Cold Water Immersion Directly and Mediated by Alleviated Pain to Promote Quality of Life in Indonesian with Gout Arthritis: A Community-based Randomized Controlled Trial

Maria Dyah Kurniasari, Karen A. Monsen, Shuen Fu Weng, Chyn Yng Yang, Hsiu Ting Tsai

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Gout arthritis is an autoinflammatory arthritis that generates chronic long-term pain. Pain impacts physical activities, joint mobility, stress, anxiety, depression, and quality of life. Cold-water immersion therapy reduces inflammation and pain associated with gout arthritis. However, cold-water immersion therapy has not been conducted among people worldwide with gout arthritis. Objective: To investigate the cold-water immersion intervention on pain, joint mobility, physical activity, stress, anxiety, depression, and quality of life among acute gout patients. Methods: A community-based randomized control trial design with two parallel-intervention groups: a cold-water immersion group (20–30°C 20 minutes/day for 4 weeks) and a control group. In total, 76 eligible participants in Tomohon City, Indonesia, were recruited using a multi-stage sampling method and were randomly assigned using block randomization. A generalized estimating equation model was used to analyze the results (coef. β) and produce 95% confidence intervals (CIs). A path analysis was used to analyze mediating effects. Results: Significant pain alleviation (β = −2.06; −2.42), improved joint mobility (β = 1.20, 1.44), physical activity (β = 2.05,.59), stress (β = −1.25; −1.35), anxiety (β = −.62; −1.37), and quality of life (β = 5.34; 9.93) were detected after cold-water immersion at the second-week, and were maintained to the fourth-week time point, compared to pre-intervention and the control group. Depression (β = −1.80) had decreased by the fourth week compared to the pre-test and control group. Cold-water immersion directly mediated alleviation of pain (β = −.46, p ≤.001) and to promote the quality of life (β =.16, p =.01). Conclusions: Cold-water immersion decreased pain, stress, anxiety, and depression, and increased joint mobility, physical activity, and quality of life. It mediated alleviation of pain to increase the quality of life.

Original languageEnglish
JournalBiological Research for Nursing
DOIs
Publication statusAccepted/In press - 2022

Keywords

  • cold-water immersion
  • gout
  • pain
  • quality of life
  • randomized control trial

ASJC Scopus subject areas

  • Research and Theory

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