• Journal of Korean Medicine Rehabilitation
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• v.29 no.3
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• pp.51-60
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• 2019

Objectives Osteoarthritis is hard to manage with both conventional and Korean medicine treatment. The core outcome set (COS) to demonstrate the effectiveness of Korean medicine treatment has not been established yet. We aimed to present preliminary data of COS by performing a literature review on the evaluation indices used in existing clinical research. Methods We examined the literature from 2000 to 2017 in two Korean electronic databases (Korea citation index and oriental medicine advanced searching integrated system) by searching for the following 3 terms 'total knee replacement (Korean)', 'total knee replacement,' and 'knee surgery.' We found 333 articles; among them, 50 duplicates were removed. Finally, we selected 160 articles after complete screening. We then extracted measured indices and clinical outcomes from the selected articles and categorized the relevant criteria. Results According to this study, the hospital for special surgery and knee society, range of movement angle, cross leg, Berg balance scale and balance ability, muscle strength, 6 minutes walking test, visual analogue scale, self-efficacy, the 12-item and 36-item short form survey and self-rated health status are the most commonly used outcomes of knee. Conclusions This study found that the several categories after total knee replacement (TKR) are being evaluated in the literature, and we were able to verify the most frequently used evaluation indices in these categories. The results of this study will be used to establish evaluation indices for the treatment of TKR in the future using Korean medicine.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.3
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• pp.13-20
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• 2024

PURPOSE: To determine the effect of four weeks of exercise training on knee circumference and range of motion (ROM), pain perception, wellness, and VO_2max in patients at Osun State University Teaching Hospital, Osogbo, Nigeria. METHODS: Forty subjects who met the inclusion criteria were randomized into control and experimental groups. patients were subjected to four weeks of flexibility and strengthening exercise, which included squatting exercise, ROM exercise, both groups were given some cardiovascular exercise. VO_2max), Wellness score and circumference. RESULTS: Compared to the baseline values (week 1), there was increase in the knee ROM, and decrease in the pain perception in both groups after four weeks. However, the improvements seen in the experimental group, were significantly better relative to the control group after four weeks of intervention. owever, knee ROM and wellness scores of the experimental group, and the VO_2max of both significantly increase, but significantly decrease in the knee circumference and pain perception of both groups following 4 weeks of exercise was recorded. CONCLUSION: he exercise modality in the study promote cardiovascular endurance, knee joint integrity, reduce pain perception in subjects. xercise intervention s beneficia to both groups since both reduction in the pain felt and also in knee swelling.

• Journal of Acupuncture Research
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• v.26 no.6
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• pp.77-83
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• 2009

Objectives : The aim of this study was to evaluate the usefulness of ultrasonography of knee osteoarthritis. Methods : 124 osteoarthritis patients classified by the American College of Rheumatology (ACR) clinical criteria were included in the study. Simple X-ray and ultrasonography examination (effusion, osteophyte, articular cartilage, Backer's cyst) of knee in pain were performed. Also VAS, KWOMAC score were checked. Results : X-ray showed abnormal findings in 112 patients, but ultrasonography showed abnormal findings in all 124 patients. 12 Patients with unremarkable knee X-ray showed effusion and osteophyte in the ultrasonography. Effusion was discovered only in 18 cases of X-ray and 62 cases of ultrasonography. Group with effusion showed higher VAS mean figure but couldn't retrieve significant difference. KWOMAC showed no significant difference. Conclusions : Osteoarthritis patients with no abnormality in X-ray diagnosed abnormal findings through sonograph, which manifest that sonograph can be utilized for differential diagnosis especially sensitive on the problem of effusion.

• Journal of Acupuncture Research
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• v.38 no.2
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• pp.96-109
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• 2021

The purpose of this study was to evaluate the effectiveness and safety of acupotomy for the treatment of patients with knee osteoarthritis. There were 9 databases searched to retrieve randomized controlled trials until August 3, 2019 regarding acupotomy versus conventional Western medicine, conventional Western medicine treatment with and without acupotomy, and Korean medicine treatment with and without acupotomy, and meta-analysis was performed. Of 303 potentially relevant studies retrieved, 43 were systematically reviewed. All studies were conducted in China. Effective rate, visual analogue scale, and Western Ontario and McMaster Universities Osteoarthritis index were used as the evaluation scales. The Ashi point was selected most frequently. In all studies, the intervention group was more effective than the control group. Meta-analysis revealed that acupotomy showed statistically significant beneficial results. Although acupotomy had a beneficial effect on knee osteoarthritis, the risk of bias of the included studies was not low. The majority of the results from the evaluation scales used were highly heterogeneous (> 50%) which reduced confidence in the estimation of effect, or had a small sample size. Further clinical research and development is required in the future.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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• pp.93-101
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• 2023

PURPOSE: The Western Ontario and McMaster Universities Arthritis (WOMAC) index has been used to measure the outcome of total knee replacement (TKR), but studies on its reliability and validity are limited. The present study examined the reliability and validity of this index for patients with knee osteoarthritis who underwent TKR. METHODS: Seventy-one inpatients and outpatients who underwent bilateral TKR for knee osteoarthritis were included in this study. The pain assessment scale and WOMAC index were used to evaluate the participants every two weeks to examine the test-retest reliability, internal consistency, and construct validity. RESULTS: The test-retest reliability scores for pain, stiffness, and physical function were .75-.92, .85-.90, and .75-.95, respectively. The corresponding intraclass correlation coefficients were .75-.88, .76-.88, and .71-.95, respectively. The internal consistency score in the first and second examinations was .92. Furthermore, the construct validity scores for pain, stiffness, and physical function were .83, .41, and .58, respectively. CONCLUSION: The application of the WOMAC index in patients who underwent TKR showed high test-retest reliability and internal consistency with the use of the WOMAC index and good validity with the use of the pain assessment scale.

• The Journal of Korean Medicine
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• v.26 no.2 s.62
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• pp.231-240
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• 2005

Objectives: In order to investigate the efficacy and safety of the newly developed herbal medicine Jetongdan, a placebo­controlled, randomized clinical trial of patients with osteoarthritis of the knee was undertaken. Methods: Data were obtained from 80 patients with OA of the knee. After enrollment, they were asked to answer a disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index) and analyzed with the erythrocyte sedimentation rate (ESR) in order to evaluate the efficacy of Jetongdan, and analyzed for aspartate transaminase (AST) level, alanine transaminase (ALT) level, blood mea nitrogen (BUN) level, and creatinine (Cr) level in order to evaluate the safety of Jetongdan. Results: The liver function and renal function did not deteriorate after treatment with Jetongdan. Composite WOMAC score and physical function subscale was improved, but pain subscale, stiffness subscale, and ESR were not improved by. This was possibly because the baseline characteristics of the two groups were not homogenized after randomization. Conclusions: Jetongdan could be a promising treatment option for osteoarthritis of the knee. Further study in a larger population with appropriate severity grades is recommended.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.14 no.2
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• pp.34-40
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• 2008

Purpose: We defined osteoarthritis of the knee as knee pain and crepitus in over 40 years old. The usual clinical manifestation include pain, stiffness, crepitus and loss of function. Methods: We studied 40 cases of the degenerative arthritis of knee clinically. The body mass index(BMI, weight(kg)/height($m^2$) was used as a measure of obesity. Pain self assessment scale by Million Index in according to age, occupation, BMI. Results: Gender by pain self assessment scale was 6.5 in male and 6.6 in female(P<0.05). The prevalence rates obese was 40%. Occupation by pain self assessment scale was 7.0 in Sitting and 5.7 in Standing(P<0.05). Prevalence was increased with age by pain self assessment scale in aged 40-69 years. Conclusion: It has been known that the obesity is one of the predispsing factors of the primary degenerative arthritis of knee. A flexion weight bearing view of the knee obtained at $30^{\circ}$ to $40^{\circ}$ of the joint flexion may be more sensitive in assessing damages to hyaline cartilage because the knee flexion is an important component of the stance phase.

• Journal of Korean Academy of Nursing
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• v.35 no.3
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• pp.514-525
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• 2005

Purpose: This study was to examine the effects of a Self-management program on physical function and quality of life of women with knee osteoarthritis. Method: The participants for this study, who had knee osteoarthritis, were recruited from an arthritis clinic, at a university hospital located in S city, Korea between February 16, 2004 and June IS, 2004. Seventeen subjects in the control group received no intervention and 18 subjects in for experimental group received an individual Self-management program. The self-management program consisted of dietary education and home-based exercise; walking and resistance exercise. The subjects performed this program 5 times per week during 8 weeks and recorded a diary for diet and exercise. In order to verify the effects of the Self-management program, physical function and Quality of life as a dependent variable were measured at three points in time: before, week4 and week8 after the interventions. Result: There were significant increases on physical function (F=5.08, p=.002) and significant interaction effects (F=7.42, p=.002) in the intervention group over the three measurement points in time. In addition, there were significant increases on quality of life (F=8.08, p=.002) and significant interaction effects (F=4.89, p=.016) in the intervention group over the three measurement points in time. Conclusion: This study revealed that a Self-management program can be used as an efficient nursing intervention for women with knee osteoarthritis.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.5
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• pp.1154-1162
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• 2007

This study was to investigate the effects of Bee-venom Treatment on the monosodium iodoacetate(MIA)- induced osteoarthritis in rats. Arthritis was induced by injection of MIA(0.5 mg) into knee joints of rats. Arthritic rats were divided into control(n=8) and treated(n=8) group. Control group was injected with normal saline once a day for 20 days, while treated group was injected with Bee-venom extract once a day for same duration. Body weights were measured at 0, 5, 10, 15, 20 days after injection. At the end of experiment, gross and histopathological examination on the articular cartilages of the knee joints were performed. Proteoglycan contents of articular cartilages were analysed by safranine O staining method. The contents of $TNF-{\alpha}$, $IL-1{\beta}$ and IL-6 in synovial fluids were analysed by ELISA method. And also, COX-2 and iNOS immunohistochemical examination on the knee joints were performed. Body weights of the treated group were increased compared with control group at 20 days after injection. Grossly, the severity of osteoarthritis in the treated group were alleviated compared with control group. PG contents in articular cartilages of the treated group were significantly increased compared with control group. Histopathologically, degenerative and necrotic lesion of articular cartilages in the treated group were alleviated compared with those of the control group. $TNF-{\alpha}$ contents in synovial fluids of the treated group were decreased compared with control group. Positive reactions of COX-2 in chondrocytes and synovial membranes of the treated group were decreased compared with the control group. On the basis of these results, we concluded that Bee-venom treatment has anti-arthritic effects on the monosodium iodoacetate-induced osteoarthritis in rats. And it's effects were related with reduced secretion of $TNF-{\alpha}$ and COX-2 from osteoarthritic chondrocytes and synovial membranes.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.1
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• pp.81-94
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• 2024

PURPOSE: This study aimed to investigate the effect of a progressive balance training program with whole-body vibration stimulation on knee joint pain, dysfunction, psychosocial status, and balance ability in individuals aged ≥ 65 years with knee osteoarthritis. METHODS: A total of 40 individuals aged ≥ 65 years with osteoarthritis of the knees participated in the study. Using a randomization program, participants were assigned to an experimental group (n = 20) or a control group (n = 20). Both groups were assigned a knee strength training program, and a progressive balance training program with whole-body vibration stimulation was assigned to the experimental group. All interventions were conducted three times a week for four weeks. Participants were evaluated for the following: pain (numeric rating scale, NRS), knee dysfunction (Korean version of the Western Ontario and McMaster Universities Arthritis Index, K-WOMAC), fall efficacy (Korean Version Falls Efficacy Scale, K-FES), quality of life (Euro Quality of life 5 Dimension, EQ-5D), and advanced balance scale score (Fullerton advanced balance scale, FAB) before and after the intervention, and the effects of the intervention were compared accordingly between groups. RESULTS: Both groups showed significant differences in the results of the NRS, K-WOMAC, K-FES, and EQ-5D assessments before and after the intervention, and there was a significant difference in the amount of change between the two groups (p < .05). There was a significant improvement in FAB in all but items FAB 8 and FAB 9 after the intervention in the experimental group. In the control group, there was a significant improvement in FAB 1, FAB 2, FAB 7, and FAB total after the intervention (p < .05). In addition, there was a significant difference in the amount of change between the two groups in all items except FAB 8 and FAB 9 (p < .05). CONCLUSION: The progressive balance training program with whole body vibration stimulation is an effective intervention method with clinical significance in improving knee joint pain, knee disability index, psychosocial level, and balance ability in adults aged ≥ 65 with osteoarthritis of the knees.