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Research Article

Beneficial effect of climatic therapy on inflammatory arthritis at Tiberias Hot Springs

Pages 172-177 | Published online: 12 Jul 2009

  • therapy includes many facets of treatment of which
  • warm weather and sun is only one aspect. 1. Hill DF, Holbrook WP. The role of climate in the treatment
  • An ESR was not obtained and functional question-of rheumatic disease. Clinics 1942;1:577-81. 2. Edstrom G, Lundin G, Wramner T. Investigations into the
  • naires were not administered (25,26; validated in eVect of hot, dry microclimate on peripheral circulation, etc.
  • Swedish for RA and AS, respectively). Therefore the in arthritis patients. Ann Rheum Dis 1948;7:76-82.
  • criteria for response was more stringent; a ? 20% 3. Sukenik S, Buskila D, Horowitz J. Hot spa balneotherapy in
  • improvement was needed in all 3 remaining criteria, rheumatic diseases. Harefuah 1990;119:16 5-70.
  • pain, physician and patient global assessments in RA
  • Sukenik S, Flusser D, Abu-Shakra M. The role of spa therapy in various rheumatic diseases. Rheum Dis Clin North Ampatients and morning stiVness, pain and patient global 1999;25:883-97.assessment in AS patients. The number of responders
  • 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
  • redundant response criteria. The non-responders in 1991;18:1799-803.
  • 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
  • months, although the peak was immediately after 2000;43:2743-50.
  • therapy and then gradually decreased (12). 15. Anderson JJ, Baron G, van der Heijde D, Felson DT,
  • It is important for physicians to show that climatic Dougados M. Ankylosing spondylitis assessment group prelim-
  • therapy is eVective by accepted criteria since therapy inary de? nition of short-term improvement in ankylosing
  • 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

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