Thermotherapy for treating rheumatoid arthritis.

Authors: Robinson V (1) , Brosseau L (2) , Casimiro L (3) , Judd M (4) , Shea B (5) , Wells G (6) , Tugwell P (7)

Affiliations:

(1) University of Ottawa, Centre for Global Health, Institute of Population Health (2) University of Ottawa, School of Rehabilitation Sciences, Faculty of Health Sciences (3) University of Ottawa, School of Rehabilitation Sciences (4) Canadian Health Services Research Foundation/Fondation canadienne de la recherche sur les services de santé, Research Use/Agence principale de programme, Utilisation de la Recherche (5) University of Ottawa, CIET, Institute of Population Health (6) University of Ottawa, Department of Medicine (7) University of Ottawa, Department of Epidemiology and Community Medicine

Source: Cochrane Database Syst Rev. 2002;(1):CD002826.

DOI: 10.1002/14651858.CD002826 Publication date: Not specified E-Publication date: April 22, 2002 Availability: abstract Copyright: © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Language: English Countries: Not specified Location: Not specified Correspondence address: Vivian Welch,
Centre for Global Health, Institute of Population Health, University of Ottawa, 1 Stewart Street, Room 206, Ottawa, Ontario, K1N 6N5, Canada.
Email : vivian.welch@uottawa.ca.

Keywords

Article abstract

BACKGROUND:

Thermotherapy is often used as adjunct in the treatment of rheumatoid arthritis (RA) by rehabilitation specialists.

OBJECTIVES:

To evaluate the effectiveness of different thermotherapy applications on objective and subjective measures of disease activity in patients with RA.

SEARCH STRATEGY:

We searched Medline, EMBASE, Pedro, Current Contents, Sports Discus and CINAHL up to and including September 2001. The Cochrane Field of Rehabilitation and related therapies and the Cochrane Musculoskeletal Review Group were also contacted for a search of their specialized registers. Hand searching was conducted on all retrieved articles for additional articles.

SELECTION CRITERIA:

Comparative controlled studies, such as randomized controlled trials, controlled clinical trials, cohort studies or case/control studies, of thermotherapy compared to control or active interventions in patients with RA were eligible. No language restrictions were applied. Abstracts were accepted.

DATA COLLECTION AND ANALYSIS:

Two independent reviewers identified potential articles from the literature search (VR, LB). These reviewers extracted data using pre-defined extraction forms. Consensus was reached on all data extraction. Quality was assessed by two reviewers using a 5 point scale that measured the quality of randomization, double-blinding and description of withdrawals.

MAIN RESULTS:

Seven studies (n=328 subjects) met the inclusion criteria. The results of this systematic review of thermotherapy for RA found that there was no significant effect of hot and ice packs applications (Ivey 1994), cryotherapy (Rembe 1970) and faradic baths (Hawkes 1986) on objective measures of disease activity including joint swelling, pain, medication intake, range of motion (ROM), grip strength, hand function compared to a control (no treatment) or active therapy. There is no significant difference between wax and therapeutic ultrasound as well as between wax and faradic bath combined to ultrasound for all the outcomes measured after 1, 2 or 3 week(s) of treatment (Hawkes 1986). There was no difference in patient preference for all types of thermotherapy. No harmful effects of thermotherapy were reported.

REVIEWER'S CONCLUSIONS:

Superficial moist heat and cryotherapy can be used as a palliative therapy. Paraffin wax baths combined with exercises can be recommended for beneficial short term effects for arthritic hands. These conclusions are limited by methodological considerations such as the poor quality of trials.

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