Crenobalneotherapy in fibromyalgia, a systematic review

The purpose of the study is to find and summarize the best evidence for crenobalneotherapy in fibromyalgia syndrome. Method Bibliographic analysis. Performed by 3 reviewers (FBF, AD, ND), on multiple databases with keywords: “Fibromyalgia” AND “spa” OR “balneotherapy” OR “hydrotherapy” OR “mud” OR “peloid” OR “bath” OR “pool” OR “thalassotherapy” OR “mineral water” OR “hot bath” OR “aquatic” OR “thermal water”. Inclusion criteria were: comparative studies evaluating interventions of 1 to 6 weeks, diagnostic of fibromyalgia with 1990 ACR classification criteria, trials performed after 1990, No restriction in length of follow up, studies in English, French, and Turkish. Methodological analysis. Internal validity is estimated by CLEAR NTP (10 items): evaluating selection bias, performance bias, detection bias & attrition bias. External validity & Statistical validity is estimated by personal checklists. We also performed an empirical analysis of publication bias by the graphical test proposed by Sutton (Sutton BMJ 2012).