• Title/Summary/Keyword: 무릎골관절염

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Regulatory mechanism of Angelica Gigas extract powder on matrix metalloproteinases in vitro and in vivo model (참당귀 추출분말이 in vitro and in vivo model에서 MMPs 조절 기전)

  • Kwon, Jin-Hwan;Han, Min-Seok;Lee, Yong-Moon
    • Analytical Science and Technology
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    • v.28 no.6
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    • pp.361-369
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    • 2015
  • The precise mechanism underlying the therapeutic efficacy of an extraction powder of Angelica gigas (AGE) for the treatment of degenerative osteoarthritis was investigated in primary cultured rabbit chondrocytes and in a monosodium-iodoacetate (MIA)-induced osteoarthritis rat model. The treatment with AGE (50 μg/mL) effectively inhibited NF-B activation. The anti-inflammatory mechanism was clarified by gelatin zymography and western blotting measurements of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) activities. The AGE (50 μg/mL) treatment significantly reduced MMP-9 activity. The constituents of AGE— decursinol, decursin, and decursinol angelate—were determined by LC-MS/MS after a 24 hr treatment of rabbit chondrocytes. The contents of the major products, decursin and decursinol angelate, were 3.62±0.47 and 2.14 ±0.36 μg/mg protein, respectively in AGE-treated (50 μg/mL) rabbit chondrocytes. An in vivo animal study on rats fed a diet containing 25, 50, and 100 mg/kg AGE for 3 weeks revealed a significant inhibition of the MMPs in the MIA-induced rat articular cartilage. The genetic expression of arthritic factors in the articular cartilage was examined by RT-PCR of collagen Type I, collagen Type II, aggrecan, and MMP (MMP3, MMP-9, MMP13). Specifically, AGE up-regulated the expression of collagen Type I, collagen Type II, and aggrecan and inhibited MMP levels at all tested concentrations. Collectively, AGE showed a strong specific site of action on MMP regulation and protected against the degeneration of articular cartilage via cellular regulation of MMP expression both in vitro and in vivo.

Aquatic exercise for the treatment of knee osteoarthritis: a systematic review & meta analysis (무릎 골관절염 환자를 대상으로 한 수중 운동과 지상운동 비교: 체계적 문헌고찰 및 메타분석)

  • Kim, Young-il;Choi, Hyo-Shin;Han, Jung-haw;Kim, Juyoung;Kim, Gaeun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.9
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    • pp.6099-6111
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    • 2015
  • This study was a systematic review and meta-analysis comparing the effects of aquatic exercise and land-based exercise in the treatment of knee osteoarthritis. 7 studies (n=449) met selection and exclusion criteria out of 287 potential studies obtained from the literature search via Ovid-Medline, Cochrane Library CENTRAL, CINAHL, RISS and KISS. The overall risk of bias of selected studies using SIGN (Scottish Intercollegiate Guidelines Network) checklist for randomized controlled trials (RCT) was regarded as low. As a result of meta analysis, Standardized Mean Difference (SMD) for pain was -0.26(95% CI -0.49, -0.03, p=0.03, $I^2=14%$), which implies that aquatic exercise groups had significant less pain than land-based exercise groups. On the other hand, there was no significant difference between aquatic exercise groups and land based exercise groups for flexion Range of Motion (ROM) (-0.12, 95% CI -0.51, 0.27, p=0.53, $I^2=0%$), extension ROM (-0.04, 95% CI -0.55, 0.48, p=0.89, $I^2=43%$), physical function (-0.12, 95% CI -0.44, 0.19, p=0.44, $I^2=0%$), Quality of Life (QOL) (-0.15, 95% CI -0.54, 0.24, p=0.46, $I^2=0%$). This study has some limitations due to few RCTs comparing aquatic exercise groups and land-based exercise groups in the treatment of knee osteoarthritis. Therefore, further RCTs should be conducted along with long-term outcomes.

Biomechanical Effect on Knee Adduction Moment by Lateral Wedge Insole in Transfemoral Amputee (외측웨지인솔이 대퇴절단자의 무릎내전모멘트에 미치는 영향)

  • Chang, Yun-Hee;Lee, Wan-Hee
    • Journal of the Korean Society for Precision Engineering
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    • v.29 no.2
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    • pp.239-244
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    • 2012
  • The prevalence of knee osteoarthritis was higher people with lower limb amputation. This was identified that transfemoral amputees have a greater external knee adduction moment than ablebodied subjects by biomechanical studies. Therefore, they need rehabilitative intervention for prevention and reduction of knee osteoarthritis. The purpose of this study was to determine the effect of lateral wedge insole used in the treatment of knee osteoarthritis. This study was participated in fourteen unilateral transfemoral amputees and we were analyzed the difference gait variables between without lateral wedge insole and with $5^{\circ}$ and $10^{\circ}$ lateral wedge insole during gait. Our results showed that step length ratio was more symmetrical and, hip adduction and ankle inversion angle were more close to normal value, and knee adduction moment was decreased as the wedge angle increases. We proposed that these data would be utilized conservative treatment of knee osteoarthritis in lower limb amputees.

The Comparison of Knee Joint Displaying between The Anteroposterior Weight Bearing View and the Metatarsophalangeal View with Osteoarthritis Patients (골관절염 환자의 촬영방법에 대한 고찰 : AP-WB(Weight-bearing AP), MTP(semiflexed) 촬영법의 비교 고찰을 중심으로)

  • Jeon, Ju-Seob;Park, Hwan-Sang;Moon, Il-Bong;Moon, Ju-Wan;Choi, Nam-Kil;Kim, Chang-Bok;Eun, Sung-Jong
    • Journal of radiological science and technology
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    • v.28 no.2
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    • pp.97-103
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    • 2005
  • Objective : The aim of this study was to compare the knee joint displaying between the anteroposterior weight bearing(AP-WB) View and the metatarsophalangeal(MTP) view for assessing joint space narrowing(JSN) and osteophytes in osteoarthritis patients. Subjects and Materials : Two hundreds of twenty patients(38 men) who came rheumatoid caused by knee pain, had both AP-WB and MTP views taken on a day. Radiographs were evaluated independently by 13 experienced observers(3 orthopedics surgeon, 2 rheumatogist, 3 radiologist, 5 radiological technologist) They assessed JSN and osteophytes using by PACS monitor JSN was scored by the optic evaluation to the nearest at the narrowest point in medial compartments of the tibiofemoral joint in both knees. Osteophytes were graded 0 to 3(bad 0, not bad 1, good 2 and very good 3) according to a standard atlas. All exam was using by Philips(Buckey Diagnostic-TH) X-ray material. Exposure condition was 60 kv, 8 mAs and 100 cm focus to film distance. Results : JSN was scored $1.32{\pm}0.050$ in AP-WB view, $2.51{\pm}0.046$ in MTP view. MTP view of JSN score is higher to AP-WB view significantly(p<0.05). Osteophytes scored $2.14{\pm}0.054$ in AP-WB view, $2.10{\pm}0.054$ in MTP view. There was no difference(p<0.05) between MTP view and AP-WB view in osteophytes. But MTP view was more reproducible than AP-WB view Conclusions : Joint space narrowing is most important factor to diagnosis with knee joint Osteoarthritis patients. This study was summarized as follows; In comparision of JSN, MTP view was more widely displayed than AP-WB view. In comparision of Osteophytes, there was no difference between MTP view and AP-WB view. It was concluded MTP view was more useful method to diagnosis of knee joint Osteoarthritis patients.

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Reproduction of Walking Asymmetry in Knee Osteoarthritis with Split-Belt Conditions (분할 벨트 조건을 이용한 무릎 관절 이상군의 보행 비대칭성 모사)

  • Lee, Myunghyun;Park, Heewon;Park, Sukyung
    • Journal of the Korean Society for Precision Engineering
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    • v.32 no.10
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    • pp.885-890
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    • 2015
  • Walking on split-belt treadmill has been applied to study walking disabilities, such as osteoarthritis (OA), to show asymmetric walking characteristics. In this study, we compared asymmetric walking in OA patients with healthy subjects under split-belt conditions and examined the reproduction of walking asymmetry in OA. Seven OA patients were instructed to walk at four frequencies, while four healthy subjects walked on a treadmill with tied-belt and split-belt conditions. To compare walking asymmetries, kinetic and kinematic measurements were made using force-plates and motion capture cameras, and subsequently center of mass (CoM) velocity, mechanical work and potential energy were calculated. Horizontal velocity change during split-belt walking of healthy subjects was similar to OA patients. Difference of mechanical work during single support phase occurred due to fall of CoM in fast belt. OA walking asymmetry could be reproduced by reducing differences of belt speeds to prevent rapid fall of CoM.

Kinetic Gait Analysis of a Dog with Knee Osteoarthiritis Treated with Acupuncture (무릎관절 골관절염이 있는 개에서 침술 적용 효과에 대한 역학적 보행분석 1례)

  • 김순영;정성목;서강문;남치주
    • Journal of Veterinary Clinics
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    • v.20 no.4
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    • pp.504-507
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    • 2003
  • Force plate analysis was used to describe the effect of acupuncture on right knee osteoarthritis (OA) in a seven-year-old hound breed dog weighing 27 kg. The acupuncture treatment was performed twice a week for 3 weeks. Ground reaction forces (GRFs) and subjective clinical scores in both hind limbs were obtained prior to and 72 hours after each treatment. Right vertical peak force was increased as the dog was acupunctured. Although their sensitivity was lower than that of the GRF data, the subjective clinical scores reflected an improvement. In addition, vertical peak force of normal left hind limb was also increased during this trial. These results indicate that gait analysis may be valuable objective method in future evaluation of acupuncture for OA of the stifle joint.

침치료에 대한 환자진료 평가 프로그램-독일 보험회사들의 침효과에 대한 검증-

  • Melchart, Dieter
    • Journal of Pharmacopuncture
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    • v.6 no.1
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    • pp.33-34
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    • 2003
  • 배경: 독일 의사와 보험회사 위원회 (The German Board of Physicians and Insurance Companies:Bundesausschuss der Arzte und Krankenkassen)가 앞으로 일부 적응증에 대한 침치료에 대해 공적 보험회사가 보험료를 지급해야 할 지에 대한 추가 결정을 하기 위해 침의 효과를 평가하기로 했다. 목적: 1) 침치료가 편두통의 예방, 긴장성 두통, 요통, 무릎과 고관절의 골관절염치료에 대조군 침치료보다 효과가 있는지 검증 2) 침치료가 편두통의 예방적 치료에 표준 약물 치료와 비슷하게 효과가 있는지 검증 3) 보건의료 서비스체계 안에서 주어진 조건에 대한 일상적 침치료의 질적인 부분을 서술하고, 안전성을 평가하며, 다른 침술학파간의 임상결과의 차이와 비용의 효용적 활용부분을 평가한다. 4) 위의 적응증에 해당하는 모든 임상실험연구를 찾아내어 기존의 고찰내용을 갱신한다. 방법: 1) 무작위 표본추출 임상 실험, 침치료, 거짓침 치료, 대기자 명단 대조군, 출발시점 4주, 28주 관찰 2) 무작위 표본추출 임상 실험, 침치료, 표준약물치료 대조군, 츨발시점 4주, 28주 관찰 3) 전향적 다중 의료기관 관찰 연구, 두 가지 다른 자료를 활용하여서, 치료 결과를 침 시술자에 의한 모든 환자 평가 자료와, 열 두 명의 환자 가운데 한 명의 환자로부터 직접 받은 평가 자료 (관찰 출발시점, 치료 출발 시점, 치료 시작 후 6 개월) 실험공간: 1) and 2) 높은 수준의 수련을 한 침 시술 의사가 시술하는 병원이나 일차 진료기관의 외래. 3) 보건 의료 서비스내 저급의 침 시술 의사 (140 시간 수강, 학점 이수 필수) 참가자: 1) $4{\times}320$ 편두통의 예방, 긴장성 두통, 요통, 무릎과 고관절의 골관절염 환자 2) 480 편두통 환자(긴장성 두통 환자 추가적) 3) 약 500,000 환자, 2년 반 동안: 대략 한 적응증 당 10,000 환자 치료법: 모든 침치료 자리는 체침만 허용함. 1) 진짜 침은 학파의 지침에 따른 심자, 거짓 침은 비특이적 자리의 표피만 찌르는 자침 (12-15회, 8주): 대기자 대조군은 12주 동안에 아무 치료도 받지 않는다. 2) Group 1(N=240): 최대 15회 치료, 12주 동안: Group II (N=240) 투약 Proponolol (80-240mg), Metoprolol (100-200mg) or Flunarizin (5-10mg) 하루, 16주 이상 3) 치료회수와 침자리의 선정은 참가자가 결정 주된 임상 결과 지표: 1) 군 간의 치료 전 및 치료 진행 도중 4주 마다의 두통을 느낀 날 수의 차이 (평균 혹은 이상의 편두통이나 긴장성 두통) 2) 요통환자 군간의 기능을 측정하는 FFbH-R (Funktionsfragebogen Hannover) 비교 3) 관절염 환자의 군간 WOMAC 지표 비교 4) 군 간의 24주 동안 두통을 느낀 날 수의 차이(평균 혹은 이상의 편두통이나 긴장성 두통) 5) 적응증, 부작용, 성공율에 대한 거시적 평가, 사용한 침수, 환자의 만족도, SES(?). ADS(?) 통증 장애 지표(PDI), 삶의 질 지표(SF36). 예비 결과 위의 결과가 큰 관찰 연구에 초점을 맞추면서 소개될 것임.

Development of Instrument for Korean Osteoarthritis Impact Measurement Scale (KAIMS) in Hip and Knee Osteoarthritis (한국형 골관절염영향측정척도(KAIMS) 도구개발 - 무릎 및 엉덩관절의 골관절염환자 중심 -)

  • Yi, Seung-Ju;Kim, Jin-Seop
    • The Journal of Korean Physical Therapy
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    • v.26 no.2
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    • pp.82-89
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    • 2014
  • Purpose: This study was conducted in order to develop an instrument for the Korean Osteoarthritis Impact Measurement scale (KAIMS) in hip and knee osteoarthritis patients. Methods: A sample of 426 subjects was recruited in Ulsan metropolitan city (six hospitals and clinics) and Andong city (five hospitals and clinics) from June 2010 to May 2011. Item internal consistency and item discriminant validity were analyzed on the item-level, and floor (%) and ceiling (%) effect were analyzed on the scale-level. Exploratory factor analysis was performed for construction of items in the KAIMS instrument; confirmative factor analysis was also performed to test the fit of the model. Results: In 426 respondents, age was 64.3 years. The reliability for r coefficient 0.90 (mobility) and 0.89 (pain and stiffness) (Cronbach's alpha 0.95, 0.95 respectively) was high in the test-retest, and there was no significant difference in paired t-test (p>0.05). Item internal consistency (${\alpha}=0.92$, ${\alpha}=0.87$ respectively) was also high. It was constructed of two factors (mobility, pain and stiffness dimension) and nine items in explanatory factor analysis; results of confirmatory factor analysis also indicated that the dimensional structure model was fitted well in the test of model fit (${\chi}^2=83.83$, df=26, p=0.000; RMR=0.05; GFI=0.96; AGFI=0.83). Conclusion: In conclusion, the results of this study showed that the KAIMS that was developed was a reliable and valid instrument for measurement of osteoarthritis (OA) patients. We recommend further research for additional development of the instrument on OA in Korea.

Effects of Aroma Massage on Pain, Activities of Daily Living and Fatigue in Patients with Knee Osteoarthritis (무릎 골관절염 환자에게 시행한 아로마 마사지가 통증, 일상활동 능력 및 피로에 미치는 효과)

  • Kim, In-Ja;Kim, Eun-Kyung
    • Journal of muscle and joint health
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    • v.16 no.2
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    • pp.145-153
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    • 2009
  • Purpose: The effects of aroma massage on pain, activities of daily living, and fatigue were investigated in the patients who have knee osteoarthritis. Method: A quasi-experimental design with non-equivalent control group pretest-posttest measures was used. Twenty one and twenty subjects were included in control and experimental group, respectively. Subjects in experimental group had aroma massage which used lavender, chamomile, and ginger oil on painful knee. They were encouraged to implement aroma massage at least two times a day for 2 weeks. Subjects in the control group had conventional oil massage implementing by exactly same method as did in the experimental group. GRS(graphic rating scale), Korean version of WOMAC (Western Ontario and McMaster) osteoarthritis index, and MAF(multidimensional assessment of fatigue) were used to measure the outcome variables such as pain, activities of daily living and fatigue, respectively. Results: After 2 weeks, those in the experimental group reported significantly less pain and fatigue and better activities of daily living than those in the control group. Conclusion: Based on these results, aroma massage could be recommended as a self managed intervention for the patients with knee osteoarthritis.