JORR
Journal of Orthopedics Research and Rehabilitation

The Journal of Orthopedics Research and Rehabilitation welcomes scholarly papers inorthopaedic surgery, physical therapy and rehabilitation, neurosurgery, neurology and clinic anesthesiology and reanimation. This journal is indexed by indices that are considered international scientific journal indices (DRJI, ESJI, OAJI, etc.). According to the current Associate Professorship criteria, it is within the scope of International Article 1-d. Each article published in this journal corresponds to 5 points.

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Original Article
The effect of balneotherapy and physical therapy applied to patients with chronic low back pain on pain intensity, quality of life, disability and mental symptoms
Abstract
Aims: The aim of present study was to evaluate effects of balneotherapy and physical therapy combination against only physical therapy on pain, guality of life, disability and psychological symptoms in chronic low back pain. Methods: Sixty patients with chronic low back pain were included in the study. Patients were divided into two groups: Balneotherapy and physical therapy group (n=30) and physical therapy group (n=30). Balneotherapy group hospitalized for 20 minutes a day every day for 3 weeks to balneotherapy sessions with 40°C thermomineral water and 5 days a week for 3 weeks to 15 sessions of physical therapy session. Physical therapy group recieved 5 days a week for 3 weeks to 15 sessions of physical therapy session in the treatment unit Both groups recieved ultrason treatment which has 1.5W/cm 2 dose and 1MHz frequency for 6 minutes, Transcutaneous Electrical Nerve Stimulation (TENS) (50-100 Hz) for 20 minutes and hot pack for 20 minutes as physical therapy. Patients in both groups were given a patient-based standardized lumbar exercise in addition to physical therapy. The following parameters were measured: Visual Analog Scale (VAS) for pain intensity, Short Form-36 (SF-36) to evaluate guality of life, Oswestry Disability lndex (ODI) to evaluate functional disability and Symptom Check List-90 to query psychological symptoms. First evaluations were done at the beginning of treatment and second evaluations were done at the end of treatment before and after treatment. Results: We observed more significant decrease in VAS scores in the group administered balneotherapy (FT+BT) and physical therapy compared with the group treated only physical therapy (FT) (p<0,05). At the end of treatment in FT+BT group subscale of guality of life; Physical role limitations, mental health, pain and general health were significantly higher than the FT group (p<0,05). In FT+BT group except social functioning and in FT group except vitality and general health, ali other dimensions of guality of life showed significant improvement (p<0,05). Although pretreatment disability rate of FT+BT is more, in this group decline of scores were more (30.4% to 14.2%). When compared to before and after treatment scores on the SCL-90 sub-parameters in FT+BT individuals were significantly different in ali the sub-parameters but in FT group except phobic anxiety and paranoid ideation, found significant differences in other parameters (p<0,05). In addition the decline of statistically significant decrease in the parameters was observed lesser extent in FT group compares to FT+BT group. Conclusions: In present study we observed that balneotherapy in addition to physical therapy against routin physical treatment program showed more decline in pain and functional disability, more increase in guality of life and more improvements in psychological symptoms in addition relationship between psychologic symptom scores and disability is stronger than the relationship between psychologic symptom scores and pain scores.

Keywords : Chronic low back pain, guality of life, functional disability, psychological symptoms, balneotherapy

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1. Inanıcı F. Bel ağrısı nedenleri ve muayenesi. İ&ccedil;inde: Beyazova M, G&ouml;k&ccedil;eKutsal Y (edt). Fiziksel Tıp ve Rehabilitasyon; G&uuml;neş Tıp Kitapevleri,2011, 2053-2066.
2. Rackwitz B, de Bie R, Limm H, von Garnier K, Ewert T, Stucki G.Segmental stabilizing exercises and low back pain. What is theevidence? A systematic review of randomized controlled trials. ClinRehabil. 2006;20(7):553-567. doi:10.1191/0269215506cr977oa
3. Grabois M. Management of chronic low back pain. Am J Phys MedRehabil. 2005;84(3 Suppl):S29-S41.
4. Oğuz H. Bel ağrıları. İ&ccedil;inde: Oğuz H, Dursun E, Dursun N, edt. TıbbiRehabilitasyon. Nobel Tıp Kitabevleri 2004; 1131-1172
5. Escortell-Mayor E, Riesgo-Fuertes R, Garrido-Elustondo S, et al.Primary care randomized clinical trial: manual therapy effectivenessin comparison with TENS in patients with neck pain. Man Ther.2011;16(1):66-73. doi:10.1016/j.math.2010.07.003
6. Akarırmak &Uuml;. Bel Ağrılarında Konservatif Tedavi. Clinic Medicine. BelAğrısı &Ouml;zel Sayısı 2007; 1: 40-46.
7. Karatas M. Balneoterapi. İ&ccedil;inde: Oğuz H, Dursun E, Dursun N, eds.Tıbbi Rehabilitasyon. Nobel Tıp Kitabevleri, 2004: 355-362.
8. Imamura M, Furlan AD, Dryden T, Irvin E. Evidence-informedmanagement of chronic low back pain with massage. Spine J.2008;8(1):121-133. doi:10.1016/j.spinee.2007.10.016
9. Doğan BM. Kaplıca Tedavisi, Balneoterapi ve Klimaterapi. İ&ccedil;inde:Doğan BM, Karag&uuml;lle MZ (eds). Kaplıca Tıbbı ve T&uuml;rkiye KaplıcaRehberi. Nobel Tıb Kitabevleri, 2007: 1-21.
10. Frank AO, De Souza LH. Conservative management of low back pain.Int J Clin Pract. 2001;55(1):21-31.
11. Kara H, Abay E. Kronik ağrıya psikiyatrik yaklaşım. Anadolu PsikiyatriDerg 2000;1(2): 89-99.
12. Gonzales VA, Martelli MF, Baker JM. Psychological assessment ofpersons with chronic pain. NeuroRehabilitation. 2000;14(2):69-83.
13. Altındağ &Ouml;, Altındağ A, Soran N. Kronik ağrılı hastalarda depresyond&uuml;zeyinin ağrı şiddeti ve s&uuml;resi ile ilişkisinin araştırılması. NewSymposium Journal. 2006; 44(4):178-181.
14. T&uuml;t&uuml;nc&uuml; R, G&uuml;nay H. Kronik ağrı, psikolojik etmenler ve depresyon/Chronic pain, psychological factors and depression.Dicle Tip Dergisi.2011;38(2):257. doi: 10.5798/diclemedj.0921.2011.02.0028
15. Erdine S. Ağrının tanımı. İ&ccedil;inde: Erdine S. (ed). Ağrı sendromları veTedavisi. Gizben Matbaacılık 2003:16.
16. Balogh Z, Ord&ouml;gh J, G&aacute;sz A, N&eacute;met L, Bender T. Effectiveness ofbalneotherapy in chronic low back pain -- a randomized single-blind controlled follow-up study. Forsch Komplementarmed KlassNaturheilkd. 2005;12(4):196-201. doi:10.1159/000086305
17. Kulisch A, Bender T, N&eacute;meth A, Szekeres L. Effect of thermal waterand adjunctive electrotherapy on chronic low back pain: a double-blind, randomized, follow-up study. J Rehabil Med. 2009;41(1):73-79.doi:10.2340/16501977-0291
18. Tefner IK, N&eacute;meth A, L&aacute;szl&oacute;fi A, Kis T, Gyetvai G, Bender T. The effectof spa therapy in chronic low back pain: a randomized controlled,single-blind, follow-up study. Rheumatol Int. 2012;32(10):3163-3169.doi:10.1007/s00296-011-2145-y
19. Kesiktas N, Karakas S, Gun K, Gun N, Murat S, Uludag M.Balneotherapy for chronic low back pain: a randomized, controlledstudy. Rheumatol Int. 2012;32(10):3193-3199. doi:10.1007/s00296-011-2163-9
20. Onat ŞŞ, Taşoğlu &Ouml;, G&uuml;neri FD, &Ouml;zişler Z, Safer VB, &Ouml;zgirgin N.The effectiveness of balneotherapy in chronic low back pain. ClinRheumatol. 2014;33(10):1509-1515. doi:10.1007/s10067-014-2545-y
21. Dogan M, Sahin O, Elden H, Hayta E, Kaptanoglu E. Additionaltherapeutic effect of balneotherapy in low back pain. South Med J.2011;104(8):574-578. doi:10.1097/SMJ.0b013e318224644f
22. Quint U, Hasenburg H, Patsalis T, Franke GH. PsychischeBelastung bei station&auml;ren Patienten mit akutem und chronischemLumbalsyndrom [Psychological stress of inpatients with acute andchronic lumbar syndrome]. Z Orthop Ihre Grenzgeb. 1998;136(5):444-450. doi:10.1055/s-2008-1053682
23. Pincus T, Burton AK, Vogel S, Field AP. A systematic reviewof psychological factors as predictors of chronicity/disabilityin prospective cohorts of low back pain. Spine (Phila Pa 1976).2002;27(5):E109-E120. doi:10.1097/00007632-200203010-00017
24. George SZ, Coronado RA, Beneciuk JM, Valencia C, Werneke MW, HartDL. Depressive symptoms, anatomical region, and clinical outcomesfor patients seeking outpatient physical therapy for musculoskeletalpain. Phys Ther. 2011;91(3):358-372. doi:10.2522/ptj.20100192
25. Nickel R, Egle UT, Eysel P, Rompe JD, Z&ouml;llner J, Hoffmann SO. Health-related quality of life and somatization in patients with long-term lowback pain: a prospective study with 109 patients. Spine (Phila Pa 1976).2001;26(20):2271-2277. doi:10.1097/00007632-200110150-00020
Article available in :
Volume 1, Issue 1, 2023
Page : 5-10
https://doi.org/10.51271/JORR-0002
Article Information
Received : 23 Oca 2023
Accepted : 26 Oca 2023
Published : 29 Oca 2023
Corresponding Author :

Ayşe Gülşen Doğan: Department of Physical Medicine and Rehabilitation, Erol Olçok Training and Research Hospital, Hitit University, Çorum, Turkey

[email protected]
Citation : Kulaoğlu O, Elden H, Doğan AG. The effect of balneotherapy and physical therapy applied to patients with chronic lack pain on pain intensity, quality of life, disability and mental symptoms. J Orthop Res Rehabil 2023; 1(1): 5-10.

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