• 제목/요약/키워드: Knee OA

검색결과 95건 처리시간 0.025초

퇴행성 슬관절염 환자 평가 설문도구의 내적 신뢰도, 상관성에 관한 연구 (The Study about Internal Reliability and Correlation among Assessment Instruments of Knee OA)

  • 류성룡;안경애;서병관;강중원;이상훈;이재동;최도영;김건식;이두익;이윤호
    • Journal of Acupuncture Research
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    • 제22권3호
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    • pp.271-280
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    • 2005
  • 2005년 1월 1일부터 3월 1일 까지 신문과 방송 그리고 경희의료원 홈페이지를 통해 모집된 퇴행성 슬관절염 핀자에 VAS, LFI, WOMAC, KHAQ 의 설문을 시행하여 다음과 같은 결론을 얻었다. 1. LFI, WOMAC Pain Subscale, WOMAC Function Subscale, WOMAC Total Score, KHAQ 모두 Cronbach`s alpha가 0.70이상 (p=.000)으로 내적 신뢰도가 높았다. WOMAC Stiffness Subscle 만이 Cronbach`s alpha가 0.6679(p=.000)이나 이는 문항수가 작기 때문이다. 2. LFI, WOMAC 각 항목, WOMAC Total Score, KHAQ는 모두 Pearson correlation coefficient가 0.612(p=.000)이상으로 높은 상관성을 보였으며, 이중 LFI와 WOMAC Pain Subscale의 상관관계가 비교적 높았다. 이는 통증이 관전기능에 큰 영향을 미치며, 관절염 증상의 악화는 곧 삶의 질에 큰 영향을 미친다는 것을 의미한다. 3. 관절염에 의한 통증, 강직, 관절기능의 제한은 환자의 삶의 질에 큰 영향을 미치게 되므로 관절염의 치료는 통증조절 등의 대증요법이외에 환자의 삶의 질에 초점을 두어야 하고 이를 위해 적절한 설문도구를 활용이 필요하다.

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Report of the 3rd Japan-Korea Workshop on Acupuncture and EBM;Protocol development for the acupuncture trial on the osteoarthritis of the knee

  • Jang, Jun-Hyouk;Kenji, Kawakita;Hahn, Seo-Kyung;Park, Hi-Joon;Lee, Seung-Deok;Kim, Yong-Suk;Norihito, Takahashi;Toshiyuki, Shichidou;Kazunori, Itoh;Eiji, Sumiya;Eiji, Furuya;Hitoshi, Yamashita;Hiroshi, Tsukayama
    • Journal of Acupuncture Research
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    • 제23권6호
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    • pp.239-254
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    • 2006
  • The 3rd Japan-Korea Workshop on Acupuncture and EBM was held at Kanazawa on June $16^{th}$. From Korea team, 4 papers were presented. Dr. Hahn introduced a new approach of data analysis on series of n-of-1 trials using the Bayesian statistics. It offered important information for the future n-of-1 trials. Dr. Park clearly demonstrated the significance of various sham devices proposed and stressed the importance of research questions when we choose the control intervention in RCT. Dr. Lee reported the results of survey in Korean Medical Doctors (KMD) for their point selection and techniques to the distal and local points. Dr. Kim presented the results of face to face survey on the KMD with 28 items for acupuncture treatment on the knee OA. Finally, a draft of protocol was introduced by Dr. Kim. The title was "multi-center, a randomized, single blinded, two arms, parallel-group study to compare the effectiveness and safety of 'individualized acupuncture' and 'standardized minimal acupuncture' in Korean and Japanese patients with knee osteoarthritis (Phase IV)". From Japan team, 7 speakers presented their comments and proposals on the protocol. Dr. Takahashi introduced several issues regarding n-of-1 trials and pointed out the importance of obtaining generalizability from n-of-1 trials. Dr. Shichidou pointed the importance of research design, selection of outcome measures and reduction of biases. Dr. Itoh presented the results of point selection for the knee OA based on the literature survey. Dr. Sumiya introduced several differences between KMD and Japanese acupuncturists based on the questionnaire used in KMD survey. Dr. Furuya demonstrated a result of press tack needle and its sham device on shoulder stiffness. Dr. Yamashita introduced the results of literature survey regarding adverse events occurred by acupuncture on knee OA. Dr.Tsukayama stressed the importance of responsibility of Institutional Review Board (IRB) for the conduction of clinical trials. After several issues were discussed, the need of continued meeting for final protocol development was agreed, then the workshop was closed.

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퇴행성 슬관절염에서의 온침과 침의 효능 비교 연구 (Comparison of Warm-Needling and Acupuncture for Knee Osteoarthritis: A Randomized Controlled Trial)

  • 민웅기;여수정;김이화;송호섭;구성태;이재동;임사비나
    • Korean Journal of Acupuncture
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    • 제30권1호
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    • pp.64-72
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    • 2013
  • 목적 : 본 연구는 퇴행성 슬관절염 환자의 통증을 줄이고 증상을 개선하는데 있어 현재 침구임상에서 활용되고 있는 온침이 침보다 더욱 유효한지를 알아보기 위하여 임상연구로 시행되었다. 방법 : 총 76명의 퇴행성 슬관절염 지원자가 연구에 참가하였으며, 이들 모두는 선정기준과 제외기준에 의하여 선발되었고 최종적으로 임상연구를 마친 지원자는 66명이었다. 지원자들은 무작위로 온침군과 침군 중에 할당이 되었다. 실험군(온침)에 속한 38명은 온침시술을, 대조군(침)에 속한 38명은 침시술을 받았으며, 8주 동안 총 16회의 시술을 환측의 무릎에 시행하였다. 주된 평가척도는 Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)이었고, 부수적 평가척도는 physical health score based on the 36-Item Short-Form Health Survey(SF-36), Patient Global Assessment이었다. 결과 : 실험군이 대조군에 비해서 WOMAC의 pain, function, total score와 Patient Global Assessment에서 월등한 감소를 나타내었으나 SF-36에서는 유의한 변화가 없었다. 결론 : 이번 연구의 결과를 통해 온침이 침에 비하여 퇴행성 슬관절염 환자의 통증 감소와 기능개선에 유의성있게 효과가 있음을 확인하였다.

내반슬 골관절염 환자에 대한 밀착형 외측 쐐기 스트랩 발받침이 한국형 WOMAC에 미치는 영향에 관한 연구 (Study on Effect of KWOMAC of a Contact Lateral-Wedged Insole with Strapping in Patients with Varus Deformity Osteoarthritis of the Knee)

  • 이상용;공원태
    • 대한정형도수물리치료학회지
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    • 제13권1호
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    • pp.26-35
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    • 2007
  • The purpose are to demonstrate the pain, stiffness, and physical function by the Korean Western Ontario MacMaster University(KWOMAC) score of the patients with varus deformity osteoarthritis of the knee after treatment period. Twenty outpatients with knee osteoarthritis(OA) were randomized and divided into the control(n=10) and wedge(n=10) groups. The remission scores of the KWOMAC index of severity for knee OA were compared between the groups. The result of repeated two-way ANOVA's revealed that a contact lateral-wedged insole with strapping produced significantly differences in the pain and physical function score between groups after treatment period(P<0.05), but it was not significant differences in the stiffness score between groups(P>0.05). These results suggest that the pain relief and improvement in function reported by patients with osteoarthritis while using lateral-wedged insole with strapping may be achieved by a reduction in external varus moment and medial compartment load.

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Endochondral Ossification Signals in Cartilage Degradation During Osteoarthritis Progression in Experimental Mouse Models

  • Kawaguchi, Hiroshi
    • Molecules and Cells
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    • 제25권1호
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    • pp.1-6
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    • 2008
  • Osteoarthritis (OA), one of the most common skeletal disorders characterized by cartilage degradation and osteophyte formation in joints, is induced by accumulated mechanical stress; however, little is known about the underlying molecular mechanism. Several experimental OA models in mice by producing instability in the knee joints have been developed to apply approaches from mouse genetics. Although proteinases like matrix metalloproteinases and aggrecanases have now been proven to be the principal initiators of OA progression, clinical trials of proteinase inhibitors have not been successful for the treatment, turning the interest of researchers to the upstream signals of proteinase induction. These signals include undegraded and fragmented matrix proteins like type II collagen or fibronection that affects chondrocytes through distinct receptors. Another signal is proinflammatory factors that are produced by chondrocytes and synovial cells; however, recent studies that used mouse OA models in knockout mice did not support that these factors have a role in the central contribution to OA development. Our mouse genetic approaches found that the induction of a transcriptional activator Runx2 in chondrocytes under mechanical stress contributes to the pathogenesis of OA through chondrocyte hypertrophy. In addition, chondrocyte apoptosis has recently been identified as being involved in OA progression. We hereby propose that these endochondral ossification signals may be important for the OA progression, suggesting that the related molecules can clinically be therapeutic targets of this disease.

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

  • 이병찬;김아란;김은경;김선정;김상준
    • Clinical Pain
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    • 제19권1호
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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.

MIA로 유발된 골관절염 동물모델에서 산수유 추출물의 골관절염 개선 효과 (Protective Effect of Corni Fructus Extracts on MIA-induced Animal Model of Osteoarthritis: Effect of Corni Fructus Extracts on OA)

  • 백경민;안유민;신미래;김민주;이진아;노성수
    • 대한한방내과학회지
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    • 제41권1호
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    • pp.1-13
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    • 2020
  • Objectives: Osteoarthritis (OA) is a chronic and degenerative joint disease characterized by progressive degeneration of articular cartilage. Inflammation is a recognized and important factor of OA progression. The present study was designed to investigate the protective effect of Corni Fructus water extract (CFW) on a monosodium iodoacetate (MIA)-induced rat model of OA. Methods: Osteoarthritis was induced by injection of MIA (50 µL; 80 mg/mL) into the knee joint cavity of rats. After an adaptation period for seven days, the rats were divided into 4 groups (n=8/group): normal, control, indomethacin-treated (5 mg/kg), and CFW-treated (200 mg/kg) groups. The rats were treated orally for 14 days. Pain was evaluated by determining hind paw weight distribution. For biochemical analyses, we measured the changes in reactive oxygen species (ROS) and peroxynitrite (ONOO-) in the knee joint. The presence of anti-oxidant proteins and inflammatory proteins was determined by western blotting. Results: The administration of CFW significantly improved the hind paw weight distribution. The ROS and ONOO- levels of knee joint were significantly decreased in the CFW group. CFW inhibited the production of inflammatory mediators, such as COX-2, and inflammatory cytokines, including IL-6 and IL-1β, via the NF-κB signaling pathway. The expression of anti-oxidant enzymes, such as catalase and GPx-1/2 also increased significantly. Conclusions: The findings indicate that CFW has a therapeutic and protective effect on OA by suppression of inflammation. Therefore, CFW could represent a potential and effective candidate for OA treatment.

무릎관절 골관절염이 있는 개에서 침술 적용 효과에 대한 역학적 보행분석 1례 (Kinetic Gait Analysis of a Dog with Knee Osteoarthiritis Treated with Acupuncture)

  • 김순영;정성목;서강문;남치주
    • 한국임상수의학회지
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    • 제20권4호
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    • pp.504-507
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    • 2003
  • Force plate analysis was used to describe the effect of acupuncture on right knee osteoarthritis (OA) in a seven-year-old hound breed dog weighing 27 kg. The acupuncture treatment was performed twice a week for 3 weeks. Ground reaction forces (GRFs) and subjective clinical scores in both hind limbs were obtained prior to and 72 hours after each treatment. Right vertical peak force was increased as the dog was acupunctured. Although their sensitivity was lower than that of the GRF data, the subjective clinical scores reflected an improvement. In addition, vertical peak force of normal left hind limb was also increased during this trial. These results indicate that gait analysis may be valuable objective method in future evaluation of acupuncture for OA of the stifle joint.

퇴행성 관절질환을 동반한 비만환자의 운동프로그램 개발에 대한 연구 (A Development of Exercise Program on Obese patients with Osteoarthritis)

  • 임형호;송윤경
    • 한방비만학회지
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    • 제3권1호
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    • pp.17-24
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    • 2003
  • Obesity increases the risk of knee and to a lesser extent hip OA, which combined affect a large percentage of middle-aged and elderly adults and which are major source of disability, and factor of drop a lowering in the physical exercise ability. Energy expenditure from physical activity accounts for up to 30% of total energy expenditure, it can have a significant impact on energy balance. We studied a exercise therapy that improved long-term weight management and produced additional benefits - loss of joint pain, improved joint mobility, and this exercise program will enhance the weight loss and health benefits from physical activity in the treatment of obese patients with osteoarthritis.

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보존적 물리치료가 퇴행성 슬관절염 환자의 균형 능력에 미치는 영향 (Effect on Balance Ability of Knee Osteoarthritis by modality)

  • 정현성;배성수;전호영
    • 대한물리의학회지
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    • 제1권1호
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    • pp.67-75
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    • 2006
  • Purpose : The main purpose of this study was to investigate the effect on Balance Ability of Knee Osteoarthritis(OA) by modality. Methods : The subjects were consisted of 30 women patients with knee OA. All subjects were randomly assigned to modality group. Each group had a treatment for 45 minutes per day and three times a week during 8 weeks period. Was used to measure recovery or worse of patient's condition, muscle assessment questionnaire(MAQ) was used to measure patient's muscular strength, Endurance, coordination/balance, KWOMAC was used to pain, stiffness, and physical function, and BPM was used to measure velocity, anterior-posterior. Results : This study results in following conclusions. 1. MAQ score was significantly decreased in modality group(p<.05). 2. KWOMAC score was significantly decreased in modality group(p<.05). 3. BPM were score was significantly decreased in modality group(p<.05). Conclusions : From this result the modality treatment retrogression characteristic will be effective in treatment of patient.

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