Evidence map›Paper›PMID 41735629›Full record

Observational studyInternational journal of biometeorology2026

Does the predominance of central sensitization alter the effect of balneotherapy combined with conventional physical therapy in patients with chronic low back and knee pain?

Dilek Ulusoy Özkan, Musa Polat

Abstract readComparative StudyObservational Study
In one paragraph

Observational study in International journal of biometeorology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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

2 authors.

Dilek Ulusoy ÖzkanDepartment of Physical Medicine and Rehabilitation, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey. dulusoyozkan@cumhuriyet.edu.tr.ORCID http://orcid.org/0009-0001-0313-2717
Musa PolatDepartment of Physical Medicine and Rehabilitation, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Various methods, including balneotherapy, are employed in the management of patients with chronic pain. This research investigated the effect of the predominance of central sensitization on responses to balneotherapy applied together with conventional physical therapy in patients with chronic low back and knee pain. This prospective study included 75 patients with chronic low back or knee pain, classified as having predominant central sensitization (n = 35) or not (n = 40). All participants received a three-week course of whole-body balneotherapy combined with conventional physical therapy, including transcutaneous electrical nerve stimulation, hot pack, and therapeutic ultrasound. Pain intensity, as the primary outcome, was assessed using the visual analogue scale (VAS), while quality of life and emotional status were evaluated using the Short Form-12 (SF-12) and the Hospital Anxiety and Depression Scale (HADS), respectively. Disability associated with chronic pain was evaluated using the Roland Morris Disability Questionnaire in patients with low back pain and the Knee Injury and Osteoarthritis Outcome Score (KOOS) in those with knee pain. Changes in outcomes over time and between groups were analyzed using linear mixed-effects models. Improvement in the VAS, SF-12 Physical and Mental Component, HADS-Depression, and HADS-Anxiety scores was observed in both groups post-treatment (between p < 0.01 and p = 0.015). Also, post-treatment improvement in disability scores was observed in both groups (between p < 0.01 and 0.021). Group × time interaction was observed only for the SF-12 mental component score, in favor of the predominant central sensitization group (ΔΔ = 5.95, 95% CI 1.31 to 10.59, p = 0.013). No significant group × time interaction was observed for other outcomes (range: 0.10-0.97). Applied together with physical therapy agents with balneotherapy can reduces pain severity and disability levels, and increases their quality of life in patients with chronic pain with and without predominant central sensitization. Improvements in mental health-related quality of life were more pronounced in patients with predominant central sensitization.

Indexed as

BalneologyCentral Nervous System SensitizationChronic PainLow Back PainPhysical Therapy ModalitiesAdultAgedCombined Modality TherapyFemaleHumansMaleMiddle AgedPain MeasurementProspective StudiesQuality of LifeTranscutaneous Electric Nerve StimulationBalneotherapycentral sensitizationchronic painphysical therapy

Identifiers

PMID41735629
PMCPMC12932310

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Registered trials

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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.