• Physical Therapy Rehabilitation Science
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• v.10 no.4
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• pp.387-397
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• 2021

Objective: The purpose of this case study was to investigate selective region high-frequency diathermy at trigger points with therapeutic exercises on pain, function, balance and gait in older patients with degenerative knee osteoarthritis (DKO). Design: A case report. Methods: The patient who participated in this study was a 71-year-old woman, who had been diagnosed with moderate osteoarthritis with grade II Kellgren & Lawrence grading scale. The intervention consisted of selective region high-frequency diathermy at trigger points, with hip and knee stretching and strengthening exercises. The participant was given assessments before and after every intervention session using the Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), the Timed Up and Go test (TUG) and the 10 Meter Walk Test (10MWT). The participant performed the intervention 18 times for a total of 30 minutes each. Results: As a result of this study, the patient VAS decreased to 3 points, and the WOMAC decreased to 53 points. In addition, the TUG decreased to 3.25 s and the 10MWT decreased to 1.14 s. Conclusions: The results of this study suggest that selective region high-frequency diathermy at trigger points with therapeutic exercises may be an effective intervention to decrease pain, improve knee function, balance and gait in patients with DKO. The selective region high-frequency diathermy with therapeutic exercises may be feasible and provide potential benefits for rehabilitation of DKO.

• The Korean Journal of Pain
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• v.36 no.4
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• pp.450-457
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• 2023

Background: Genicular nerve neurolysis with phenol and radiofrequency ablation (RFA) are two interventional techniques for treating chronic refractory knee osteoarthritis (KOA) pain. This study aimed to compare the efficacy and adverse effects of both techniques. Methods: Sixty-four patients responding to diagnostic blockade of the superior medial, superior lateral, and inferior medial genicular nerve under ultrasound guidance were randomly divided into two groups: Group P (2 mL phenol for each genicular nerve) and Group R (RFA 80℃ for 60 seconds for each genicular nerve). The numeric rating scale (NRS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used to evaluate the effectiveness of the interventions. Results: RFA and phenol neurolysis of the genicular nerves provided effective analgesia within groups at 1 week, 1 month, and 3 months compared to baseline. There was no significant difference between the groups in terms of NRS and WOMAC scores at all measurement times. At the 3rd month follow-up, 50% or more pain relief was observed in 53.1% of patients in Group P and 50% of patients in Group R. The rate of transient paresthesia was 34.4% in Group P and 6.3% in Group R, and this was significantly higher in Group P. Conclusions: Neurolysis of the genicular nerves with both RFA and phenol is effective in the management of KOA pain. Phenol may be a good alternative to RFA. Further studies are needed on issues such as dose adjustment to prevent transient paresthesia response.

• Journal of Medicine and Life Science
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• v.20 no.2
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• pp.60-66
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• 2023

Gentamicin-loaded bone cement used in total joint arthroplasty is indispensable, as it provides stability by directly binding the surfaces of implants and bones. Depending on multiple factors, including the material of the bone cement used, common complications, such as aseptic loosening, osteolysis, and infection can occur postoperatively. In clinical practice, Doujet bone cement is easy to handle (pre-packed all-in-one system), and has shown low failure rates and non-inferior results compared with similar available products. We conducted a retrospective comparative study to analyze the clinical and radiological results of each bone cement group to establish the safety and usefulness of Doujet bone cement. From July 2020 to July 2022, we enrolled 198 patients in this study after an average follow-up period of 37 months (range, 6-48 months). In 99 patents, Doujet^® bone cement (Injecta, Gunpo, Korea) was used for total knee arthroplasty (TKA), while Refobacin^® bone cement (Biomet, Warsaw, IN, USA) was used in 99 patients. The average range of motion (ROM) of the knee increased by 2.4° (from 127.0° preoperatively to 129.4° postoperatively) in the Doujet group, and by 0.1° (from 128.7° to 128.8°) in the Refobacin group (P=0.701). The Western Ontario and McMaster Universities (WOMAC) osteoarthritis index scores decreased from 44.1 to 7.8 in the Doujet group, and from 44.2 to 6.3 in the Refobacin group (P=0.162). Complications, such as osteolysis or post-operative wound infection, did not occur in more than two cases in both groups. The WOMAC and ROM of the knee in both groups had no clinical differences. Both Doujet and Refobacin similarly showed low complication rates after TKA.

• The Korean Journal of Pain
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• v.36 no.2
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• pp.195-207
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• 2023

Background: This study aimed to compare the effectiveness of the pericapsular nerve group (PENG) block and intra-articular injection (IAI) of steroid-bupivacaine in the treatment of hip osteoarthritis (OA). Methods: After randomization, patients received either a PENG block or IAI under ultrasound-guidance. Clinical evaluations were recorded at baseline, day 1, and weeks 1, 4, and 8 post-intervention. The numerical rating scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Harris Hip Scale (HHS) scores, pain medication use determined by a quantitative analgesic questionnaire, and patient satisfaction were evaluated. Results: Sixty patients were included in this study. NRS scores improved significantly for both groups during the follow-up compared to pretreatment (P < 0.001), with better pain scores for the PENG group (P < 0.001) at day 1 with larger effect size (Cohen's d = 4.62), and IAI group at 4 (Cohen's d = 5.15) and 8 (Cohen's d = 4.33) weeks (P < 0.001). There was no significant difference in pain medication consumption (P = 0.499) and patient satisfaction (P = 0.138) between groups. Patients in the IAI group experienced significant improvement in HHS (Cohen's d = 2.16, P = 0.007) and WOMAC (Cohen's d = 1.02, P = 0.036) scores at 8 weeks compared to the PENG group. Conclusions: The ultrasound-guided PENG block provides effective pain relief which improves functionality and quality of life in hip OA patients up to 2 months. The PENG block can be considered an easy, safe, and useful alternative treatment modality for hip OA.

• Physical Therapy Korea
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• v.30 no.2
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• pp.110-119
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• 2023

Background: Osteoarthritis is a common condition with an increasing prevalence and is a common cause of disability. Osteoarthritic pain decreases the quality of life, and simple gait training is used to alleviate it. Knee osteoarthritis limits joint motion in the sagittal and lateral directions. Although many recent studies have activated orthotic research to increase knee joint stabilization, no study has used patellar tendon straps to treat knee osteoarthritis. Objects: This study aimed to determine the effects of patellar tendon straps on kinematic, mechanical, and electromyographic activation in patients with knee osteoarthritis. Methods: Patients with knee osteoarthritis were selected. After creating the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), leg length difference, Q-angle, and thumb side flexion angle of the foot were measured. Kinematic, kinetic, and muscle activation data during walking before and after wearing the orthosis were viewed. Results: After wearing the patellar tendon straps, hip adduction from the terminal stance phase, knee flexion from the terminal swing phase, and ankle plantar flexion angle increased during the pre-swing and initial swing phases. The cadence of spatiotemporal parameters and velocity increased, and step time, stride time, and foot force duration decreased. Conclusion: Based on the results of this study, the increase in plantar flexion after strap wearing is inferred by an increase due to neurological mechanisms, and adduction at the hip joint is inferred by an increase in adduction due to increased velocity. The increase in cadence and velocity and the decrease in gait speed and foot pressure duration may be due to joint stabilization. It can be inferred that joint stabilization is increased by wearing knee straps. Thus, wearing a patellar tendon strap during gait in patients with knee osteoarthritis influences kinematic changes in the sagittal plane of the joint.

• Journal of Chest Surgery
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• v.56 no.6
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• pp.420-430
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• 2023

Background: This study provides an update to a landmark 2004 report describing demographics, training, and trends in adherence to thoracic surgery practice standards in Canada. Methods: An updated questionnaire was administered to all members of the Canadian Association of Thoracic Surgeons via email (n=142, compared to n=68 in 2004). Our report incorporates internal data from Ontario Health and the Canadian Partnership Against Cancer. Results: Forty-eight surgeons completed the survey (male, 70.8%; mean±standard deviation age, 50.3±9.3 years). This represents a 33.8% response rate, compared to 64.7% in 2004. Most surgeons (69%) served a patient population of over 1 million per center; 32%-34% reported an on-call ratio of 1:4-1:5 days, and the average weekly hours worked was 56.4±11.9. Greater access to dedicated geographic units per center (73% in 2021 vs. 53% in 2004) has improved thoracic-associated services and house staff, notably endoscopy units (100% vs. 91%), with 73% of respondents having access to both endobronchial and endoscopic ultrasound. Access to thoracic radiology has also improved, particularly regarding positron emission tomography scanners per center (76.9% vs. 13%). Annual case volumes for lung (255 vs. 128), esophageal (41 vs. 19), and mediastinal resections (30 vs. 13), along with hiatal hernia repair (45 vs. 20), have increased substantially despite reports of operating room availability and radiology as rate-limiting steps. Conclusion: This survey characterizes compliance with current practice standards, addressing the needs of thoracic surgeons across Canada. Over 85% of respondents were aware of the 2004 compliance paper, and 35% had applied for resources and equipment in response.

• Physical Therapy Rehabilitation Science
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• v.13 no.1
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• pp.8-17
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• 2024

Objective: This study aims to explore the relationship between isokinetic strength training and the enhancement of physical function in older adults. It also evaluates the effectiveness of isokinetic strength training equipment. Method: This study randomly divided twenty healthy adults into two groups.The experimental group engaged in isokinetic strength training for 30 minutes, three times a week, over a four-week period. In contrast, the control group did not participate in any exercise regimen. We assessed several outcome measures including physical functions (sit-to-stand test, flexibility, Timed Up and Go test), grip strength, balance, thigh circumference, the Korean version of the Patient Health Questionnaire-9 (PHQ-9), and the Korean version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Additionally, the experimental group's self-perceived improvement in lower limb condition was evaluated using the Global Rating of Change (GROC) scale. Results: The experimental group showed significant improvements compared to the control group in various aspects: reduced sit-to-stand test duration (7.00±2.05 seconds), increased flexibility (4.69±3.90 cm), improved grip strength (1.54±1.74 kg), increased thigh circumference (left: 1.29±1.19 cm, right: 1.19±1.27 cm), enhanced Timed Up and Go test performance (-1.47±0.86 seconds), better balance (eyes open stance: -8.08±4.03 cm, eyes closed stance: -0.27±0.13 cm/s), and a decrease in depression severity (-0.15±1.51 points). Furthermore, significant increases were observed in the experimental group's maximal isokinetic strength at 90°/s for both flexion (19.62±7.03 Nm) and extension (19.60±14.65 Nm) over the study period. Conclusion: The findings suggest that isokinetic strength training equipment can significantly enhance physical functions in seniors when incorporated into an exercise regimen.

• The Korean Journal of Pain
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• v.37 no.3
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• pp.264-274
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• 2024

Background: Radiofrequency ablation is an effective treatment modality in the symptomatic treatment of knee osteoarthritis. Our aim was to compare the efficacy of radiofrequency ablation of the superomedial and inferomedial genicular nerves (2 branches) with the superolateral, superomedial, and inferomedial genicular nerves (3 branches) and to show whether the 2-branch procedure is inferior to the 3-branch procedure. Methods: This study is a prospective, randomized, single-blind clinical study. Eligible participants were randomized into 2 groups: group A, which applied the procedure to the superomedial and inferomedial genicular nerves, and group B, which applied it to the superomedial, superolateral and inferomedial genicular nerves. Pain was evaluated with the numerical rating scale, quality of life with the Short Form-36 (SF-36), and disability with the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index before, and at 1 and 3 months after the procedure. Results: A total of 41 patients were included. There were no differences between the groups except for the SF-36 physical health sub-score at baseline. A significant improvement was seen in the numeric rating scale (NRS) score, SF-36 sub-scores, WOMAC Index total, as well as pain and physical function scores in both groups, though no significant difference was detected between the groups during follow-up. Conclusions: Although we were unable to establish the noninferiority of conventional radiofrequency ablation (CRFA) applied to 2 branches to CRFA applied to 3 branches, in this trial, significant and similar improvement was observed in NRS, WOMAC total, pain, and physical function and SF-36 scores in both groups.

• Safety and Health at Work
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• v.15 no.2
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• pp.164-171
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• 2024

Background: Telework adoption in Taiwan has surged because of government guidelines during the COVID-19 pandemic. This study examined the disclosure practices of Taiwanese-listed companies, assessing their adherence to government telework guidelines and their correlation with corporate governance, focusing on occupational health measures. Methods: We conducted a guideline-adherent cohort analysis of the 2020 and 2021 sustainability reports of 295 Taiwanese-listed companies. We assessed their disclosure of corporate measures for teleworking in alignment with two government guidelines, specifically occupational health measures. Using the McNemar test and general estimating equation analysis, we compared the 2020 and 2021 responses and examined their associations with corporate governance rankings. Results: Telework adoption increased significantly from 2020 to 2021, with 68% of companies reporting new work modes. The mentioning of government guidelines also increased to 67% by 2021. Companies with higher governance rankings were more likely to adopt online occupational health measures, including occupational health services (RR = 2.03; 95% CI = 1.41-2.94; p < 0.001) and mental health promotion activities (RR = 2.01; 95% CI = 1.06-3.82; p = 0.032), than those with low rankings. Although on-site and online occupational health services increased, home workspace assessments did not. Conclusion: Our findings highlight significant upward trends in the disclosure of telework measures following the issuance of government guidelines. Corporate governance is significantly associated with the implementation of occupational health measures. Amid the evolution of teleworking, both government guidelines and corporate governance have become essential for shaping work arrangements and ensuring workforce well-being.

• Hip & pelvis
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• v.36 no.2
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• pp.120-128
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• 2024

Purpose: The purpose of this study was to compare the clinical and radiographic outcomes with use of short-curved stems versus standard-length single wedged stems over a minimum follow-up period of five years. Materials and Methods: A retrospective study of primary total hip arthroplasties performed using the Fitmore^® stem (127 hips, 122 patients) and the M/L taper^® stem (195 hips, 187 patients) between October 2012 and June 2014 was conducted. The clinical and radiographic outcomes were obtained for evaluation over a minimum follow-up period of five years. Results: In both the Fitmore^® and M/L taper^® groups, the mean Harris hip score improved from 52.4 and 48.9 preoperatively to 93.3 and 94.5 at the final follow-up, respectively (P=0.980). The mean Western Ontario and McMaster Universities Osteoarthritis Index scores also improved from 73.3 and 76.8 preoperatively to 22.9 and 25.6 at the final follow-up, respectively (P=0.465). Fifteen hips (Fitmore^®: 14 hips; M/L taper^®: one hip, P<0.001) developed intraoperative cracks and were treated simultaneously with cerclage wiring. Radiography showed a radiolucent line in 24 hips in the Fitmore^® group and 12 hips in the M/L taper^® group (P=0.125). Cortical hypertrophy was detected in 29 hips (Fitmore^® group: 28 hips; M/L taper^® group: one hip, P<0.001). Conclusion: Similarly favorable clinical and radiographic outcomes were achieved with use of both short-curved stems and standard-length single wedged stems. However, higher cortical hypertrophy and a higher rate of femoral crack were observed with use of Fitmore^® stems.