülle MZ Long-term efficacy of spa therapy in patients with rheumatoid arthritis. Rheumatol Int 2018;38:353–362
  • Özkuk K, Dilekçi E. The effects of balneotherapy in elderly patients with chronic low back pain treated with physicaltherapy: a pilot study. J Ist Faculty Med 2019;82(4):186-92. doi: 10.26650/IUITFD.2019.0025
  • Codish S, Dobrovinsky S, Abu Shakra M, Flusser D, Sukenik S Spa therapy for ankylosing spondylitis at the Dead Sea. Isr Med Assoc J 2005;7:443–44
  • Yurtkuran M, Ay A, Karakoc Y Improvement of the clinical outcome in ankylosing spondylitis by balneotherapy. Joint Bone Spine 2005;72:303–308
  • Altan L, Bingol U, Aslan M, Yurtkuran M The effect of balneotherapy on patients with ankylosing spondylitis. Scand J Rheumatol 2006;35:283–289
  • van Tubergen A, Landewé R, van der Heijde D, Hidding A, Wolter N, Asscher M, Falkenbach A, Genth E, Thè HG, van der Linden S Combined spa-exercise therapy is effective in patients with ankylosing spondylitis: a randomized controlled trial. Arthritis Rheum 2001;45:430–438
  • Fioravanti A, Cantarini L, Guidelli GM, Galeazzi M Mechanisms of action of spa therapies in rheumatic diseases: what scientific evidence is there? Review. Rheumatol Int. 2011;31:1–8
  • Morer C, Roques CF, Françon A et al. The role of mineral elements and other chemical compounds used in balneology: data from double-blind randomized clinical trials. Int J Biometeorol 2017;61: 2159-73. https://doi.org/10.1007/s00484-017-1421-2
  • Bender T, Karagülle Z, Bálint GP et al. Hydrotherapy, balneotherapy and spa treatment in pain management. Rheumatol Int 2005;25(3):220-4 https://doi.org/10.1007/s00296-004-0487-4
  • Guidelli GM, Tenti S, De Nobili E, Fioravanti A Fibromyalgia syndrome and spa therapy: myth or reality? Clin Med Insights Arthritis Musculoskelet Disord 2012;5:19–26
  • Gálvez, I., Torres-Piles, S., & Ortega-Rincón, E. Balneotherapy, Immune System, and Stress Response: A Hormetic Strategy?. International journal of molecular sciences 2018;19(6), 1687. doi:10.3390/ijms19061687
  • Oláh M., Koncz A., Fehér J., Kálmánczhey J., Oláh C., Balogh S., Nagy G., Bender T. The effect of balneotherapy on C-reactive protein, serum cholesterol, triglyceride, total antioxidant status and HSP-60 levels. Int. J. Biometeorol 2010;54:249–254. doi: 10.1007/s00484-009-0276-6.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Orijinal Araştırma
Yazarlar

Kağan Özkuk 0000-0001-6448-8146

Bilal Uysal 0000-0003-1674-7216

Yayımlanma Tarihi 31 Aralık 2020
Kabul Tarihi 28 Şubat 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 3 Sayı: 3

Kaynak Göster

EndNote Özkuk K, Uysal B (01 Aralık 2020) The Effectiveness of Balneotherapy in Patients with Ankylosing Spondylitis and Its Effect on Inflammation, A Pilot Study. Ege Tıp Bilimleri Dergisi 3 3 84–92.

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