Characteristics of included studies. From Verhagen, et al. Cochrane Database Sys Review 2007; CD006864; with permission.
| Study | Methods | Participants | Interventions | Outcomes | Results | Notes |
|---|---|---|---|---|---|---|
| Allard 199819 | Unclear allocation concealment; overall quality score: 1 | Northern France spa, rheumatic disease, 4% patients with RA, n = 148 | I: Spa therapy, n = 74 C: No treatment, n = 74 Also nonrandomized spa therapy group (n = 72) | Medication, costs | No data | 14 dropouts in I, 6 in C; study designed to evaluate costs |
| Green 199320 | Unclear allocation concealment; blinded outcome assessment; overall quality score: 3 | St. James Hospital, Leeds, UK; radiographic hip OA; n = 63 | I: Deep pool baths twice weekly + home exercise twice daily, n = 24; 25% male, mean age 65.7 yrs C: Home exercise twice daily, n = 23; 26% male, mean age 68 yrs; treatment for 6 wks; followup at 9, 12, 18 wks | Pain (VAS), function, range of motion, muscle strength | Stiffness: WMD = 19.2 (95% CI −4.4; 42.7) | 16 dropouts |
| Kovacs 200221 | Unclear allocation concealment; blinded patients and outcome assessment; overall quality score: 4 | Cserkeszölö health resort, Hungary; clinically and radiologically established knee OA; n = 70 | I: Deep bathing in thermal water for 30 min for 15 days, n = 31 C: Daily bathing in tap water (placebo) for 30 min for 15 days, n = 27 | Pain (VAS), range of motion (goniometer), function (stair climbing, 4-pt Likert), perceived recovery | Pain: Abs ben: 0.0006% | 12 dropouts; only pre-post analysis |
| Nguyen 199722 | Unclear allocation concealment; observer clearly aware of treatment allocation; overall quality score:4 | France; knee, hip or lumbar spine OA; n = 233 | I: Spa treatment for 21 days, n = 91; 22% male, mean age 64 yrs; mean DOC 11 yrs C: No treatment, routine maintained, n = 97; 16% male, mean age 63, mean DOC 12 yrs; followup at 24 wks | Pain (VAS), function (WDI, AIMS), mobility, medication | Pain: Abs ben: 0.09%; Rel ben: 18.5% (WMD = −0.3; 95%CI −0.6; −0.1); AIMS: WMD = −0.4; (95% CI −0.7; −0.1) | 45 dropouts directly after randomization, 4 exrtra dropouts |
| Sukenik 199923 | Unclear allocation concealment; blinded outcome assessment; overall quality score: 4 | Outpatient clinic, Soroka Medical Centre, Israel; moderate or severe radiographic knee OA, n = 40 | I1: Sulfur baths, n = 10; 20% male, mean age 63.2 yrs, mean DOC 11.6 yrs; I2: Dead Sea baths, n = 10; 10% male, mean age 65.4 yrs, mean DOC 9.2 yrs; I3: I1 + I2; n = 10; 0% male, mean age 57.6 yrs; mean DOC 9.3 yrs C: No treatment, n = 10; 11% male; mean age 65.9 yrs, mean DOC 8.4 yrs. All treatments 20 min twice daily for 2 wks | Pain (patient assessment of severity), function (Lequesne Index), range of motion | Pain: Abs ben I1 vs C: 0.004%; 12 vs C: 0.009%; 13 vs C: 0.014%; Rel ben I1 vs C: 6.6% (WMD = −0.4; 95% CI −1.8; 1.0); I2 vs C: 14.8% (WMD = −0.5; 95% CI −1.7; 0.7); I3 vs C: 23% (WMD = −0.9; 95% CI −2.5; 0.7) | 3 dropouts in 13, 1 in C; only pre-post analysis |
| Tishler 200424 | Unclear allocation concealment; overall quality score: 4 | Israel, patients with knee OA, n = 72 | I: Mineral baths once weekly for 6 weeks, n = 48; 21% male, mean age 65.2 yrs, mean DOC 8.6 yrs C: No treatment, n = 24; 21% male, mean age 63.1 yrs, mean DOC 7.5 yrs; followup at 10 wks | Pain (VAS), pain (WOMAC), analgesic intake | Pain: Abs ben: 0.376%; Rel ben: 56.6% (WMD = −1.6; 95%CI −2.2; −1.1); analgesic intake: RR = 0.05 (95% CI 0.01; 0.2) | 4 dropouts in I; pre-post analysis |
| Wigler 199525 | Unclear allocation concealment; blinded patients and outcome assessment; overall quality score: 6 | Tiberias spa hotel, Israel; moderate or severe radiographic knee OA, n = 33 | I: Mineral baths daily + mud packs on alternate days for 20 min, n = 11; 9% male, mean age 66 yrs, mean DOC 8 yrs C1: Mineral baths daily + rinsed mud packs on alternate days, n = 10; 10% male, mean age 63 yrs, mean DOC 10 yrs C2: tap water baths daily + rinsed mud packs on alternate days for 20 min, n = 12; 16% male, mean age 65 yrs, mean DOC 7 yrs; treatment period of 2 wks; followup: 20 wks | Pain (VAS), function (ISK) | No data | 2 dropouts |
OA: osteoarthritis, DOC: duration of complaints; I: intervention; C: control; VAS: visual analog scale; WDI: Waddel Disability Index; HAQ: Health Assessment Questionnaire; WMD: weighted mean difference; ISK: index of severity knee osteoarthrosis; WOMAC: Western Ontario and McMaster Universities OA Index; Abs ben: absolute benefit; Rel ben: relative benefit; sign: statistical significant difference. RR: relative risk; CI: confidence interval.