Supplementary Table S2 The outcomes of the study population based on spa resort

Outcome / Whole Sample / Gönen, Balıkesir / Karahayıt, Denizli / Bursa / Afyon / Balçova, Izmir / Tuzla, Istanbul
Pain VAS
n
Before
After
Change
P value / 499
65.00 (50.00-80.00)
38.00 (20.00-51.00)
-26.00 (-45.00- -8.00)
0.001a* / 311
67.00 (50.00-82.00)
39.00 (21.00-51.00)
-27.00 (-44.00- -9.00)
<0.001 a* / 121
63.85±18.86
37.83±24.26
-26.03(-31.4 to -20.6)
<0.001* / 9
68.00 (56.00-81.00)
48.00 (30.50-52.00)
-19.00(-32.50- -13.0)
0.008 a* / 19
66.79±12.59
41.53±19.02
-25.26(-35.7 to -14.8)
<0.001* / 10
62.20±13.63
32.20±17.15
-30.00(-41.8 to -18.1)
<0.001* / 3
65.00 (47.00-N/A)
40.00 (13.00-N/A)
-9.00 (-68.00-N/A)
N/A
PtGE VAS
n
Before
After
Change
P value / 497
60.00 (47.00-77.00)
36.00 (19.50-50.00)
-23.00 (-43.00- -5.50)
<0.001 a* / 309
61.88±20.09
35.62±21.52
-27.00(-29.9 to -24.1)
<0.001* / 121
60.15±17.24
38.33±20.86
-21.82(-26.8 to -16.8)
<0.001* / 9
79.00 (48.50-91.50)
48.00 (34.00-61.50)
-22.00 (-45.00-4.00)
0.139 a / 19
67.32±17.61
40.32±19.24
-27.00(-39.1 to -14.9)
<0.001* / 10
62.20±21.09
34.00±14.54
-28.20(-40.6 to -15.8)
0.001* / 3
56.00 (37.00-N/A)
41.00 (13.00-N/A)
-3.00 (-80.00-N/A)
N/A
PhGE VAS
n
Before
After
Change
P value / 488
60.00 (48.00-72.00)
31.00 (15.00-45.00)
-28.00(-44.00- -12.0)
<0.001 a* / 302
61.00 (48.75-73.00)
29.00 (13.00-45.00)
-31.00 (-45.0- -14.0)
<0.001 a* / 120
56.89±15.33
34.30±19.25
-22.59(-26.9 to -18.3)
<0.001* / 9
70.00 (64.50-80.50)
33.00 (17.00-52.50)
-34.00 (-58.50- -4.50)
0.017 a* / 19
63.68±12.91
34.79±14.34
-28.89(-40.1 to -17.7)
<0.001* / 10
62.50±19.05
31.60±13.76
-30.90(-43.6 to -18.2)
<0.001* / 3
57.00 (45.00-N/A)
41.00(9.00-N/A)
-6.00 (-64.00-N/A)
N/A
HAQ
n
Before
After
Change
P value / 487
0.80 (0.50-1.20)
0.55 (0.25-0.90)
-0.15(-0.45-0.05)
<0.001 a* / 302
0.85 (0.50-1.30)
0.60 (0.30-0.95)
-0.15 (-0.45-0.00)
<0.001 a* / 123
0.79±0.45
0.58±0.42
-0.21(-0.29 to -0.14)
<0.001* / 9
0.20 (0.08-1.28)
0.35 (0.17-0.60)
0.00 (-0.65-0.15)
0.674 a / 20
0.86±0.44
0.65±0.40
-0.21 (-0.39 to –0.27)
0.027* / 10
1.17±0.45
0.65±0.36
-0.52 (-0.80 to -0.24)
0.002* / 2
0.73 (0.70-N/A)
0.53 (0.40-N/A)
-0.20 (-0.35-N/A)
N/A
WOMAC pain
n
Before
After
Change
P value / 388
10.00 (7.00-12.00)
7.00 (4.00-11.00)
-2.00 (-5.00-1.00)
<0.001 a* / 251
9.80±4.19
7.61±4.34
-2.19 (-2.73 to -1.66)
<0.001* / 92
9.46±3.88
7.28±4.10
-2.17 (-3.13 to -1.22)
<0.001* / 4
8.00 (5.25-10.00)
10.50 (8.25-16.50)
2.50 (-0.25-9.75)
0.144 a / 13
11.77±4.90
8.23±4.21
-3.54 (-6.30 to -0.77)
0.016* / 7
12.00 (7.00-14.00)
7.00 (5.00-17.00)
0.00 (-9.00-6.00)
0.753 a / 3
7.00 (6.00-N/A)
7.00 (6.00-N/A)
0.00 (-1.00-N/A)
N/A
WOMAC stiff.
n
Before
After
Change
P value / 387
4.00 (3.00-5.00)
3.00 (2.00-4.00)
-1.00 (-2.00-0.00)
<0.001 a* / 250
4.00 (3.00-5.00)
3.00 (2.00-4.00)
-1.00 (-2.00-0.00)
<0.001 a* / 92
30.52±12.17
24.77±13.63
-0.92 (-1.31 to -0.54)
<0.001* / 4
3.00 (0.50-4.75)
4.50 (1.75-5.00)
0.50 (0.00-2.50)
0.180 a / 13
4.54±2.26
3.62±1.56
-0.92 (-2.12 to 0.27)
0.118 / 7
5.00 (4.00-6.00)
4.00 (2.00-6.00)
-1.00 (-4.00-1.00)
0.348 a / 3
3.00 (2.00-N/A)
3.00 (2.00-N/A)
0.00 (0.00-0.00)
N/A
WOMAC func.
n
Before
After
Change
P value / 378
32.00 (22.00-41.00)
25.50 (13.00-37.00)
-6.00 (-15.25-2.00)
<0.001 a* / 245
32.29±14.02
25.40±14.34
-6.89 (-8.57 to -5.21)
<0.001* / 91
30.52±12.17
24.77±13.63
-5.75 (-8.71 to -2.78)
<0.001* / 4
32.50 (19.00-43.75)
30.50 (14.00-39.50)
-6.00 (-8.75-3.50)
0.273 a / 12
35.92±13.24
25.92±12.98
-10.00 (-16.8 to -3.2)
0.008* / 7
43.00 (37.00-57.00)
32.00 (16.00-51.00)
-16.00 (-25.00-14.00)
0.176 a / 2
33.00 (31.00-N/A)
30.00 (24.00-30.00)
-3.00 (-7.00- -3.00)
N/A
WOMAC total
n
Before
After
Change
P value / 375
45.03±18.98
35.82±19.21
-9.21(-11.08 to -7.33)
<0.001* / 241
46.05±19.12
36.29±19.44
-9.76(-12.00 to -7.52)
<0.001* / 92
43.61±16.83
34.78±18.28
-8.83(-12.76 to -4.89)
<0.001* / 3
41.00 (21.00-N/A)
53.00 (18.00-N/A)
-3.00 (-7.00-N/A)
N/A / 12
52.17±19.54
37.42±17.34
-14.75(-25.0 to -4.5)
0.009* / 7
60.00 (50.00-79.00)
40.00 (22.00-72.00)
-20.00 (-39.00-22.00)
0.310 a / 2
43.50 (39.00-N/A)
40.00 (32.00-N/A)
-3.50 (-7.00-N/A)
N/A
LFI for knee
n
Before
After
Change
P value / 280
11.24±4.36
9.23±4.76
-2.01(-2.51 to -1.52)
<0.001* / 183
11.32±4.47
8.98±4.93
-2.33 (-2.95 to -1.73)
<0.001* / 61
11.16±4.09
9.26±3.84
-1.90 (-2.87 to -0.88)
<0.001* / 9
13.50 (5.75-15.25)
10.00 (4.25-14.50)
-3.00 (-4.75-0.50)
0.069 a* / 4
12.50 (12.13-16.63)
14.00 (7.38-16.88)
-1.00 (-6.00-4.00)
0.715 a / 4
10.50 (8.88-13.63)
9.50 (7.88-12.25)
-1.50 (-3.88-2.00)
0.465 a
LFI for hip
n
Before
After
Change
P value / 58
11.43±4.81
9.46±4.59
-1.97 (-3.56 to -0.39)
0.016* / 40
12.31±4.72
9.30±4.64
-3.01 (-4.92 to -1.11)
0.003* / 14
9.29±5.00
9.32±4.45
0.36 (-3.23 to 3.30)
0.982 / 1
6.50 (6.50-6.50)
16.00 (16.00-16.00)
9.50 (9.50-9.50)
N/A / 1
12.00 (12.00-12.00)
11.00 (11.00-11.00)
-1.00 (-1.00- -1.00)
N/A
WI
n
Before
After
Change
P value / 284
7.00 (5.00-8.00)
6.00 (4.00-8.00)
-1.00 (-2.00-1.00)
<0.001 a* / 181
7.00 (5.00-8.00)
6.00 (4.00-8.00)
-1.00 (-2.00-1.00)
<0.001 a* / 71
7.00 (5.00-8.00)
6.00 (3.00-8.00)
-1.00 (-4.00-1.00)
<0.001 a* / 11
7.36±1.80
6.45±1.81
-0.91 (-1.97 to 0.15)
0.085* / 4
7.00 (6.00-8.00)
7.50 (7.00-8.00)
0.50 (-0.75-1.75)
0.414 a / 3
5.00 (3.00-N/A)
6.00 (3.00-N/A)
1.00 (0.00-N/A)
N/A
NPDS
n
Before
After
Change
P value / 176
56.50 (41.00-68.00)
42.00 (24.00-58.75)
-11.00 (-23.75- -1.25)
<0.001 a* / 116
53.85±20.44
42.13±20.99
-11.72 (-15.0 to -8.5)
<0.001* / 45
50.64±19.07
34.16±17.72
-16.49(-22.2 to -10.8)
<0.001* / 9
56.00 (54.50-75.50)
62.00 (43.50-68.50)
-5.00 (-10.5-8.00)
0.594 a / 2
67.00 (58.00-N/A)
59.50 (57.00-N/A)
-7.50 (-14.00-N/A)
N/A / 1
64.00 (64.00-64.00)
44.00 (44.00-44.00)
-20.00(-20.0- -20.0)
N/A
SDQ
n
Before
After
Change
P value / 73
68.75 (43.75-87.50)
43.75 (25.00-75.00)
-12.50 (-31.25-3.13)
<0.001 a* / 48
66.93±27.41
51.04±30.63
-15.89 (-23.3 to -8.5)
<0.001* / 18
53.13±22.61
47.22±28.46
-5.90 (-18.17 to 6.37)
0.324 / 1
0.00 (0.00-0.00)
0.00 (0.00-0.00)
0.00 (0.00-0.00)
N/A / 2
78.13 (75.00-N/A)
37.50 (31.25-N/A)
-40.63 (-43.75-N/A)
N/A
FIQ
n
Before
After
Change
P value / 85
64.66±15.76
48.78±21.33
-15.89(-20.2 to -11.6)
<0.001* / 55
65.57±51.62
51.62±21.35
-13.95 (-18.9 to -9.0)
<0.001* / 19
62.91±13.14
39.39±21.32
-23.52(-36.0 to -11.0)
0.001* / 3
58.10 (44.06-N/A)
44.53 (37.89-N/A)
-6.17 (-13.68-N/A)
N/A / 5
74.00 (61.47-87.59)
58.48 (46.62-70.00)
-14.00 (-33.38- -0.19)
0.138 a / 1
63.28 (63.28-63.28)
35.03 (35.03-35.03)
-28.25(-28.25--28.25)
N/A / 1
37.00 (37.00-37.00)
34.00 (34.00-34.00)
-3.00 (-3.00- -3.00)
N/A
BDI
n
Before
After
Change
P value / 77
16.92±8.95
11.35±8.38
-5.57 (-7.58 to -3.57)
<0.001* / 48
16.44±9.46
11.71±8.99
-4.73 (-7.17 to -2.29)
<0.001* / 18
18.72±9.03
10.33±8.37
-8.39(-13.87 to -2.91)
0.005* / 3
12.00 (8.00-N/A)
13.00 (12.00-N/A)
1.00 (0.00-N/A)
N/A / 4
18.00 (11.00-22.75)
11.50 (5.75-14.25)
-9.00 (-10.00- -1.25)
0.141 a

Supplementary Table S2 continued

Outcome / Bolu / Yoncalı, Kütahya / Other spa resorts
Pain VAS
n
Before
After
Change
P value / 7
48.00 (39.00-65.00)
34.00 (22.00-48.00)
-14.00 (-26.00-4.00)
0.270 a / 7
70.00 (48.00-76.00)
42.00 (20.00-57.00)
-26.00(-52.00- -9.00)
0.041 a / 12
52.50±24.67
28.33±18.39
-24.17 (-44.4 to -3.9)
0.024*
PtGE VAS
n
Before
After
Change
P value / 7
60.00 (49.00-67.00)
39.00 (13.00-50.00)
-17.00 (-25.00- -6.00)
0.043 a / 7
48.00 (40.00-69.00)
27.00 (10.00-49.00)
-13.00 (-49.00-0.00)
0.058 a / 12
49.42±19.63
29.08±17.57
-20.33(-35.6 to -5.1)
0.014*
PhGE VAS
n
Before
After
Change
P value / 6
54.50 (38.25-66.00)
28.50 (13.00-43.50)
-24.50(-30.0- -20.0)
0.028 a / 7
64.00 (54.00-72.00)
24.00 (9.00-47.00)
-28.00 (-52.0- -25.0)
0.018 a / 12
46.00±14.94
26.17±19.69
-19.83 (-34.4 to -5.3)
0.012*
HAQ
n
Before
After
Change
P value / 4
0.43 (0.10-0.64)
0.45 (0.15-0.98)
0.03 (-0.26-0.65)
0.593 a / 8
0.78 (0.43-1.23)
0.35(0.13-0.85)
-0.23 (-0.68-0.06)
0.092 a / 9
0.45 (0.25-0.58)
0.40 (0.05-0.50)
-0.05 (-0.18-0.08)
0.362 a
WOMAC pain
n
Before
After
Change
P value / 5
9.00 (0.00-14.50)
6.00 (3.50-9.50)
-4.00 (-7.50-6.50)
0.588 a / 5
7.00 (5.50-8.50)
6.00 (4.00-10.00)
0.00 (-2.50-2.00)
0.854 a / 8
4.50 (3.00-8.00)
4.50 (0.75-7.75)
-1.50 (-4.75-5.00)
0.932 a
WOMAC stiff.
n
Before
After
Change
P value / 6
4.50 (0.00-6.25)
2.50 (1.50-3.50)
-1.00 (-3.50-0.75)
0.276 a / 5
3.00 (2.50-4.00)
3.00 (2.00-3.50)
0.00 (-1.50-0.50)
0.414 a / 7
2.00 (1.00-4.00)
2.00 (1.00-3.00)
-1.00 (-1.00-1.00)
0.726 a
WOMAC func.
n
Before
After
Change
P value / 5
36.00 (2.50-41.00)
21.00 (10.00-38.50)
-1.00 (-22.50-20.50)
0.893 a / 5
30.00 (11.00-31.50)
23.00 (12.50-30.50)
-1.00 (-13.50-11.00)
0.786 a / 7
13.00 (8.00-19.00)
13.00 (8.00-37.00)
-6.00 (-8.00-24.00)
0.612 a
WOMAC total
n
Before
After
Change
P value / 5
50.00 (2.50-61.00)
29.00 (14.50-51.00)
-6.00 (-34.00-28.50)
0.893 a / 6
36.00 (12.00-43.00)
27.50 (14.75-41.50)
-3.00 (-13.25-9.75)
0.674 a / 7
23.00 (10.00-31.00)
22.00 (10.00-48.00)
-9.00 (-12.00-31.00)
0.611 a
LFI for knee
n
Before
After
Change
P value / 7
11.00 (3.00-12.00)
12.00 (10.50-14.00)
3.00 (-1.00-8.00)
0.175 a / 4
10.75 (8.25-14.00)
6.00 (2.50-11.00)
-6.25 (-7.00- -0.25)
0.141 a / 4
7.25 (4.63-10.25)
11.25 (4.75-17.00)
3.75 (-1.13-8.25)
0.273 a
LFI for hip
n
Before
After
Change
P value / 2
11.00 (10.00-N/A)
9.50 (4.00-N/A)
-1.50 (-6.00-N/A)
N/A
WI
n
Before
After
Change
P value / 4
6.50 (5.25-7.75)
7.00 (3.25-8.50)
0.50 (-3.00-1.75)
1.000 a / 3
9.00 (9.00-9.00)
8.00 (7.00-N/A)
-1.00 (-2.00-N/A)
N/A / 4
6.00 (3.00-8.25)
5.00 (2.50-6.75)
0.50 (-5.25-1.75)
1.000 a
NPDS
n
Before
After
Change
P value / 1
59.00 (59.00-59.00)
15.00 (15.00-15.00)
-44.00 (-44.0- -44.0)
N/A / 1
56.00 (56.00-56.00)
63.00 (63.00-63.00)
7.00 (7.00-7.00)
N/A
SDQ
n
Before
After
Change
P value / 1
37.50 (37.50-37.50)
12.50 (12.50-12.50)
-25.00 (-25.0- -25.0)
N/A
FIQ
n
Before
After
Change
P value / 1
46.00 (46.00-46.00)
33.00 (33.00-33.00)
-13.00 (-13.00- -13.0)
N/A
BDI
n
Before
After
Change
P value

VAS Visual Analog Scale, PtGE Patient’s general evaluation, PhGE Physician’s general evaluation, HAQ Health Assessment Questionnaire, WOMAC Western Ontario and Mcmaster Universities Index, Stiff Stiffness, Func Function, LFI Lequesne Functional Index, WI Waddell Index, NPDS Neck Pain and Disability Scale, SDQ Shoulder Disability Questionnaire, FIQ Fibromyalgia Impact Questionnaire, BDI Beck Depression Inventory, N/A not applicable.

Normal Font: Before-after variables are expressed as mean±standard deviation, difference variables as mean (95% confidence interval). Paired-t-test was used.

Italic Font: Before-after and difference variables are expressed as median (25th-75th percentile). a Wilcoxon signed-rank test was used.

*Statistically significant with Benjamini-Hochberg correction.