Rehabilitation treatment of coxo-femoral osteo-arthritis - a usefull alternative

Non-pharmacological strategies are recommended as first-line therapy for hip osteoarthritis (OA), yet evidence for balnear rehabilitation remains limited, particularly in Romanian settings. We aimed to evaluate the short-term effectiveness of a two-week Techirghiol balneo-physical programme—sapropel...

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Main Authors: Sterian Apostol, Liliana-Elena Stanciu, Corneliu-Dan Blendea, Andreea-Dalila Nedelcu, Elena Apostol, Dimitri Apostol, Petru Bordei
Format: Article
Language:English
Published: Romanian Association of Balneology, Editura Balneara 2025-06-01
Series:Balneo and PRM Research Journal
Subjects:
Online Access:https://bioclima.ro/Balneo813.pdf
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author Sterian Apostol
Liliana-Elena Stanciu
Corneliu-Dan Blendea
Andreea-Dalila Nedelcu
Elena Apostol
Dimitri Apostol
Petru Bordei
author_facet Sterian Apostol
Liliana-Elena Stanciu
Corneliu-Dan Blendea
Andreea-Dalila Nedelcu
Elena Apostol
Dimitri Apostol
Petru Bordei
author_sort Sterian Apostol
collection DOAJ
description Non-pharmacological strategies are recommended as first-line therapy for hip osteoarthritis (OA), yet evidence for balnear rehabilitation remains limited, particularly in Romanian settings. We aimed to evaluate the short-term effectiveness of a two-week Techirghiol balneo-physical programme—sapropelic mud, warm mineral-water immersion, adjunct physical agents and tar-geted kinetotherapy—on pain, function and quality of life in hip OA. In this prospective single-centre cohort, this study included patients who presented with clinical symptoms of hip pain and were subsequently diagnosed with hip osteoarthritis based on radiographic evaluation; 37 met inclusion criteria and completed follow-up (73 % women; mean age ± SD = 64 ± 8 years). Outcomes were recorded at admission, discharge (week 2) and one-month post-therapy: Visual Analogue Scale (VAS) pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short-Form-20 (SF-20). Within-group changes were analysed with paired-samples t tests (VAS, SF-20) and Wilcoxon signed-rank tests (WOMAC). Effect sizes were expressed as Hedges g or rank-biserial r. Kinetotherapy effects were explored with Mann-Whitney U tests. Mean VAS decreased by 3.87 points (95 % CI 3.58–4.15; t(36)=27.5; p<0.001; g=0.86), and SF-20 rose by 6.14 points (95 % CI 4.94–7.33; t(36)=-10.4; p<0.001; g=–1.69). Median WOMAC total improved by 12 points (IQR 9–17; Z=-5.30; p<0.001; r=0.87). All gains persisted at one-month follow-up. Patients receiving supervised kinetotherapy (n = 17) achieved greater WOMAC-Activity improvement than those without (U = 243.5; p=0.024; r=0.37). No adverse events or drop-outs occurred. A brief, multimodal Techirghiol programme produced large, clinically relevant reductions in pain and disability and durable quality-of-life gains, supporting its use as a safe, first-line non-pharmacologic option for symptomatic hip OA. Augmenting balneotherapy with structured kinetotherapy further enhances functional recovery and should be routinely incorpo-rated into balnear rehabilitation protocols.
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spelling doaj-art-b789293c40414f2899e658de24bdd7a92025-08-20T02:40:40ZengRomanian Association of Balneology, Editura BalnearaBalneo and PRM Research Journal2734-84582025-06-0116280810.12680/balneo.2025.813Rehabilitation treatment of coxo-femoral osteo-arthritis - a usefull alternativeSterian Apostol 0Liliana-Elena Stanciu1Corneliu-Dan Blendea 2Andreea-Dalila Nedelcu 3Elena Apostol4Dimitri Apostol 5Petru Bordei 6„Ovidius” University of Constanta, 900470 Constanta, Romania„Ovidius” University of Constanta, 900470 Constanta, Romania; Balneal and Rehabilitation Sanatorium of Techirghiol,, 906100, Techirghiol, Romania;“Titu Maiorescu” University of Bucharest, 031593 Bucharest, Romania„Ovidius” University of Constanta, 900470 Constanta, Romania„Ovidius” University of Constanta, 900470 Constanta, Romania“Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania„Ovidius” University of Constanta, 900470 Constanta, RomaniaNon-pharmacological strategies are recommended as first-line therapy for hip osteoarthritis (OA), yet evidence for balnear rehabilitation remains limited, particularly in Romanian settings. We aimed to evaluate the short-term effectiveness of a two-week Techirghiol balneo-physical programme—sapropelic mud, warm mineral-water immersion, adjunct physical agents and tar-geted kinetotherapy—on pain, function and quality of life in hip OA. In this prospective single-centre cohort, this study included patients who presented with clinical symptoms of hip pain and were subsequently diagnosed with hip osteoarthritis based on radiographic evaluation; 37 met inclusion criteria and completed follow-up (73 % women; mean age ± SD = 64 ± 8 years). Outcomes were recorded at admission, discharge (week 2) and one-month post-therapy: Visual Analogue Scale (VAS) pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short-Form-20 (SF-20). Within-group changes were analysed with paired-samples t tests (VAS, SF-20) and Wilcoxon signed-rank tests (WOMAC). Effect sizes were expressed as Hedges g or rank-biserial r. Kinetotherapy effects were explored with Mann-Whitney U tests. Mean VAS decreased by 3.87 points (95 % CI 3.58–4.15; t(36)=27.5; p<0.001; g=0.86), and SF-20 rose by 6.14 points (95 % CI 4.94–7.33; t(36)=-10.4; p<0.001; g=–1.69). Median WOMAC total improved by 12 points (IQR 9–17; Z=-5.30; p<0.001; r=0.87). All gains persisted at one-month follow-up. Patients receiving supervised kinetotherapy (n = 17) achieved greater WOMAC-Activity improvement than those without (U = 243.5; p=0.024; r=0.37). No adverse events or drop-outs occurred. A brief, multimodal Techirghiol programme produced large, clinically relevant reductions in pain and disability and durable quality-of-life gains, supporting its use as a safe, first-line non-pharmacologic option for symptomatic hip OA. Augmenting balneotherapy with structured kinetotherapy further enhances functional recovery and should be routinely incorpo-rated into balnear rehabilitation protocols.https://bioclima.ro/Balneo813.pdfhip osteoarthritiscoxarthrosisbalneotherapysapropelic mud therapykinetotherapynon-pharmacological rehabilitationquality of life
spellingShingle Sterian Apostol
Liliana-Elena Stanciu
Corneliu-Dan Blendea
Andreea-Dalila Nedelcu
Elena Apostol
Dimitri Apostol
Petru Bordei
Rehabilitation treatment of coxo-femoral osteo-arthritis - a usefull alternative
Balneo and PRM Research Journal
hip osteoarthritis
coxarthrosis
balneotherapy
sapropelic mud therapy
kinetotherapy
non-pharmacological rehabilitation
quality of life
title Rehabilitation treatment of coxo-femoral osteo-arthritis - a usefull alternative
title_full Rehabilitation treatment of coxo-femoral osteo-arthritis - a usefull alternative
title_fullStr Rehabilitation treatment of coxo-femoral osteo-arthritis - a usefull alternative
title_full_unstemmed Rehabilitation treatment of coxo-femoral osteo-arthritis - a usefull alternative
title_short Rehabilitation treatment of coxo-femoral osteo-arthritis - a usefull alternative
title_sort rehabilitation treatment of coxo femoral osteo arthritis a usefull alternative
topic hip osteoarthritis
coxarthrosis
balneotherapy
sapropelic mud therapy
kinetotherapy
non-pharmacological rehabilitation
quality of life
url https://bioclima.ro/Balneo813.pdf
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AT lilianaelenastanciu rehabilitationtreatmentofcoxofemoralosteoarthritisausefullalternative
AT corneliudanblendea rehabilitationtreatmentofcoxofemoralosteoarthritisausefullalternative
AT andreeadalilanedelcu rehabilitationtreatmentofcoxofemoralosteoarthritisausefullalternative
AT elenaapostol rehabilitationtreatmentofcoxofemoralosteoarthritisausefullalternative
AT dimitriapostol rehabilitationtreatmentofcoxofemoralosteoarthritisausefullalternative
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