Comparison of high-frequency intensive balneotherapy with low-frequency balneotherapy combined with land-based exercise on postural control in symptomatic knee osteoarthritis: a randomized clinical trial.

Authors: Peultier-Celli L (1,2) , Lion A (1,2,3) , Chary-Valckenaere I (4,5) , Loeuille D (4,5) , Zhang Z (1,6) , Rat AC (5,7) , Paysant J (8,1) , Perrin P (1,2)
(1) Faculty of Medicine and UFR STAPS, University of Lorraine, EA 3450, Development, Adaptation and Handicap (2) Laboratory for the Analysis of Posture, Equilibrium and Motor Function (LAPEM), University Hospital of Nancy (3) Fédération Luxembourgeoise des Associations de Sport de Santé (4) Rheumatology Department, Nancy University Hospital, and UMR 7365 CNRS-UL IMoPA (Ingéniérie Moléculaire & Physiopathologie Articulaire), Université de Lorraine (5) Department of Rheumatology, University Hospital of Nancy (6) Department of Orthopaedics, Renmin Hospital of Wuhan University (7) INSERM, CIC-EC, CIE6, F-54000 (8) Regional Institute of Physical Medicine and Rehabilitation
Source: Int J Biometeorol. 2019 May 7
DOI: 10.1007/s00484-019-01727-9 Publication date: Not specified E-Publication date: May 7, 2019 Availability: abstract Copyright: © ISB 2019
Language: English Countries: Not specified Location: Not specified Correspondence address:


Article abstract

Knee osteoarthritis (KOA) can generate postural control impairments which can increase fall risk. Land-based exercise (LBE) and balneotherapy are two modalities currently prescribed, but the impact of the latter on balance control has not been studied. This study aimed to compare two programs of balneotherapy with or without LBE to improve postural control, looking at frequency and duration of treatment. A total of 236 KOA patients (mean age = 64 years) were included in this prospective and randomized study: 122 patients went through 3 weeks of standardized continuous balneotherapy (high frequency/short duration) program (Gr1) and 114 went through 3 weeks of discontinuous (low frequency) balneotherapy program followed by 3 weeks of LBE (Gr2). The total number of treatment sessions was the same for both groups. Posturography was carried out before balneotherapy (W0) and at 3 (W3), 6 (W6), and 12 (W12) weeks after the beginning of treatment. Postural control increased in Gr1 from W0 to W3 and from W0 to W12 and in Gr2 from W0 to W6 and from W3 to W6. The improvement was greater in Gr1 from W0 to W3 and from W6 to W12 and in Gr2 from W3 to W6. High-frequency intensive balneotherapy improved posture control at 3 weeks, while low-frequency balneotherapy did not. This improvement persisted over a 12-week assessment period at the same level. LBE generated an improvement that did not persist over time. Sustained improvement of postural control requires high-frequency repetition of consecutive balneotherapy sessions.

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