Spa therapy together with supervised self-mobilisation improves pain, function and quality of life in patients with chronic shoulder pain: a single-blind randomised controlled trial

Authors: Chary-Valckenaere I (1) , Loeuille D (1) , Jay N (2) , Kohler F (2) , Tamisier JN (3) , Roques CF (4) , Boulangé M (5) , Gay G (5)
(1) Rheumatology Department, Nancy University Hospital, and UMR 7365 CNRS-UL IMoPA (Ingéniérie Moléculaire & Physiopathologie Articulaire), Université de Lorraine (2) Service Epidémiologie et Statistiques, Nancy University Hospital, Université de Lorraine (3) Balneotherapy Care facility (4) Paul Sabatier University (Toulouse) and Académie Nationale de Médecine (5) Hydrologie et Climatologie Médicale, Nancy University Hospital, Université de Lorraine
Source: Int J Biometeorol. 2018 Feb 3
DOI: 10.1007/s00484-018-1502-x Publication date: Not specified E-Publication date: Feb. 3, 2018 Availability: full text Copyright: Not specified
Language: English Countries: France, Luxembourg Location: Not specified Correspondence address:


Article abstract

To determine whether spa therapy has a beneficial effect on pain and disability in patients with chronic shoulder pain, this single-blind randomised controlled clinical trial included patients with chronic shoulder pain due to miscellaneous conditions attending one of four spa centres as outpatients. Patients were randomised into two groups: spa therapy (18 days of standardised treatment combining thermal therapy together with supervised mobilisation in a thermal pool) and controls (spa therapy delayed for 6 months: 'immediate versus delayed treatment' paradigm). All patients continued usual treatments during the 6-month follow-up period. The main endpoint was the mean change in the French-Quick DASH (F-QD) score at 6 months. The effect size of spa therapy was calculated, and the proportion of patients reaching minimal clinically important improvement (MCII) was compared. Secondary endpoints were the mean change in SF-36, treatment use and tolerance. One hundred eighty-six patients were included (94 patients as controls, 92 in the spa group) and analysed by intention to treat. At 6 months, the mean change in the F-QD score was statistically significantly greater among spa therapy patients than controls (- 32.6 versus - 8.15%; p < 0.001) with an effect size of 1.32 (95%CI: 0.97-1.68). A significantly greater proportion of spa therapy patients reached MCII (59.3 versus 17.9%). Spa therapy was well tolerated with a significant impact on SF-36 components but not on drug intake. Spa therapy provided a statistically significant benefit on pain, function and quality of life in patients with chronic shoulder pain after 6 months compared with usual care.

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