Table 1.
Characteristics of the included randomized controlled trials.
| Study | Design | Characteristics of subjects | Mineral composition | Intervention group | Comparison group | Intervention and treatment duration | QoL Scales | Location of OA | Outcome measurements | Follow-up |
| Fraioli et al (2011) | RCT 3 parallel groups | Italy age: > 50 yr M/F:unclear | HCO3-, SO42–, Mg2+ | Group I, Mud-bath therapy + mineral water immersion, N = 17 | Group II, Standard treatment, N = 44 | 47°C,15 min; 3 full cycles | ND | Knee | VAS, LI | 1 yr |
| Branco et al (2016) | RCT 3 parallel groups | Brazil Age: 64.8 ± 8.9 yr M/F:25/115 | The sulfurous water: H2S, SO42–,HCO3, F−, Na+; non-sulfurous water: CI−, Fe3+, Mn2+,F− | Group I, mineral water immersion, N = 47 | Group II, non-sulfurous water immersion, N = 50; Group III, standard treatment, N = 43 | 37°C–39°C, 20 min; 3 times a wk for 10 wks | HAQ | Knee | VAS, LI | 2 mo |
| Hanzel et al (2018) | RCT 2 parallel groups | Hungary Age: 66.7 ± 4.79 yr M/F: 17/33 | Na+, Ca2+, Mg2+, NH4+, K+, et al | Group I, mineral water immersion, N = 26 | Group II, tap water immersion, N = 24 | 34°C, 30 min; 3–5 d of treatment per wk, a total of 15 treatments | SF-36 | Hip or knee | VAS, WOMAC ROM | 3 mo |
| Kulisch et al (2014) | RCT 2 parallel groups | Hungary Age: 45–75 yr M/F:17/60 | Na+, Cl−, K+, I−, Mg2+, F−, Ca2+, HCO3-, Fe3+, et al | Group I, mineral water immersion, N = 38 | Group II, tap water immersion, N = 39 | 34°C, 30 min; 5 d of treatment per wk, a total of 15 treatments | EQ-5D | Knee | VAS, WOMAC | 15 wk |
| Hanzel et al (2019) | RCT 3 parallel groups | Hungary Age: 67.3 ± 4.48 yr M/F: 24/50 | Na+, Ca2+, Mg2+, NH4+, K+, Fe2+, Li+, Cl−, Br− | Group I, mineral water immersion, N = 26 | Group II, tap water immersion, N = 24; group III, organic fraction, N = 24 | 34°C, 30 min; 5 times a wk for 3 wk | SF-36 | Hip or knee | VAS, WOMAC, ROM | 3 mo |
| Fioravanti et al (2010) | RCT 2 parallel groups | Italy age: 54–81 yr M/F: 20/60 | HS−, CO2, HCO3−, SO42−, Ca2+, Mg2+, et al | Group I, mud-bath therapy + mineral water immersion, N = 40 | Group II, standard treatment, N = 40 | 38°C, 15 min; 12 times in 2 wk | AIMS1 | Knee | VAS, LI | 9 mo |
| Varzaityte et al (2020) | RCT 3 parallel groups | Lithuania age: 64.6 ± 11.4 yr M/F:13/87 | Na+, Cl−, et al | Group I, mineral water immersion, N = 30; | Group II, Mud-bath therapy, N = 32; Group III, standard treatment, N = 30 | 36°C–42°C, 20 min; 10 procedures every other d | SF-36 | Knee | VAS, KOOS | 1 mo |
| Bálint et al (2007) | RCT 2 parallel groups | Hungary age: 50–75 yr M/F: 33/19 | Na+, K+, NH4+, Ca2+, Mg2+, et al | Group I, mineral water immersion, N = 27 | Group II, Short wave therapy, N = 25 | 34°C, 30 min; 5 d for 4 wk | ND | Knee | WOMAC | 3 mo |
| Kovács et al (2002) | RCT 2 parallel groups | Hungary M/F: 41/17 | NaHCO3, H2SiO3,et al | Group I, mineral water immersion, N = 31 | Group II, tap water immersion, N = 27 | 36°C, 30 min; 15 d | ND | Knee | VAS, Symptom scores | 3 mo |
| Cantarini et al (2007) | RCT 3 parallel groups | Italy age: 48–86 yr M/F: 47/27 | H2AsO3, Fe2+, et al | Group I, mud-bath therapy + mineral water immersion, N = 30 | Group II, tap water immersion, N = 24; group III, standard Treatment, N = 20 | Mud-bath therapy: 45°C, 20 min; mineral water immersion: 38°C, 15 min; 15 times in 3 wk | AIMS1 | Knee | VAS | 3 mo |
| Kovács et al (2012) | RCT 2 parallel groups | Hungary Age: 47–73 yr M/F: 3/42 | Na+, K+, NH4+, Ca2+, Mg2+, Fe3+, Mn2+, et al | Group I, mineral water immersion, N = 24 | Group II, Standard treatment, N = 21 | 37°C, 20 min; 15 times in 3 wk | HAQ, EQ-5D | Hand | VAS | 6 mo |
| Fioravanti et al (2014) | RCT 2 parallel groups | Italy Age: 50–75 yr M/F: 8/52 | Ca2+, Mg2+, Na+, K+, NH4+, F−, HCO3−, et al | Group I, mud-bath therapy + mineral water immersion, N = 30 | Group II, standard treatment, N = 30 | Mud-bath therapy: 43°C, 20 min; mineral water immersion: 38°C, 15 min; 2 wk | HAQ, SF-36 | Hand | VAS, FIHOA | 6 mo |
| Horváth et al (2012) | RCT 2 parallel groups | Hungary Age: 50–70 yr M/F: 12/51 | K+, Na+, Ca2+, NH4+, Mg2+, Fe3+, et al | Group I, II mineral water immersion N = 42 | Group II, standard treatment, N = 21 | 36°C and 38°C, 20 min; 15 times in 3 wk | HAQ, SF-36 | Hand | VAS | 13 wk |
| Kovács et al (2016) | RCT 3 parallel groups | Hungary Age: 40–75 yr M/F: unclear | Na+, K+, NH4+, Ca2+, Mg2+, Fe3+, et al | Group I, mineral water immersion, N = 21 | Group III, standard treatment, N = 20 | 36°C, 20 min; 15 times in 3 wk | EQ-5D | Hip | VAS, WOMAC, MCII | 12 wk |
| Forestier et al (2009) | RCT 2 parallel groups | France Age: 63.0 ± 9.1 (group I); 64.3 ± 10.4 (group II) M/F: 237/145 | ND | Group I, mud-bath therapy + mineral water immersion + massage, N = 195 | Group II, standard Treatment, N = 187 | Mud-bath therapy: 45°C, 15 min; massage: 38°C, 10 min; mineral water immersion: 37°C, 15 min; 3 wk | SF-36 | Knee | VAS, WOMAC, MCII | 9 mo |
| Evcik et al (2007) | RCT 3 parallel groups | Turkey Age: 39–78 M/F: 6/74 | Na+, HCO3−, SO42−, Ca2+, Mg2+, et al | Group I, mineral water immersion, N = 25 | Group II, Mud-bath therapy, N = 29; group III, hot-pack therapy, N = 26 | Mineral water immersion: 36°C, 20 min; 10 times in 5 wk | NHP | Knee | VAS, WOMAC, | 3 mo |
AIMS1 = arthritis impact measurement scale, EQ-5D = European quality of life 5-dimension scale, FIHOA = functional index for hand osteoarthritis score, HAQ = health assessment questionnaire, KOOS = knee injury and osteoarthritis outcome score, LI = Lequesne index, M/F = male/female., MCII = minimal clinically important improvement, ND = no data, NHP = Nottingham health profile, RCT = randomized controlled clinical trials, ROM = range of movement, SF-36 = short form 36-item health survey, VAS = visual analogue scale, WOMAC = Western Ontario and McMaster Universities Osteoarthritis Index.