Evidence map›Paper›PMID 41778048›Full record

ArticleFrontiers in medicine2026

Intensive combined balneotherapy and aquatic exercise for knee osteoarthritis: short-term clinical and functional outcomes.

Gianluca Regazzo, Paola Contessa, Beatrice Forcato, Maddalena Fornasiero, Matteo Gaiofatto, Manuela Gibellini, Federico Massimo, Erika Venturini, Anna Scanu, Stefano Masiero

Abstract read
In one paragraph

Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. 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

10 authors.

Gianluca RegazzoSection of Rehabilitation, Department of Neuroscience-DNS, University of Padova, Padova, Italy.
Paola ContessaSection of Rehabilitation, Department of Neuroscience-DNS, University of Padova, Padova, Italy.
Beatrice ForcatoDepartment of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Padova, Italy.
Maddalena FornasieroDepartment of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Padova, Italy.
Matteo GaiofattoDepartment of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Padova, Italy.
Manuela GibelliniDepartment of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Padova, Italy.
Federico MassimoDepartment of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Padova, Italy.
Erika VenturiniSection of Rehabilitation, Department of Neuroscience-DNS, University of Padova, Padova, Italy.
Anna ScanuSection of Rehabilitation, Department of Neuroscience-DNS, University of Padova, Padova, Italy.
Stefano MasieroSection of Rehabilitation, Department of Neuroscience-DNS, University of Padova, Padova, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Knee osteoarthritis (OA) is a major cause of global disability, necessitating cost-effective interventions. While balneotherapy and acquatic exercise (AE) are established conservative treatments, evidence regarding their combined efficacy remains limited. This study evaluated the clinical impact of a combined program that include balneotherapy and AE in natural mineral waters - compared to balneotherapy alone in patients with mild-to-moderate knee OA in Health Resorts. Primary outcomes included pain intensity, joint range of motion (AROM/PROM), and functional indices [Western Ontario and McMaster Universities (WOMAC), Lequesne's Algofunctional Index for Knee (LAI-knee)]. Secondary outcomes encompassed quality of life (Short Form-12) and psychological well-being (Pittsburgh Sleep Quality Index and Psychological General Well-Being Index). Methods: 66 patients were allocated to either an experimental group (EG), receiving a combined two-week protocol of balneotherapy and AE in salt-bromine-iodine thermal water, or a control group (CG), receiving balneotherapy alone. Results: Both groups demonstrated significant short-term improvements in all the assessments included in study. However, the EG exhibited a superior reduction in pain intensity (31% vs. 13% in CG) and more consistent gains in bilateral active range of motion (AROM). Linear mixed-effects models confirmed significant time effects for WOMAC, LAI, and SF-12 Physical Component scores for both groups. Regression analysis revealed that higher BMI and age negatively correlated with mobility gains. Conclusion: A combined intervention significantly enhances the analgesic and functional benefits of standard balneotherapy. By leveraging physical properties of mineral water, the combined protocol addresses both the mechanical and biological components of knee OA. These findings support the integration of water exercise with balneotherapy in Health Resorts for degenerative joint diseases and the personalization of treatment based on patients age and BMI.

Indexed as

balneotherapyhealth resorthydrokinesitherapyknee OAknee osteoarthritispainquality of lifetreatment efficacy

Identifiers

PMID41778048
PMCPMC12951634

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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.