• Title/Summary/Keyword: Knee Pain

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A Randomized Clinical Trial of Local Acupoints Compared with Distal Acupoints in Degenerative Osteoarthritis on Knee (퇴행성 슬관절염에 대한 근위취혈과 원위취혈 침 치료의 효과 비교에 대한 임상연구)

  • Park, In-Shik;Jung, Chan-Young;Jang, Min-Ki;Kang, Mi-Suk;Lee, Seung-Woo;Kim, Eun-Jung;Lee, Seung-Deok;Kim, Kap-Sung
    • Journal of Acupuncture Research
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    • v.25 no.2
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    • pp.227-242
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    • 2008
  • Objectives : To compare the efficacy of local acupoint with distal acupuncture at relieving pain and improving function in knee osteoarthritis. Designs : A randomized, single-blinded, crossover clinical trial. Settings : One outpatient clinic(department of acupuncture & moxibustion) located in academic teaching hospital, South Korea. Patients : 17 patients with osteoarthritis of the knee(mean age 62.76[$SD{\pm}4.37$] years). Interventions : The trial had 4 stages : baseline(2weeks), phase I and II(each 2weeks), washout period(2weeks). Patients were randomly assigned to either group A or group B. Group A received acupuncture at local acupoints during phase I, then acupuncture at distal acupoints in phase II. Group B received the treatments in reverse order. In each phase, the patients were treated with acupuncture for 6 times. Measurements : The primary outcome was subjective pain as measured by a 100mm visual analogue scale(VAS) ranging from 0(no pain) to 10(worst pain ever). Secondary outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) total and pain scores. Measurements were obtained at baseline, 1st day of phase I and II, and 2 days after last treatment of phase I and II. Results : The 17 participants in 2 groups were well matched for age, sex, target knees, baseline VAS score, WOMAC pain score and WOMAC score. Participants in local acupoint group experienced greater improvement than distal acupoint group at 2 days after last treatment in WOMAC total score(mean difference, -10.65[95% CI, -20.56 to -0.74] ; P=0.036) but not in VAS(mean difference, -12.41[95% CI, -29.56 to 4.73] P=0.15) and WOMAC pain score(mean difference, -1.82[95% CI, -3.98 to 0.33] ; P=0.094). Conclusions : Local acupoints are more effective than distal acupoints at relieving pain and improving function in knee osteoarthritis.

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Effects of Koryo Hand Therapy(KHT) on Woman Elders' Knee Pain (고려수지요법이 여성노인의 무릎통증에 미치는 효과)

  • Koh, Hyo-Jung;Jung, Mi-Kyung;Kwon, Yun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.9
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    • pp.4022-4029
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    • 2011
  • The study was done to identify the effects of Koryo Hand Therapy(KHT) of woman elders' knee pain. This is an quasi-experiment with nonequivalent control group pre- & post-test design. The subjects consisted of 105 woman elders were admitted to in elders' hospital in D city. They are randomized 35 for the experimental group A by using ceramic Seo Am pellet therapy, 35 for the experimental group B by using Seo Am moxa therapy and 35 for the control group. The Koryo Hand Therapy(KHT) was conducted 3 times per week for 6 weeks. Data analyzed using ${\chi}^2$-test, One-way ANOVA and repeated measure ANOVA with SPSS Win 17.0 version. The results of this study was knee pain of the experimental group A provided with ceramic Seo Am pellet therapy(p=.000), the experimental group B provided with Seo Am moxa therapy(p=.000) would be lower than that the control group. Knee pain of the experimental group B provided with Seo Am moxa therapy would be lower than that the experimental group A provided with ceramic Seo Am pellet therapy(p=.001). Koryo Hand Therapy(KHT) was to be effective in relieving knee pain woman elders' and it is suggested that the therapy should be used for managing.

Differences of Onset Timing Between Vastus Medialis and Lateralis during Knee Isometric Contraction on Individuals with Genu Varum or Valgum (안굽이 및 밖굽이 무릎을 가진 젊은 성인들에게서 등척성 운동 시 안쪽넓은근과가쪽넓은근의 근수축 개시시간 차이)

  • Park, Seol;Lee, Woo-Jin;Park, Ji-Won
    • The Journal of Korean Physical Therapy
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    • v.26 no.1
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    • pp.9-14
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    • 2014
  • Purpose: The purpose of this study was to investigate how different knee alignments (genu varum and genu valgum) affected activations of quadriceps muscles with measurements of onset-time differences between vastus medialis and vastus lateralis during isometric contractions at both 30 and 60 degree knee flexion. Methods: Fifty-two adults (20 genu varum, 12 genu valgum, and 20 control) were enrolled in this study. Subjects with over 4cm distance between knee medial epicondyles were assigned to Genu varum, while subjects with over 4cm distance between ankles medial malleolus were considered as genu valgum group. Surface EMG was used to measure onset time of both vastus medialis and vastus lateralis during isometric contraction at 30 and 60 degree knee flexion. Results: The onset time of vastus lateralis was delayed in genu varum group, and that of vastus medialis was delayed in genu valgum group at both 30 and 60 degree knee flexions. Moreover, onset time difference at $30^{\circ}$ knee flexion between muscles was larger in genu valgum group than genu varum group. Conclusion: Subjects with genu varum or valgum activated quadriceps muscles with different orders pending on flexion degrees. Therefore, when quadriceps training program were planned to prevent pain or deformities, the findings that quadriceps were activated with different orders affected by knee alignments and joint degree at which trainings were performed, must be considered. If the selective training programs of quadriceps femoris are planned to prevent pain or deformities due to poor knee alignments, these should consider the subject's knee alignment condition.

The Effect of Cycle Ergometer Exercise Inducing Movement of the Affected Side on Knee Joint Function after Total Knee Arthroplasty (환측사용유도 고정식자전거운동이 무릎관절 기능에 미치는 영향: 무릎인공관절수술 환자를 대상으로)

  • Choi, Eun-Ji;Lee, Sang-Yeol
    • PNF and Movement
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    • v.20 no.1
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    • pp.91-101
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    • 2022
  • Purpose: The purpose of this study was to examine the effect of cycle ergometer exercise inducing movement of the affected side on knee joint function after total knee arthroplasty (TKA). Methods: The primary experiment was conducted on 19 members of the cycle ergometer exercise group to measure the muscle activity of the rectus femoris, hamstring, tibialis anterior, and gastrocnemius muscles during cycle ergometer exercise that induced the affected side's movement. In the second experiment, after receiving physiotherapeutic intervention for 30 min, the general bicycle exercise group and cycle ergometer exercise group performed the corresponding exercise for 15 min, 5 times per week, for 2 weeks. The ROM, muscle strength, pain, and balance were then measured and compared between the two groups. Results: In the results of the primary experiment, cycle ergometer exercise inducing movement of the affected side showed a significantly larger increase in the activity of leg muscles (rectusfemoris, hamstring, tibialis anterior, gastrocnemius) on the affected side than the general bicycle exercise (p <0.05). In the second experiment, the cycle ergometer exercise group showed a significantly larger increase in range of movement of affected side knee flexion and muscle strength of affected side knee flexion, knee extension, and plantarflexion than the general bicycle exercise (p <0.05). No significant between-group difference was observed in pain and balance before or after the intervention (p >0.05). Conclusion: Cycle ergometer exercise inducing movement of the affected side increases use of the muscles around the affected side knee joint after TKA more than general bicycle exercise and produces better effects for enhancing muscle strength. The application of cycle ergometer exercise inducing movement of the affected side is expected to reduce the patients' unbalanced use during the early postoperative period and help them to quickly return to normal daily life through rapid muscle strength recovery.

Effect of Intraarticular Ketamine after Knee Arthroscopy (무릎 관절경 수술 후 관절강내로 주입된 Ketamine의 효과)

  • Kang, Keon;Shin, Chul Ho;Lee, Young Hee;Cho, Young Woo;Park, Soon Eun;Son, Hee Won;Cho, Sung Do;Park, Se Hun
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.198-203
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    • 2005
  • Background: This study was designed to demonstrate the peripheral effect of ketamine on the synovia of the knee joint and evaluate the analgesic effect of an intraarticular ketamine injection following knee arthroscopy. Methods: In a double blind randomized study, 80 ASA class 1 or 2 patients were selected for elective arthroscopic knee surgery. The patients received either 20 ml of normal saline (Group C, n = 19), 20 ml of 0.5% ropivacaine (Group R, n = 21), 1 mg/kg of ketamine mixed with 20 ml of normal saline (Group K, n = 20) or 1 mg/kg of ketamine mixed with 20 ml of 0.5% ropivacaine (Group RK, n = 20), intraarticularly, just prior to wound closure. Postoperative pain was evaluated using a visual analogue scale (VAS 0 to 100) score at 1, 2, 6, 12, 24 and 48 hours after the intraarticular injection, with the side effects found in the four groups also evaluated. The patients' requests for rescue analgesic were recorded, total doses of tarasyn calculated and the overall patient satisfaction also evaluated. Results: The difference in the VAS scores for all time periods was not significant. The number of patients receiving rescue analgesics and the total doses received in Group C were greater than those for the other groups, but this was not significant. No side effects were observed in any of the patients. Conclusions: Ketamine and local anesthetics have been reported to have peripheral analgesic effects, with variable duration in the measurements of pain and hyperalgesia. However, we failed to demonstrate a peripheral analgesic effect on postoperative arthroscopic pain.

A Case Report on the Meniscal Tear due to Repetitive Foot-Switch Stepping (반복적으로 풋스위치를 밟는 작업에 의한 반월상 연골 손상 증례)

  • Yu, Sun-Hee;Lim, Hyun-Sul;Kim, Doo-Hie;Chae, Dong-Ju;Kang, Suk
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.4 s.59
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    • pp.805-814
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    • 1997
  • Injuries to the menisci occur in a variety of ways, most commonly with a twist, pivot, squat, or valgus stress to the knee. Tear patterns are classified to longitudinal, horizontal, or transverse features according to the mechanism of injury. Work-related meniscal tear usually occurs with a repetitive usage of the foot, hence it can be classified as a cumulative traumatic disorder. We found a 47 year-old female worker who had been taking charge of repetitive foot-switch stepping for 8 years. She suffered from pain in the right knee since 5 months ago. Tenderness along the medial joint line of the right knee was observed and pain was aggravated with full flexion of the right knee. On magnetic resonance imaging, high signal intensity was observed at the posterior horn of the medial meniscus of the right knee. Degenerative longitudinal and transverse complex tear in the medial meniscus was observed on arthroscopy. Arthroscopic partial meniscectomy was performed. We surveyed the work process and the health status of co-workers. It turned out that the work process was compatible to injure the meniscus and nine out of fourteen co-worker(64.3%) complained pain of the knee. No other factors related to her meniscal tear could be found except for the situation at her work. Therefore, we conclude that meniscal tear is related to the repetitive stepping of foot switch.

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Study protocol for clinical trial to Compare the Effectiveness of 'Individualized Acupuncture' with 'Standardized Acupuncture' in Korean patients with Knee Osteoarthritis

  • Lee, Seung-Deok;Seo, Jung-Chul;Lee, Sang-Hoon;Kim, Yong-Suk;Jang, Jun-Hyouk;Park, Hi-Joon;Choi, Sun-Mi;Park, Ji-Eun;Shin, Leem-Hee;Hahn, Seo-kyung;Norihito, Takahashi;Eiichi, Sumiya;Itoh, Kazunori;Toshiyuki, Shichidou;Kenji, Kawakita
    • Korean Journal of Acupuncture
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    • v.25 no.4
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    • pp.205-217
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    • 2008
  • Background : One of the characteristics of acupuncture, a popular modality for treating musculoskeletal pain, is a plurality in diagnosis and treatment that can profoundly influence the treatment outcome. This multiplicity in treatment modality has to be considered in any research on the effectiveness of acupuncture. Many practitioners stress the necessity for individualized patient treatment, including acupuncture point selection and manipulation technique. However, the importance of individualization in acupuncture treatment, compared with standardization, has received little attention in clinical trials. The aim of the future study described here is therefore to compare the effectiveness of individualized acupuncture for knee osteoarthritis with standardized acupuncture and no acupuncture in patients with knee osteoarthritis. Methods : A total of 195 patients aged 50 years and over with knee pain, will be randomly divided into three treatment groups: individualized acupuncture, standardized acupuncture, and waiting list. Outcome data will be collected through patient.completed questionnaires before randomization, and at 4, 8 and 12 weeks after randomization. The questionnaires will be investigated demographic details as well as information on pain, movement and function of the affected knee, general health and quality of life. Discussion : This paper presents details on the rationale, design, and methods of the trial.

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Effects of Bone Marrow Aspirate Concentrate-Platelet-rich Plasma Versus Hyaluronic Acid on Patients with Knee Osteoarthritis: A Randomized Controlled Trial (골수 흡인-혈소판 풍부 혈장과 히알루론산의 관절강내 주사의 효과 비교)

  • Lee, Byung Chan;Kim, Ah Ran;Kim, Eun Kyung;Kim, Sun Jeong;Kim, Sang Jun
    • Clinical Pain
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    • v.19 no.1
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    • pp.8-15
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    • 2020
  • Objective: To compare the therapeutic efficacy of the bone marrow aspirate concentrate (BMAC)- platelet-rich plasma (PRP) complex with hyaluronic acid in patients with knee osteoarthritis. Method: Thirty-four patients with knee osteoarthritis participated in this study. Seventeen patients in the study group underwent BMAC and PRP extraction followed by intra-articular injection of BMAC-PRP complex within affected knee. Seventeen patients in the control group underwent intra-articular injection of hyaluronic acid. Knee injury, osteoarthritic outcome score (KOOS), and EuroQol-5D (EQ-5D) questionnaire were evaluated before, one month, three months, and six months after the injection. Results: There were statistically significant temporal differences in total KOOS scores in both BMAC-PRP and HA groups. However, there were no significant group difference in the study period. In the Sports and Recreational Function Scale, there was statistically significant improvement in the BMAC-PRP group compared to the HA group at three months (p=0.041). There were no side effects or complications in both groups. Conclusion: Intra-articular injection of BMAC-PRP showed better functional recovery in the OA at three months and this can be an alternative treatment in terms of functional recovery in the OA in addition to the decrease of pain.

The Effects of Therapeutic Approach of Patellofemoral Pain Syndrome with Asymmetrical Hip Rotation : Case Study (비대칭성 고관절 회전각을 지닌 슬개대퇴통증증후군 환자의 치료적 접근 - 사례연구)

  • Jang, Hyun-Jeong;Kim, Suhn-Yeop;Kim, Ho-Bong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.17 no.2
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    • pp.41-48
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    • 2011
  • Background: Patellofemoral pain syndrome is very common knee problem and altered hip rotation may play a role in patellofemoral pain. The purpose of this case study is to describe the manual therapy of and the therapeutic exercise for a patient with asymmetrical hip rotation and patellofemoral pain. Method: The patient was a 29 years old woman with an 3 month history of anterior right knee pain, without known trauma or injury. Prior to intervention, her score on the VAS was Max 6 to Min 4. Left hip internal rotation was less than right hip internal rotation, and manual muscle testing showed weakness of the left hip internal rotator and abductor muscles. The intervention consisted of manual therapy and therapeutic exercise for three times a weeks, two weeks for increasing right hip medial rotation, improving left hip muscle strength, and eliminating anterior right knee pain. Result: After intervention for 2weeks, passive left and right hip medial rotations were symmetrical, and her right hip internal rotator and abductor muscle grades were Good plus. Her VAS score was Max 2 to Min 0. Conclusion: Manual therapy and therapeutic exercise is effective in improving for patient had patellofemoral pain with pattern of asymmetrical hip rotation.

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A Study on Pain relief effects and Allergic responses for the Osteoarthritis of the knee joint Between Sweet Bee Venom and Bee Venom Pharmacopuncture. (Sweet Bee Venom과 봉약침의 퇴행성 슬관절염에 대한 통증감소효과와 Allergy 반응 비교연구)

  • Na, Won-Min;Lee, Sung-Young;Jang, Eun-Ha;Moon, Hyung-Cheol;Kim, Seong-Min;Yoon, Chang-Ho;Jun, Bong-Hwan;Kim, Sung-Chul
    • Journal of Pharmacopuncture
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    • v.10 no.2 s.23
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    • pp.47-55
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    • 2007
  • Objectives : To verify pain relief effects and allergy inhibitory action for the osteoarthritis of the knee joint in Sweet Bee Venom in which allergy causing enzyme is removed. Methods : We randomly allocated 36 participants to treatment group Sweet Bee Venom and Bee Venom. Outcomes on pain reduction were measured by 100mm VAS(Visual Analog Scale). And we recorded into details allergic responses during Pharmacopuncture treatment. Results : Whole body condition and pain rate through VAS measurement were improved significantly in 2 weeks. We could get difference in pain score of two Pharmacopuncture groups significantly in 2 weeks. BV group showed superior reduction in pain compared to the Sweet BV group. But we could not get difference in whole score of two pharmacopuncture groups significantly. On the other hand other allergic responses such as edema, itchiness, pain were significantly lower in the Sweet BV group.