The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a valid and widely used instrument for the assessment of osteoarthritis patients. In this study, data was obtained from the out-patients with painful osteoarthritis of the knee. One hundred-three out-patients were interviewed by physical therapists. In an exploratory way, a Korean version of the KWOMAC was analyzed for unidimensionality, item separation, and item difficulty using the Winsteps programs. Ninety-five patients with osteoarthritis of the knee over 65 years were analyzed for Rash analysis. In the analysis several functional items poorly fit to the model. These items included "heavy domestic duties" and "standing". In the pain domain, one item ("at night while in bed") did not fit the model. In the stiffness domain one item ("after sitting, lying, or resting later in the day") did not fit the model. Although 4 items from the 3 domains (pain, stiffness, function domain) do not fit well, the KWOMAC domains were confirmed by Rasch analysis. Thus the KWOMAC needs to be further examined before it can be used to properly determine the health status of the elderly with OA.
Purpose: The purpose of this study was to develop a progressive exercise program based on clinical guidelines for exercise prescription for older adults with osteoarthritis, which was planned to improve the existing arthritis self-help program. Method: We analyzed the contents of the arthritis self-help program and closely reviewed the guideline of exercise prescription for elderly with osteoarthritis. Results: The major contents of the revised arthritis self-help program are as follows: 1) The weekly education is composed of one-hour exercise and one-hour health education about various subjects. 2) The weekly main exercise is composed of muscle strengthening and endurance exercise. 3) Endurance exercise consists of three steps. 4) Muscle strengthening exercise is performed by gravity at first, and then the Thera-Band muscle strengthening exercise is followed on the 4th week. Conclusion: It is necessary to verify the effect of the progressive exercise program for older adults with osteoarthritis. It is thought that this revised program could be adopted as a rehabilitation program for older adults with osteoarthritis.
Objectives : Mahaengeuigam-Tang (MHEGT) has been used as a traditional medicine for the treatment of rheumatic aerthritis, rheumatisim, eczema and asthma. The aim of this study was to investigate the molecular mechanisms of MHEGT for cartilage protection in monosodium iodoacetate(MIA)-induced osteoarthritis, particularly focusing on apoptosis. Method : Thirty young male Sprague-Dawley rats were used for the study. Rats were intra-articularly injected with 2 mg MIA in a total volume of 50 ㎕ saline. In MHEGT group, MHEGT extract was orally administered once daily to MIA-induced osteoarthritis rats, and rats of control group were given with saline only. At 4 weeks after MIA injection, all animals were sacrificed, and the histological changes and articular thickness were assessed by hematoxylin and eosin staining. Moreover, the immunohistochemical analyses of BAX and Bcl-2 were carried out. Results : The histomorphological examinations revealed that MHEGT reduced MIA-induced cartilage damage. And, MHEGT ameliorated the severity of cartilage surface damages after MIA injection. Furthermore, MHEGT suppressed the MIA-induced increases of pro-apoptotic BAX protein and increased the protein expression of anti-apoptotic Bcl-2 protein. Conclusion : These findings indicate that MHEGT protects against MIA-induced cartilage damage by inhibition of the apoptotic pathway, demonstrating significant protection of cartilage against osteoarthritis. These results suggest that MHEGT may potentially have clinical applications in the treatment of osteoarthritis.
Purpose: This study examined the comparison of effects of non-surgical continuous and intermittent traction on pain, balance and physical function in the treatment of knee osteoarthritis. Methods: A total of 30 knee osteoarthritis patients were recruited and randomized to a continuous traction group (n=10), an intermittent traction group (n=10), and a control group (n=10). The continuous traction group and intermittent traction group received a non-surgical continuous and intermittent knee joint traction workout five times a week, for 4 weeks. All subjects were assessed with the numeric rating scale (NRS), timed up and go test (TUGT), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before and after the 4-week treatment. Results: As a result of comparison within groups, the continuous traction group, intermittent traction group, and control group showed a significant difference for NRS, TUGT, and WOMAC after the experiment (p<0.05). According to the comparison of the three groups, the continuous traction group showed a more effectively significant difference than the intermittent traction group and the control group in the balance and physical functions before and after the experiment (p<0.05). Conclusion: This study showed that non-surgical continuous traction treatment was effective in improving pain, balance ability, and physical function in knee osteoarthritis patients.
Objective: To evaluate the effectiveness of dynamic balance exercise after intra-articular injection of hyaluronic acid (HA) therapy in elderly patients with unilateral knee osteoarthritis. Method: 30 patients with unilateral knee osteoarthritis were enrolled in this study. The patients were randomly divided into two groups: dynamic balance exercise after HA injection group (group A) and only HA injection group (group B). Both groups administered intra-articular HA injection and group A patients continued 20-session exercises for 4 weeks. The assessments were measured before injection and 4 weeks after treatment using the visual analog scale (VAS) for pain, the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) for physical function, Berg balance scale (BBS), and computerized dynamic posturography using SMART Balance Master system for balance function. Results: In both groups, significant improvements in VAS, WOMAC and balance function were observed. Compared between groups, group A showed significant improvements compared to group B in WOMAC and balance function. Conclusion: It is suggested that dynamic balance exercise may result in improved balance function and physical function in elderly patients with unilateral knee osteoarthritis.
Seo, Joong-Hwan;Kang, Pock-Soo;Lee, Kyeong-Soo;Yun, Sung-Ho;Hwang, Tae-Yoon;Park, Jong-Seo
Journal of agricultural medicine and community health
/
v.30
no.2
/
pp.167-182
/
2005
Objectives: This study was performed to investigate the prevalence of knee osteoarthritis according to the criteria of diagnosing knee osteoarthritis in rural women and the factors related with this disease. Methods: The data obtained from 200 women older than 40 years of age residing in 5 Ri's in Goryeong-gun. Gyeongsanbuk-do by random cluster sampling from September to October 2002. Knee osteoarthritis was determined positive according to the Kellgren and Lawrence classification and knee pain. Results: Among these subjects, 71.0% showed more than grade 2 in radiologic finding and the rate of knee pain according to the survey was 67.0%. The rate of subjects meeting the criteria of knee osteoarthritis was 54.0%. According to univariate analysis, the prevalence of knee osteoarthritis increased with age and those farming people and people working in household industry was significantly high at 58.9% compared with others. The prevalence of knee osteoarthritis showed a significant relationship with the family history and past history of knee injury and knee surgery(p<0.01), and diabetes mellitus(p<0.05). The score of ADL was significantly different in the subjects with knee osteoarthritis compared with normal group(p<0.05). When the presence of knee osteoarthritis and the period of the life style of seating down on the floor were compared, a significant difference was present between the osteoarthritis group and normal group. As for metabolic factors, the blood sugar level, bone density, and body mass index(BMI) were significantly different in the osteoarthritis group compared with normal group. When multiple logistic regression analysis was performed with the presence of knee osteoarthritis as the dependent variable, the prevalence of knee osteoarthritis was significantly affected by older age, subjects farming or working in household industry, the history of knee injury, the history of surgery, higher blood sugar level, and higher BMI. Conclusions: These subjects need an intervention through self-care programs such as exercise for preventing osteoarthritis, weight control programs, other exercise programs strengthening knee joints, and guidelines when working in vinyl houses.
Objective : Condyle hypoplasia in temporomandibular joint(TMJ) is often observed in several radiographic views. Mandibular Condyle hypoplasia is frequently confused with osteoarthritis with bony changes in TMJ. This paper investigated clinical characteristics of mandibular condyle hypoplasia as compared with TMJ osteoarthritis. Material and method : 276 patients with TMD were taken clinical and radiological examination and were divided into study group, 189 patients diagnosed with mandibular condyle hypoplasia, and control group, 87 patients diagnosed with TMJ osteoarthritis. And clinical features(Onset, Overjet, Overbite, Noise, Locking, NAS of noise, LOM, pain, MCO, and site of diagnosis and pain)of the two groups were compared. Results : 1. Mandibular condyle hypoplasia and TMJ osteoarthritis were similar in many of the clinical features. 2. Mandibular condyle hypoplasia concordance rates of the radiographic diagnosis site and the pain site was significantly lower than TMJ osteoarthritis. 3. Bilateral mandibular condyle hypoplasia group had more occlusal discomfort, and clenching habits than unilateral mandibular condyle hypoplasia group. 4. Unilateral mandibular condyle hypoplasia group had more unilateral chewing habits and LOM than unilateral TMJ osteoarthritis group. Unilateral TMJ osteoarthritis group had more morning stiffness and higher concordance rates of the radiographic diagnosis site and the click sound site than unilateral mandibular condyle hypoplasia group. 5. Bilateral mandibular condyle hypoplasia group had more usual headaches and overjet than bilateral TMJ osteoarthritis group. Conclusion : Mandibular condyle hypoplasia has somewhat distinguishing clinical characteristics as compared with TMJ osteoarthritis.
Objectives : The study was peformed to evaluate the effect of treatment for Osteoarthritis of knee joint by using Homnis Placenta Herbal Acupuncture. Methods : We investigated 60 cases of patient with Osteoarthritis of knee joint from 1st February 2005 to 31st January 2005, 60 cases of patient with Osteoarthritis in knee joint treated at the department of acupuncture & moxibustion of Kwang-Dong Oriental Medicine Hospital were randomly selected for two group. One group was treated by Homnis Placenta Herbal Acupuncture therapy, the other group was treated by Filiform Acupuncture therapy. We studied Lyshoim score, Ahlaback Grade, Nine-point scale and improvement degree of the grade of Ahlaback. Results : 1. In the Lyshoim score, Homnis Filiform Acupuncture was more effective than Filiform Acupuncture. But, there was no significance between two groups statistically in the Lyshoim score. 2. In the Nine point score, Homnis Placenta Herbal Acupuncture was more effective than Filiform Acupuncture. 3.In the improvement degree of the grade of Ahlaback., Homnis Placenta Herbal Acupuncture was as effective as Filiform Acupuncture. Conclusion : In the treatment of Osteoarthritis of knee joint, Homnis Placenta Herabl Acupuncture was not more effective than Filiform Acupuncture statistically. But both Homnis Placenta Herbal Acupuncture and Piliform Acupuncture was effective in Osteoarthritis of knee joint.
Journal of the Korean Society of Physical Medicine
/
v.15
no.1
/
pp.143-152
/
2020
PURPOSE: This study examined the effects of videoconferencing-based telerehabilitation exercise program on the gait, knee function, and quality of life of patients with knee osteoarthritis. METHODS: Forty-eight subjects, who were diagnosed with osteoarthritis of the knee by the radiologic findings, history, and a physical examination, were assigned randomly to a Control group, Experiment group I, and Experiment group II. The control group did not perform any exercise program and were educated in understanding and managing the disease of knee osteoarthritis for only one hour. Experimental groups I and II were provided with an exercise guidelines book for knee osteoarthritis, and the same exercise programs were conducted by face-to-face visits and non-face-to-face using telerehabilitation for eight weeks, respectively. To verify the effectiveness of each exercise program, the gait speed, knee disability index, and health related quality of life were measured. All assessments were conducted twice before and after the intervention. RESULTS: The participants who underwent both face-to-face and telerehabilitation exercise programs showed an improved gait speed, knee function, and health-related quality of life. In particular, there was no significant difference between the telerehabilitation exercise group and the direct face-to-face exercise group in improving the knee joint function and health related quality of life. CONCLUSION: A these findings the telerehabilitation exercise program for patients with knee osteoarthritis can alternate or supplement the face-to-face exercise program. Therefore, the telerehabilitation exercise program should be used not only as a substitute supplement program but also as an intervention for various diseases.
Objectives This study was carried out to know the effects of Keonbodan (hereinafter referred to KBD) in osteoarthritis induced by Monosodium iodoacetate(hereinafter referred to MIA) on Wistar rat. Methods Osteoarthritis was induced by injection of MIA into left knee joint cavities of rat. Osteoarthritis rats were divided into 4 groups (normal (n=6), control (n=6), indomethacin (n=6), KBD (n=6) group). The control group was administered normal saline and indomethacin group was administered indomethacin (2 mg/kg). And the KBD group was administered KBD (142 mg/kg). Each groups were administered by orally for 4 weeks. This experiment were carried out in vivo. In vivo, at the end of the experiment (5 weeks after MIA injection), effects on hepatotoxicity and nephrotoxicity, cytokines in serum, arachidonic acid, osteocalcin, MMP-9, TIMP-1 and cartilage volume were evaluated. And histopathological examinations on the articular structures of knee joints were performed. Results 1. In weight-bearing measurement, level of weight was increased. 2. In order to hepatotoxicity and nephrotoxicity, ALT, AST, BUN and creatinine were tested. And there were no significant changes. 3. In serum, levels of TNF-$\alpha$, IL-$1{\beta}$ were significantly decreased. IL-6 was insignificantly decreased. 4. In serum, level of MMP-9 and TIMP-1 was decreased. 5. In serum, level of $LTB_4$, $PGE_2$ and osteocalcin was decreased. 6. In ${\mu}$CT-arthrography, the cartilage volume was greater than that of the control group. 7. The joint damage induced by osteoarthritis was lesser than the control group in histopathologic observation (H&E, Safranin-O staining). Conclusions These results demonstrated that KBD suppressed the osteoarthritis- inducing effects of MIA in rat. And further studies are required to find out more effective substance and anti-osteoarthritic mechanism in the future.
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