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INFRARED SAUNA WHOLE-BODY HYPERTHERMIA IN
RHEUMATOID ARTHRITIS AND ANKYLOSING SPONDYLITIS. FGJ Oosterveld1,
JJ Rasker2,3, MAFJ van de Laar2 and GJ Koel1.
1Saxion University for
Professional Education, Enschede, the Netherlands. 2Department of Rheumatology, Hospital Medisch
Spectrum Twente, Enschede, the Netherlands. 3University Twente, Enschede, the Netherlands.
PURPOSE:
Through the ages heat treatment has been popular among people with rheumatic
disorders. The evidence for their application is still weak, despite the fact
that several studies investigating the effects of heat in rheumatic diseases
were conducted. Patients mention positive effects
during and after infrared (IR) sauna whole-body hyperthermia. Therefore we
decided to study these effects in patients with Rheumatoid Arthritis (RA) and
Ankylosing Spondylitis (AS). RELEVANCE: Since
about ten years a new modality for whole body hyperthermia, a compact and
user-friendly infrared (IR) 'sauna' has become available and may also further
be introduced in physical therapy practice. SUBJECTS: 17 RA
patients (3 male, 14 female) and 17 AS patients (12 male, 5 female) with a
mean age (sd) of 47 (13) and 44 (10) years respectively were included in the
study. METHODS AND MATERIALS: Patients were treated for a 4-week
period with a series of 8 sessions in an IR sauna cabin (30 minutes at an
ambient temperature of 55°C). Clinical measurements were performed at the start and at the end of the series of 8
IR sauna treatments and also four weeks before the start as well as four
weeks after the end of the treatment series. ANALYSIS: The continuous
data were checked for normality and statistically
analysed by means of repeated measures analysis with Bonferroni correction
within SPSS 9.0. Level of
significance (α) was chosen at 0.05. RESULTS: In
the RA patients the primary effect variables pain, stiffness and fatigue
showed clinical improvements during the four-week treatment period; stiffness
almost reached statistical significance: p=0.06. In the AS patients stiffness
improved after the treatment, but this did not reach statistical
significance; otherwise little effects were seen during the treatment and
post-treatment periods. Over the 12-week study period no statistically
significant changes were found on secondary clinical and functional
variables, such as ROM and DUTCH-AIMS for RA patients, and Bath Ankylosing
Spondylitis scores for AS patients. Remarkable is the clinical improvement of
RA patients on physical, affective and symptoms scales of the DUTCH-AIMS. The
effect persisted during the post treatment phase on the physical and
affective scale. No relevant changes in disease activity scores were seen as
reflected by Ritchie score and ESR in RA patients and BASDAI and ESR in AS
patients indicating neither beneficial effects nor unwanted side effects of
IR sauna treatment. CONCLUSION: During the treatment period clinical
improvement is seen regarding pain, stiffness and fatigue in RA and regarding
stiffness in AS. The function as measured by functional scales of the AIMS2
improved in RA patients. IR sauna does not influence disease activity in RA
and AS patients.
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