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- Sukneik S, Buskila D, Neumann L, Kleiner-Baumgarten A,therefore may have been somewhat underestimated. Zimlichman S, Horowitz J. Sulfur bath and mud pack treat-
- A recent study in RA has found that not using ESR ment for rheumatoid arthritis at the Dead Sea area. Ann
- and functional questionnaires as response criteria Rheum Dis 1990;49:99-102. 6. Elkayam O, Wigler I, Tishler M, Rosenblum I, Caspi D, Segal
- subtracts the proportion of responders by only 1-5% R, et al. EVect of spa therapy in Tiberias on patients with
- (14). In that study, the ESR was considered to be a rheumatoidarthritisandosteoarthritis.JRheumatol
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- this study would have not been de? ned as responders 7. Sukenik S, Giryes H, Halevy S, Neumann L, Flusser D,
- even had an ESR and functional questionnaire been Buskila D. Treatment of psoriatic arthritis at the Dead Sea. J Rheumatol 1994;21:130 5-9.
- obtained since they did not improve in more than 8. Sukenik S, Neumann L, Flusser D, Kleiner-Baumgarten A,
- one of the minor criteria. Therefore, it is probable Buskila D. Balneotherapy for rheumatoid arthritis at the Dead
- that not many responders were overlooked. Sea. Isr J Med Sci 1995;31:210-4.
- The study measured responsiveness immediately at 9. Tishler M, Brostovski Y, Yarom M. EVect of spa therapy in
- the end of therapy. Formal functional assessment at Tiberias on patients with ankylosing spondylitis. Clin Rheumatol 1995;14:21-5.
- that time may have not been appropriate since the 10. van Tubergen A, Landewe R, van der Heijde D, Hidding A,
- comparison would have been between function before Wolter N, Asscher M, et al. Combined spa-exercise therapy is
- therapy in Sweden and function at the spa, which eVective in patients with ankylosing spondylitis: a randomized
- may not represent the true functional ability at home. controlled trial. Arthritis Care Res 2001;45:430-8.
- Unfortunately, the scope of this study did not 11. Johansson M, Sullivan L. In? uence of treatment and change of climate in woman with rheumatoid arthritis. Scand J
- enable long-term follow up since I was unable to Rheumatol 1975;4 Suppl 9:1-193.
- follow the patients after they were dispersed in 12. Hafstrom I, Hallengren M. Utvardering av rehabilitering
- Sweden. Follow-up is important for long-term aspects utomlands: reumatiker. Stockholms lans landsting 1998:7-20.
- of disease in addition to activity and damage, for 13. Felson DT, Andersson JJ, Boers M, Bombardier C, Furst D,
- example work ability, medication use and hospitaliza-Goldsmith C, et al. American College of Rheumatology preliminary de? nition of improvement in rheumatoid arthritis.
- tions. In a spa-exercise study of patients with AS Arthritis Rheum 1995;38:727-35.
- improvement in functional ability, pain and stiVness 14. Paulus HE, Bulpitt KJ, Ramos B, Park G, Wong WK for the
- persisted for 40 weeks (11). Similar ? ndings were Western Consortium of Practicing Rhumatologists. Relative
- seen in a study of 105 Swedish patients that underwent contributions of the components of the American College of
- climatic therapy. Improvement continued for 6 Rheumatology 20% criteria for improvement status in patients with early seropositive rheumatoid arthritis. Arthritis Rheum
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- It is important for physicians to show that climatic Dougados M. Ankylosing spondylitis assessment group prelim-
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- is costly and is funded to a large extent by govern-spondylitis. Arthritis Rheum 2001;44:1876-86. 16. Lipsky PE, van der Heijde DM, St Clair EW, Furst DE,
- ments and medical insurances. Also, climatic therapy
Beneficial effect of climatic therapy on inflammatory arthritis at Tiberias Hot Springs
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