• Journal of Acupuncture Research
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• v.22 no.3
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• pp.271-280
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• 2005

Objective : The aim of this study is to evaluate internal reliability and correlation among assessment instruments of knee OA. Methods : Data were obtained from 85 patients with knee OA. They were asked to answer VAS pain scale, two disease-specific questionnaires (WOMAC and LFI) and one instrument about health-related quality(KHAQ). Reliability was assessed using cronbach`s alpha. Correlation was assessed by examining the pearson`s correlation coefficients. Results : Cronbach`s alpha of all Index except WOMAC stiffness subscale.(6679) exceeded the value of 0.70. A good correlation was obtained between WOMAC Subscales (especially Pain Subscale) and LFI (.726

• Journal of Korean Medicine Rehabilitation
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• v.19 no.2
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• pp.251-260
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• 2009

Objectives : To investigate reliability and validity of Korean translation of Western Ontario and McMaster Universities(WOMAC) osteoarthritis index. Methods : The reliablity, construct validity of the Korean WOMAC Index in the patient of knee osteoarthritis was investigated. Test-retest reliability was quantified with pearson's correlation coefficient and intraclass correlation coefficient. Internal consistency was quantified with Cronbach's ${\alpha}$. and construct validity with pearson's correlation coefficient by correlating of the Visual Analog Scale(VAS). Results : Test-retest reliability of Korean WOMAC Index for pain was 0.76 to 0.95, stiffness was 0.89 to 0.94, and physical function was 0.71 to 0.95. Intraclass correlation coefficient for pain was 0.76 to 0.94, stiffness was 0.54 to 0.89, and physical function was 0.70 to 0.95. Internal consistency were 0.94 and 0.94 for the first and second time, respectively. Construct validity for pain was 0.79, for stiffness was 0.66, and physical function was 0.67. Conclusions : The Korean translation of Western Ontario and McMaster Universities(WOMAC) osteoarthritis index is reliable, valid assessment tool in knee osteoarthritis.

• Physical Therapy Korea
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• v.15 no.2
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• pp.20-29
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• 2008

The purpose of this study was to examine the validity and reliability of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)-VA3.0 in patients with hip and knee osteoarthritis (OA). The sample consisted of 301 patients who had received treatments at the physical therapy units of 5 medical institutions in Andong City in june 2006. Questionnaires on the WOMAC were recruited by 12 physical therapists. The internal structure and reliability of the scales were evaluated by means of item-internal consistency (Cronbach's alpha coefficient: ${\alpha}$), item-discriminant validity, and Pearson's relation coefficient. To explore construct validity, we conducted a principal component factor analysis with varimax rotation analysis. The criterion for factor extraction was an eigenvalue >1.0. The average age of the patients was 62.1 years. All WOMAC subscales (pain, stiffness, and physical function) were internally consistent with Cronbach's coefficients of .81, .91, and .80, respectively. The internal consistency reliability of item-each scale were also internally consistent with Cronbach's coefficient of .89 (Pearson's correlation coefficient: .71~.84), .93 (.89~.91), and .96 (.67~.91), respectively. However, high correlation was found among 3 items (.66~.83, .66~.67, and .67~.83), so the item-discriminant validity was low (${\alpha}$ coefficient: .81, .91, .80, respectively). The construct validity by factor analysis was low because it was not consistent With WOMAC-VA3.0. In conclusion, the results reported here confirm the reliability of the WOMAC in patients with OA of the hip and knee. The collection of information on the hip and knee osteoarthritis using this instrument was acceptable to patients. A further prospective multi-center study will be necessary to prove the construct validity.

• Journal of International Academy of Physical Therapy Research
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• v.1 no.2
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• pp.169-175
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• 2010

The purpose of this study was to analyze and compare the effect of resistance exercise and balance exercise on proprioception and WOMAC index of patients with degenerative knee osteoarthritis. A total of 40 subjects participated in this study. The subjects were diagnosed with degenerative knee osteoarthritis and all were more than 60 years old. They were divided into three groups. Group I(n=8) was trained with resistance exercise, Group II(n=6) was trained with balance exercise and Group III(n=6) was trained with range of motion as a control. The results of this study were as follows. It was significantly indicated that the resistance exercise group and balance exercise group elicited error-reduction on proprioception goal-angle (p<.05). There was a statistically significant difference on proprioception between resistance exercise group and control(range of motion) group. There was a statistically significant reduction on WOMAC index between resistance exercise group and balance exercise group (p<.05) and on the WOMAC index between resistance exercise group and range of motion group(p<.05). In conclusion, resistance exercise and balance exercise are effective on degenerative knee osteoarthritis and resistance exercise is the most effective for improving proprioception and WOMAC index. More research on the intervention according to the degree of degenerative knee osteoarthritis is needed.

• Journal of Acupuncture Research
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• v.30 no.5
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• pp.51-64
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• 2013

Objectives : This study is performed to develop the oriental medical rating scale of knee pain and to assess its validity. Methods : 250 knee pain patients completed the previously accepted rating scale of knee pain(VAS, WOMAC(pain, function, stiffness), 6 minute walk test(number of steps, distance)) and oriental medical rating scale of knee pain which was developed by Hwang et al at 2012, before and after the 6 weeks acupuncture treatment. Comparing these results, we assessed the validity of oriental medical rating scale. Results : Comparing oriental medical rating scale of knee pain before acupuncture treatment with VAS, WOMAC(pain, function, stiffness) and 6 minute walk test(number of steps, distance), oriental medical rating scale showed correlation with VAS, WOMAC(pain, function, stiffness) and showed the highest correlation with WOMAC(function). Comparing the change of oriental medical rating scale of knee pain after 6 weeks of acupuncture treatment with the change of VAS, WOMAC(pain, function, stiffness) and 6 minute walk test(number of steps, distance) after 6 weeks, change of oriental medical rating scale showed correlation with the change of VAS, WOMAC(pain, function, stiffness) and showed the highest correlation with the change of WOMAC(function). Through factor analysis of oriental medical rating scale items, 4 factors(pain, swelling, deformation of the knee, thermal sense of the knee), 17 items were extracted. Conclusions : Oriental medical rating scale of knee pain reflected the patient's pain, functional limitation and stiffness well. And oriental medical rating scale reflected the patient's functional improvement after the treatment well.

• Research in Community and Public Health Nursing
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• v.22 no.3
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• pp.241-251
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• 2011

Purpose: This study was to develop and evaluate a health promotion program for women with osteoarthritis. Methods: The research adopted the nonequivalent control group pretest-posttest design. The subjects were 34 in the experimental group and 34 in the control group sampled among vulnerable women aged over 40. The independent variable was the health promotion program, and the dependent variables were perceived health status, balance, K-WOMAC, depression, life satisfaction and health promoting behavior. The health promotion program was performed for 50minutes each session, twice a week and for 8 weeks. Data were collected from July 1 to September 11, 2010. Results: The experimental group showed significant differences in perceived health status, balance, WOMAC pain, WOMAC difficulty of performing activity, depression, and health promoting behavior compared to the control group. There was no significant difference in WOMAC stiffness, waist, weight, and life-satisfaction. Conclusion: The results of this study suggest that the health promotion program can be applied in degenerative arthritis education to improve self-care.

• The Journal of Pediatrics of Korean Medicine
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• v.25 no.2
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• pp.27-38
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• 2011

Objectives: The purpose of this study is to demonstrate the therapeutic effect of oriental medical treatment on Hemophilic arthropathy. Methods: The patient was treated by Herb medicine, Acupuncture, Moxibustion, and Cupping. As a result, improvement in the ROM of joints was shown. ROM(Range of motion), Lequesne's functional index(LFI), WOMAC index and Visual analogue scale(VAS) were used to measure the progression. Results The ROM, LFI, WOMAC index and VAS were evaluated during admission. All scales improved; ROM of knee joint : $60^{\circ}$($105^{\circ}$ to $165^{\circ}$), ROM of ankle joint : $40^{\circ}$($20^{\circ}$ to $60^{\circ}$), LFI : 15 to 4, WOMAC index : 55 to 12 and VAS : 5.0 to 1.0. We also improved the patient's symptoms with oriental medical treatment. Conclusions: According to the results, oriental medical treatment is considered to be effective on Hemophilic arthropathy and further study is needed.

• Journal of Acupuncture Research
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• v.22 no.4
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• pp.35-45
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• 2005

Objectives : To investigate the applicability of thermography as severity measurement in the patients with osteoarthritis (OA) of the knee. Methods : Data were obtained from 80 patiens with OA of the knee. They were asked to answer two disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index. Lequesne's Functional Index (LFI)), one generic instrument (Korean Health Assessment Questionnaire (KHAQ)), VAS in order to assess the severity of disease, quality of life, and degree of pain and taken thermography in standardized environment. Results : The thermal difference between ipsilateral side and contralaterla side of lateral aspect of knee was correlated with that of medial aspect of knee, and the thermal difference of anterior thigh was correlated with that of lateral, medial aspect of knee and patella region. Age, duration of disease, duration of morning stiffness, sex, crepitus, and painful side of knee were not correlated with the thermal differences of each region. LFI, WOMAC, WOMAC pain subscale, WOMAC stiffness subscale, WOMAC physical function, KHAQ, VAS were not correlated with the thermal differences of each region. Conclusion : Futher study on the thermography on OA of the knee in population with appropriate severity grade and the standardization of analysis of thermographic data were recommended.

• The Korean Journal of Physiology and Pharmacology
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• v.13 no.1
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• pp.33-37
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• 2009

Anti-inflammatory factor(AIF) is a water soluble extract of three herbs, Panax notoginseng(Burk.) F. H. Chen, Rehmannia glutinosa Libosch and Eleutherococcus senticosus. The present study aimed to investigate the safety and efficacy of herb extracts, AIF, on Korean knee osteoarthritis patients for six weeks. Fifty seven patients with knee osteoarthritis, ranging from 43 to 73 years of age, who fulfilled the "American College of Rheumatology"(ACR) classification of idiopathic osteoarthritis of knee and radiographic criteria were randomly selected and enrolled for the study. After initial screening and resting period, two capsules each of AIF(Each capsule contains; 400 mg) and similar identical placebo were administered twice a day to both groups. Pain intensity at second, fourth, and sixth weeks of study as well as one week after discontinuation of drugs was assessed by using 100 mm visual analogue scale(VAS). Changes in the Korean version of the Western Ontario and McMaster Universities(K-WOMAC) index score were compared at the initiation and completion of the study. VAS assessed by patients were significantly reduced(at visit 2; $54.64{\pm}14.72$, at visit 4, $37.32{\pm}16.58$, p<0.001) after AIF administration. Results showed an improvement in the physical function of K-WOMAC scale which was significantly higher(p=0.013) in AIF than placebo group, and decreases of total K-WOMAC score were also significantly higher(p=0.030) in AIF groups than placebo group. No serious adverse effect was observed, and there was no difference in incidence of adverse effect between AIF and placebo groups. In this population of Korean patients with knee osteoarthritis, AIF was found to be safe, tolerable and effective for symptomatic improvement of pain and physical function.

• The Korea Journal of Herbology
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• v.30 no.3
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• pp.25-34
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• 2015

Objectives : This study was performed to investigate the efficacy and safety of the Mulberry Extract Complex in a placebo-controlled randomized clinical trial and animal study on degenerative arthritis. Methods : Animal study: Mulberry Extract Complex is composed of extracts of mulberry (Morus alba L.) fruit, mulberry leaves and black beans (Glycine max (L.) Merr.). To evaluate the serum level of interleukin-2, interferon-$\gamma$, and prostaglandin E2, an animal model of degenerative arthritis induced by monosodium iodoacetate was employed. Clinical study: The efficacy index (VAS, K-WOMAC) was compared among patients with symptoms of degenerative arthritis before and after Mulberry Extract Complex ingestion as well as the one in groups. Evaluations of the improvement by the subjects and by doctor assessment were also performed. Results : Animal study: Mulberry Extract Complex reduced the serum level of interferon-$\gamma$ and prostaglandin E2 in an animal model with degenerative arthritis. Clinical study: The VAS change showed statistical significance in the experimental groups after 4 weeks (PP set) and 8 weeks (ITT set) of ingestion. When the K-WOMAC was analyzed using a modified ITT set to determine the effectiveness, statistically significant results were obtained in the fields of pain & symptom within the Mulberry Extract Complex group as well as between the Mulberry Extract Complex and placebo groups after 8 weeks of ingestion. Results from the improvement evaluation by subjects and the assessment of improvement by doctors showed statistical significance in the experimental groups (PP set) after 8 weeks. Conclusions : Mulberry Extract Complex could be useful for the improvement of various symptoms of degenerative arthritis based on its anti-inflammatory activity and its reduction of VAS and K-WOMAC pain scores.