Evidence map›Paper›PMID 21120502›Full record

ReviewRheumatology international2011

Mechanisms of action of spa therapies in rheumatic diseases: what scientific evidence is there?

Antonella Fioravanti, Luca Cantarini, Giacomo Maria Guidelli, Mauro Galeazzi

Registry-linked trialAbstract readReview
PubMed Publisher
In one paragraph

Review in Rheumatology international, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01538043 (Spa Therapy in Knee Osteoarthritis), which is not on this map. Cited by 120 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
120citing papers in PubMed, 14 pooled it
13.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01538043 phase4completednot on this map

Spa Therapy in Knee Osteoarthritis: Study on Cost/Effectiveness - Cost/Utility and Possible Mechanisms of Action

TypeinterventionalSponsorUniversity of SienaRan2010 to 2013Enrolled100ConditionsOsteoarthritis, KneeArmslocal mud-pack therapy and balneotherapy
3 · Its place in the literature

Who cites it

120 citing papers in PubMed, 14 syntheses or guidelines pooled it, 235 citations in OpenAlex.

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  8. Clinical efficacy of medical hydrology: an umbrella review.International journal of biometeorology · 2021
    Pooled it
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  10. Efficacy of aquatic therapy for neck pain: a systematic review.International journal of biometeorology · 2020
    Pooled it
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  13. Balneotherapy in rheumatoid arthritis-a systematic review.International journal of biometeorology · 2016
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60 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Antonella FioravantiRheumatology Unit, Department of Clinical Medicine and Immunology, University of Siena, Viale Bracci 1, 53100 Siena, Italy. fioravanti7@virgilio.it
Luca Cantarini
Giacomo Maria Guidelli
Mauro Galeazzi
University of Siena · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Spa therapy represents a popular treatment for many rheumatic diseases. The mechanisms by which immersion in mineral or thermal water or the application of mud alleviates suffering in rheumatic diseases are not fully understood. The net benefit is probably the result of a combination of factors, with mechanical, thermal and chemical effects among the most prominent ones. Buoyancy, immersion, resistance and temperature all play important roles. According to the gate theory, pain relief may be due to the pressure and temperature of the water on skin; hot stimuli may influence muscle tone and pain intensity, helping to reduce muscle spasm and to increase the pain threshold. Mud-bath therapy increases plasma β-endorphin levels and secretion of corticotrophin, cortisol, growth hormone and prolactin. It has recently been demonstrated that thermal mud-pack therapy induces a reduction in the circulating levels of prostaglandin E2 (PGE2), leukotriene B4 (LTB4), interleukin-1β (IL-1β) and tumour necrosis factor-α (TNF-α), important mediators of inflammation and pain. Spa therapy has been found to cause an increase in insulin-like growth factor-1 (IGF1), which stimulates cartilage metabolism, and transforming growth factor-β (TGF-β). There is also evidence of the positive action of mud-packs and thermal baths on the oxidant/antioxidant system, with a reduction in the release of reactive oxygen (ROS) and nitrogen (RNS) species. Overall, thermal stress has an immunosuppressive effect. Many other non-specific factors may also contribute to the beneficial effects observed after spa therapy in some rheumatic diseases, including effects on cardiovascular risk factors, and changes in the environment, pleasant surroundings and the absence of work duties.

Indexed as

BalneologyHydrotherapyAnalgesiaHumansRheumatic DiseasesTreatment Outcome

Identifiers

PMID21120502
OpenAlexW2157417968

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.