Efficacy of Paraffin Bath Therapy in Hand Osteoarthritis: A Single-Blinded Randomized Controlled Trial Archives of Physical Medicine and Rehabilitation (2025)

Efficacy of Paraffin Bath Therapy in Hand Osteoarthritis: A Single-Blinded Randomized Controlled Trial

Archives of Physical Medicine and Rehabilitation, 2013

Objective: To evaluate the efficacy of paraffin bath therapy on pain, function, and muscle strength in patients with hand osteoarthritis. Design: Prospective single-blinded randomized controlled trial. Setting: Department of physical medicine and rehabilitation in a university hospital. Participants: Patients with bilateral hand osteoarthritis (NZ56). Interventions: Patients were randomized into 2 groups with a random number table by using block randomization with 4 patients in a block. Group 1 (nZ29) had paraffin bath therapy (5 times per week, for 3-week duration) for both hands. Group 2 (nZ27) was the control group. All patients were informed about joint-protection techniques, and paracetamol intake was recorded. Main Outcome Measures: The primary outcome measures were pain (at last 48h) at rest and during activities of daily living (ADL), assessed with a visual analog scale (0e10cm) at 12 weeks. The secondary outcome measures were the Australian Canadian Osteoarthritis Hand Index (AUSCAN) and the Dreiser Functional Index (DFI), used for subjective functional evaluation, loss of range of motion (ROM), grip and pinch strength, painful and tender joint counts, and paracetamol intake. A researcher blind to group allocation recorded the measures for both hands at baseline, 3 weeks, and 12 weeks at the hospital setting. Results: At baseline, there were no significant differences between groups in any of the parameters (P>.05). After treatment, the paraffin group exhibited significant improvement in pain at rest and during ADL, ROM of the right hand, and pain and stiffness dimensions of the AUSCAN (P<.05). There was no significant improvement in functional dimension of the AUSCAN and the DFI (P>.05). The control group showed a significant deterioration in right hand grip and bilateral lateral pinch and right chuck pinch strength (P<.05), but there was no significant change in the other outcome measures. When the 2 groups were compared, pain at rest, both at 3 and 12 weeks, and the number of painful and tender joints at 12 weeks significantly decreased in the paraffin group (P<.05). Bilateral hand-grip strength and the left lateral and chuck pinch strength of the paraffin group were significantly higher than the control group at 12 weeks (P<.05). Conclusions: Paraffin bath therapy seemed to be effective both in reducing pain and tenderness and maintaining muscle strength in hand osteoarthritis. It may be regarded as a beneficial short-term therapy option, which is effective for a 12-week period. Archives of Physical Medicine and Rehabilitation 2013;94:642-9 ª 2013 by the American Congress of Rehabilitation Medicine

Comparison of efficacy of fluidotherapy and paraffin bath in hand osteoarthritis: A randomized controlled trial

Archives of Rheumatology, 2021

Objectives This study aims to compare the efficacy of paraffin bath therapy and fluidotherapy on pain, hand muscle strength, functional status, and quality of life (QoL) in patients with hand osteoarthritis (OA). Patients and methods This prospective randomized controlled study included 77 patients (8 males, 69 females; mean age: 63.1±10.3 years; range 39 to 88 years) with primary hand OA who applied between July 2017 and March 2018. The patients were randomized into two groups with the sealed envelope method: Paraffin bath therapy (20 min, one session per day, for two weeks) was applied for 36 patients whereas 41 patients received fluidotherapy for the same period. The pain severity of the patients, both at rest and during activities of daily living (ADL) within the last 48 hours was questioned and scored using Visual Analog Scale. Duruöz Hand Index (DHI) was used to evaluate hand functions. Gross grip strength was measured using Jamar dynamometer whereas fine grip strength was mea...

Supplementary_Material_3 – Supplemental material for The Ottawa Panel guidelines on programmes involving therapeutic exercise for the management of hand osteoarthritis

2018

Supplemental material, Supplementary_Material_3 for The Ottawa Panel guidelines on programmes involving therapeutic exercise for the management of hand osteoarthritis by Lucie Brosseau, Odette Thevenot, Olivia MacKiddie, Jade Taki, George A Wells, Paulette Guitard, Guillaume Léonard, Nicole Paquet, Sibel Z Aydin, Karine Toupin-April, Sabrina Cavallo, Rikke Helene Moe, Kamran Shaikh, Wendy Gifford, Laurianne Loew, Gino De Angelis, Shirin Mehdi Shallwani, Ala&#39; S Aburub, Aline Mizusaki Imoto, Prinon Rahman, Inmaculada C Álvarez Gallardo, Milkana Borges Cosic, Nina Østerås, Sabrina Lue, Tokiko Hamasaki, Nathaly Gaudreault, Tanveer E Towheed, Sahil Koppikar, Ingvild Kjeken, Dharini Mahendira, Glen P Kenny, Gail Paterson, Marie Westby, Lucie Laferrière and Guy Longchamp in Clinical Rehabilitation

… recommendations for the management of hand osteoarthritis: report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including …

Annals of the …, 2007

To develop evidence based recommendations for the management of hand osteoarthritis (OA). Methods: The multidisciplinary guideline development group comprised 16 rheumatologists, one physiatrist, one orthopaedic surgeon, two allied health professionals, and one evidence based medicine expert, representing 15 different European countries. Each participant contributed up to 10 propositions describing key clinical points for management of hand OA. Final recommendations were agreed using a Delphi consensus approach. A systematic search of Medline, Embase, CINAHL, Science Citation Index, AMED, Cochrane Library, HTA, and NICE reports was used to identify the best available research evidence to support each proposition. Where possible, the effect size and number needed to treat were calculated for efficacy. Relative risk or odds ratio was estimated for safety, and incremental cost effectiveness ratio was used for cost effectiveness. The strength of recommendation was provided according to research evidence, clinical expertise, and perceived patient preference. Results: Eleven key propositions involving 17 treatment modalities were generated through three Delphi rounds. Treatment topics included general considerations (for example, clinical features, risk factors, comorbidities), non-pharmacological (for example, education plus exercise, local heat, and splint), pharmacological (for example, paracetamol, NSAIDs, NSAIDs plus gastroprotective agents, COX-2 inhibitors, systemic slow acting disease modifying drugs, intra-articular corticosteroids), and surgery. Of 17 treatment modalities, only six were supported by research evidence (education plus exercise, NSAIDs, COX-2 inhibitors, topical NSAIDs, topical capsaicin, and chondroitin sulphate). Others were supported either by evidence extrapolated from studies of OA affecting other joint sites or by expert opinion. Strength of recommendation varied according to level of evidence, benefits and harms/costs of the treatment, and clinical expertise. Conclusion: Eleven key recommendations for treatment of hand OA were developed using a combination of research based evidence and expert consensus. The evidence was evaluated and the strength of recommendation was provided.

There Is Inadequate Evidence to Determine the Effectiveness of Nonpharmacological and Nonsurgical Interventions for Hand Osteoarthritis: An Overview of High-Quality Systematic Reviews

Physical Therapy, 2009

Background. Patients with hand osteoarthritis are commonly treated by health care professionals (allied to medicine). Practice should be informed by updated evidence from systematic reviews of randomized controlled trials.

P05.31. Development of a manualized protocol of massage therapy for clinical trials in osteoarthritis

BMC Complementary and Alternative Medicine, 2012

Background: Clinical trial design of manual therapies may be especially challenging as techniques are often individualized and practitioner-dependent. This paper describes our methods in creating a standardized Swedish massage protocol tailored to subjects with osteoarthritis of the knee while respectful of the individualized nature of massage therapy, as well as implementation of this protocol in two randomized clinical trials. Methods: The manualization process involved a collaborative process between methodologic and clinical experts, with the explicit goals of creating a reproducible semi-structured protocol for massage therapy, while allowing some latitude for therapists' clinical judgment and maintaining consistency with a prior pilot study. Results: The manualized protocol addressed identical specified body regions with distinct 30-and 60-min protocols, using standard Swedish strokes. Each protocol specifies the time allocated to each body region. The manualized 30-and 60-min protocols were implemented in a dual-site 24-week randomized dose-finding trial in patients with osteoarthritis of the knee, and is currently being implemented in a three-site 52-week efficacy trial of manualized Swedish massage therapy. In the dose-finding study, therapists adhered to the protocols and significant treatment effects were demonstrated.

The Turkish League Against Rheumatism Recommendations for the Management of Hand Osteoarthritis Under Guidance of the Current Literature and 2018 European League Against Rheumatism Recommendations

Archives of Rheumatology, 2020

Objectives: This study aims to explore the accordance to the 2018 European League Against Rheumatism (EULAR) recommendations for the management of hand osteoarthritis (OA) among the Turkish League Against Rheumatism (TLAR) expert panel and composition of TLAR recommendations for the management of hand OA under guidance of the current literature. Materials and methods: The TLAR convener designated an expert panel of 10 physicians experienced in hand OA for this process. The 2018 EULAR recommendations for the management of hand OA and the systematic review of the literature were sent to the expert panel via e-mails. The e-mail process which included Delphi round surveys was completed. The EULAR standard operational procedure Appraisal of Guidelines for Research and Evaluation II was followed. The level of agreement was calculated for each item and presented as mean, standard deviations, minimum and maximum and comparisons of 2018 EULAR recommendations were performed. Results: Five overarching principles and 10 recommendations were discussed. Revisions were held for the sixth, seventh, and ninth recommendations with lowest level of agreements. These recommendations were revised in accordance with suggestions from the experts and re-voted. The revised forms were approved despite the lack of statistically significant difference between these forms (p=0.400, p=0.451, p=0.496, respectively). Except for the ninth recommendation about surgery (p=0.008), no significant difference in level of agreements was observed between the EULAR and TLAR hand OA recommendations. The 11 th recommendation about paraffin bath was added. Conclusion: The optimal treatment of hand OA consists of personalized non-pharmacological (self-management, exercise, splint), pharmacological (topical non-steroidal anti-inflammatory drugs as the first choice), and interventional procedures (only for refractory cases) based on shared decision between the patient and physician. TLAR hand OA recommendations were created mainly based on the most recent literature and the last EULAR hand OA management recommendations, which are widely approved among the TLAR experts.

Comparison of two Traditional Spa Therapy Regimens in Patients with Knee Osteoarthritis

Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin, 2002

Ziel der Studie: Vergleich der Wirkungen zweier verschiedener traditioneller Kurortbehandlungsregimes bei Patienten mit Knieosteoarthritis auf Kniefunktion und Schmerzen. Methodik: Alle Patienten mit nachgewiesener Knieosteoarthritis, die im Badeort Sandikli eine traditionelle Kur (8-tägig) durchführten, wurden um eine Teilnahme an der Studie gebeten. 49 Patienten stimmten der Teilnahme nach entsprechender Aufklärung zu und wurden in die folgenden Behandlungsgruppen eingeteilt: Gruppe I (n = 24) erhielt je ein Thermalwasserbad (39 8C, 20 min) und ein Peloidbad (45 8C, 20 min) pro Tag; Gruppe II (n = 25) erhielt zwei Thermalwasserbäder (39 8C, 20 min) pro Tag. Hauptzielparameter war der Lequesne-Index für Kniebeschwerden. Sekundäre Zielparameter waren Schmerzintensität (VAS), 10-Meter-Gehzeit, Dauer von drei Kniebeugen und Zeit für das Herauf-und Herabgehen von 10 Treppenstufen. Diese Parameter wurden von einem nicht verblindeten Untersucher zu Beginn und am Ende der Therapiephase erhoben. Ergebnisse: In beiden Gruppen fand sich eine signifikante (p < 0,001) Verbesserung des Lequesne-Knie-Index (Gruppe I: 49,3 %; Gruppe II: 31,3 %). Die Verbesserung war in Gruppe I signifikant stärker als in Gruppe II (p < 0,001). Die Schmerzangaben in der VAS verringerten sich in beiden Gruppen (Gruppe I: 37,3; Gruppe II: 30,1 %). Diese Reduktion war in Gruppe I signifikant stärker als in Gruppe II (p = 0,003). Auch die anderen drei Parameter zeigten signifi-Abstract Purpose: To compare the effects of two different traditional spa therapy regimens for knee osteoarthritis (OA) on function and pain. Patients and Methods: Patients with knee osteoarthritis staying in a spa hotel in Sandõklõ Spa for traditional spa therapy (8 days) were asked to be included in the study. Total of 49 patients gave informed consent consisting two groups based on treatment regimens as follows: Group I (n = 24) had a thermal water bath and a peloid bath per day; Group II (n = 25) had two thermal mineral water baths per day. The primary outcome measure was Lequesne's knee severity index. Secondary measures were pain intensity (visual analogue scale), 10 meters walking time, 3 times squatting down and up time and 10 stairs stepping up and down time. An unblinded observer carried out all assessments at the beginning and at the end of the spa therapy. Results: In both groups, improvements were found in Lequesne's Knee Index (49.3 % in group I and 31.3 % in group II, respectively) (p < 0.001) and improvement in group I was significantly higher than group II (p < 0.001). VAS scores for pain reduced in both groups (37.3 % and 30.1 %) and this reduction was significantly higher in group I (p = 0.003). All other 3 measures also showed significant improvements in both groups and again improvements were significantly higher in group I than group II. Conclusions: Both traditional spa therapy regimens could significantly improve the functional status and pain on patients with knee OA

Comparison of two Traditional Spa Therapy Regimens in Patients with Knee Osteoarthritis: An Exploratory Study

Physikalische Medizin Rehabilitationsmedizin Kurortmedizin, 2002

Ziel der Studie: Vergleich der Wirkungen zweier verschiedener traditioneller Kurortbehandlungsregimes bei Patienten mit Knieosteoarthritis auf Kniefunktion und Schmerzen. Methodik: Alle Patienten mit nachgewiesener Knieosteoarthritis, die im Badeort Sandikli eine traditionelle Kur (8-tägig) durchführten, wurden um eine Teilnahme an der Studie gebeten. 49 Patienten stimmten der Teilnahme nach entsprechender Aufklärung zu und wurden in die folgenden Behandlungsgruppen eingeteilt: Gruppe I (n = 24) erhielt je ein Thermalwasserbad (39 8C, 20 min) und ein Peloidbad (45 8C, 20 min) pro Tag; Gruppe II (n = 25) erhielt zwei Thermalwasserbäder (39 8C, 20 min) pro Tag. Hauptzielparameter war der Lequesne-Index für Kniebeschwerden. Sekundäre Zielparameter waren Schmerzintensität (VAS), 10-Meter-Gehzeit, Dauer von drei Kniebeugen und Zeit für das Herauf-und Herabgehen von 10 Treppenstufen. Diese Parameter wurden von einem nicht verblindeten Untersucher zu Beginn und am Ende der Therapiephase erhoben. Ergebnisse: In beiden Gruppen fand sich eine signifikante (p < 0,001) Verbesserung des Lequesne-Knie-Index (Gruppe I: 49,3 %; Gruppe II: 31,3 %). Die Verbesserung war in Gruppe I signifikant stärker als in Gruppe II (p < 0,001). Die Schmerzangaben in der VAS verringerten sich in beiden Gruppen (Gruppe I: 37,3; Gruppe II: 30,1 %). Diese Reduktion war in Gruppe I signifikant stärker als in Gruppe II (p = 0,003). Auch die anderen drei Parameter zeigten signifi-

The Ottawa Panel guidelines on programmes involving therapeutic exercise for the management of hand osteoarthritis

Clinical rehabilitation, 2018

To identify programmes involving therapeutic exercise that are effective for the management of hand osteoarthritis and to provide stakeholders with updated, moderate to high-quality recommendations supporting exercises for hand osteoarthritis. A systematic search and adapted selection criteria included comparable trials with exercise programmes for managing hand osteoarthritis. Based on the evaluated evidence, a panel of experts reached consensus through a Delphi approach endorsing the recommendations. A hierarchical alphabetical grading system (A, B, C+, C, C-, D-, D, D+, E, F) was based on clinical importance (≥15%) and statistical significance ( P &lt; 0.05). Ten moderate- to high-quality studies were included. Eight studies with programmes involving therapeutic exercise (e.g. range of motion (ROM) + isotonic + isometric + functional exercise) seemed to be effective. Forty-six positive grade recommendations (i.e. A, B, C+) were obtained during short-term (&lt;12 weeks) trials for...