• The Journal of Korean Physical Therapy
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• v.31 no.5
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• pp.317-321
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• 2019

Purpose: To identify the effect of knee joint traction therapy on pain, physical function, and depression in patients with degenerative arthritis. Methods: In total, 30 patients with degenerative arthritis were randomly assigned to one of two groups: the experimental group, who underwent knee joint traction therapy, and the control group, who underwent general physical therapy (15 patients per group). Pain was measured using the visual analogue scale (VAS), physical function was measured using the Western ontario and McMaster universities osteoarthritis (WOMAC) index, and depression was measured using the Beck depression inventory (BDI). The VAS, WOMAC score, and BDI score were recorded before and after the 4-week treatment. Results: As a result of comparison within groups, the experimental and control group showed significant difference for VAS, WOMAC and BDI after the experiment (p<0.05). In comparison between the two groups, the experimental group in which knee joint traction was applied showed more significant change in VAS, WOMAC and BDI than the control group (p<0.05). Conclusion: This study showed that knee joint traction therapy was effective in improving pain, physical function, and depression in patients with degenerative arthritis.

• Journal of Korean Medicine Rehabilitation
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• v.27 no.3
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• pp.137-146
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• 2017

Objectives The purpose of this study is to compare the effects between the KL-Grade and improvement of knee pain treated by Korean Medicine therapy. Methods 114 patients who received inpatient treatment from July 2014 to May 2017 in the Daejeon Jaseng of Korean Medicine Hospital were divided into 5 groups by the KL-Grade. All patients received a combination of treatment including acupunture, pharmacopunture, herbal medication. They were compared and analyzed on the basis of improvement between measuring Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index), EuroQol-5 Dimension Index (EQ-5D Index) as they were hospitalized and as they were discharged. The statistically significance was evaluated by SPSS 23.0 for windows. Results After treatment, KL-Grade 0 group's Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index), EuroQol-5 Dimension Index (EQ-5D Index) improvement was $2.02{\pm}1.69$, $7.50{\pm}9.67$ and $0.11{\pm}0.15$ respectively. KL-Grade 1 group's improvement was $2.09{\pm}1.23$, $11.75{\pm}13.99$ and $0.12{\pm}0.13$ respectively. KL-Grade 2 group's improvement was $1.60{\pm}1.07$ and $14.70{\pm}14.19$ respectively. But In this group, EQ-5D Index has decreased by $0.01{\pm}0.10$. KL-Grade 3 group's improvement was $1.88{\pm}1.31$, $7.81{\pm}13.35$ and $0.13{\pm}0.20$ respectively (p<0.034). In the case of KL-Grade 4, the population was not statistically significant (N=2) and therefore excluded from statistical significance. And there was no statistically significance between 4 group's improvement after treatment (p>0.05). Conclusions The above study showed that Korean medicine treatments showed significant therapeutic effects on knee pain and degenerative knee joints, but there was no significant difference in the effectiveness of degenerative arthritis (KL-Grade).

• 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.

• Journal of Physiology & Pathology in Korean Medicine
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• v.36 no.6
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• pp.247-251
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• 2022

This study is to show the clinical effect of Korean medicine integrated treatment for medial collateral ligament tear with bone contusion by traffic accident. The patients were treated using Korean medicine integrated treatment including acupunture, pharmacoacupunture and herbal medication. The effect of treatment was measured by Western Ontario and McMaster Universities Arthritis Index (WOMAC), EuroQol-5 Dimension Index (EQ-5D) and Numeric Rating Scale (NRS). After treatment, case 1 improved WOMAC from 94 to 24, EQ-5D from -0.056 to 0.72, and NRS from 10 to 2. Case 2 showed an improvement in symptoms from WOMAC 91 to 14, EQ-5D from 0.077 to 0.862, NRS from 10 to 2.5. In addition, as a result of follow-up about 5 months after each onset, case 1 showed a further improvement with WOMAC 0, EQ-5D 0.95 and case 2 WOMAC 7, EQ-5D 0.913. These results suggest that Korean medicine integrated treatment might be a possible therapeutic option for the medial collateral ligament tear with bone contusion by traffic accident.

• Journal of Acupuncture Research
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• v.27 no.2
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• pp.123-142
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• 2010

Objectives : The knee pain is the main reason of getting acupuncture treatment. In order to have confidence in the results of a study, it is necessary to establish that questionnaire is both valid and reliable in questionnaire related study. The aim of this study was to review the instruments that are currently in sue for assessing the knee joint. Methods : A literature study was performed to choose appropriate scales for assessment for pain and the function of the knee. Theoretically based scales were selected for review. Therefore, 18 scales for knee and 9 scale for pain were reviewed. the status of scales involved in knee treatment of acupuncture throughout several countries was evaluated. Results & Conclusion : Lysholm Knee Scoring Scale, Cincinnati knee rating system(CKRS) are adequate for ligament injury in knee. International Knee Documentation Committee scoring system(IKDC) may become a publication requirement for journals in view of the international standing of the committee. The available outcome measure for use in osteoarthritis are Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC), Lequesne Functional Severity Index(LFI) and Knee Injury and Osteoarthritis Outcome Score(KOOS), and in rheumatoid arthritis are McMaster-Toronto Arthritis patient function preference questionnaire(MACTAR), Quality of Life-Rheumatoid Arthritis Scale(QoL-RA Scale). Visual analog scale(VAS), verbal rating scale(VRS) are commonly used for the standard pain scale. For long term follow-up study The Medical Outcomes Study Short Form-36(SF-36), Arthritis Impact Measurement Scales(AIMS), Health Assessment Questionnaire(HAQ) should be included. Each measurement has its own composition and characteristics. Their validity, reliability, responsiveness and practical characteristics were already evaluated. We found 20 domestic and 28 overseas papers about knee treatment using acupuncture assessed with knee scales.

• Journal of Korean Medicine Rehabilitation
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• v.28 no.4
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• pp.71-79
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• 2018

Objectives The aim of this study is to observe the effectiveness of complex Korean medicine treatment applied to the patients with degenerative meniscal tear and the correlation among clinical effectiveness, body mass index (BMI) and Kellgren-Lawrence grade (KL-grade). Methods The study participants were 38 patients who had been diagnosed with degenerative meniscal tear. Participants were classified by BMI, KL-grade and treated with acupuncture, electroacupuncture and pharmacopuncture. Clinical outcomes were assessed using Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index) and EuroQol-5 Dimension Index (EQ-5D Index). Results Both NRS and WOMAC scores were significantly reduced after treatment (p<0.001). The EQ-5D for assessing quality of life showed further improvement (p<0.05). A statistically significant correlation was observed between the BMI and NRS, EQ-5D. KL-grade was correlated with WOMAC. Conclusions These results show that complex Korean medicine treatment to the patient with degenerative meniscal tear may be effective as a conservative therapy. Further research is required to confirm the effectiveness of Korean medicine treatment.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.11 no.1
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• pp.65-74
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• 2016

Objectives : This study was designed to assess the general distribution, clinical effectiveness of Korean medical treatment on knee pain and the correlation between Korean medical therapy on knee pain and BMI. Methods : This is an observational study. 65 patients admitted to Daejeon Jaseng Hospital of Korean Medicine with musculoskeletal disorders were observed from July, 2014 to July, 2015. They were analyzed according to sex, age, pain lesion, body mass index(BMI) and treatment efficacy. All patients received a combination of treatments during hospitalization, including acupuncture, pharmacopuncture, herbal medicines and physical therapy. A zero to ten numerating rating scale (NRS) assessing pain, Western Ontario and McMaster Universities Arthritis Index(WOMAC) index and Range of Motion(ROM) was used before and after treatments. Statistical correlations among assessment measurements were evaluated by examining the paired t-test and the Pearson's correlation coefficients. Results : The average BMI of all patients was $24.03{\pm}2.95kg/m^2$. According to clinical definition of obesity by Korean Society for the Study of Obesity, 33.8% of all patients was within normal weight, 1.5% was underweight, 33.8% was overweight, 24.6% was obesity and 6.2% was morbid obesity. For knee pain patients, NRS (Numeric Rating Scale) decreased from $6.28{\pm}1.63$ to $3.94{\pm}2.03$(p<0.001). WOMAC index decreased from $48.14{\pm}17.63$ to $40.37{\pm}18.28$(p<0.001). But, there were no significant correlations in statistics among BMI, knee pain index and knee pain index improvement. Conclusions : Korean medical combination treatment might be effective in reducing pain and improving functional disorders for patients with knee pain. This study further confirmed the efficacy of Korean medical treatment on knee pain. But, more studies on correlation between knee pain and obesity and development of assessment measurement are needed.

• Journal of Korean Medicine Rehabilitation
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• v.28 no.1
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• pp.175-184
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• 2018

The purpose of this study is to report the effectiveness of complex Korean Medicine treatment for anterior cruciate ligament (ACL) injuries with meniscus tear. Four patients were treated with complex Korean Medicine by acupuncture, pharmacopuncture and herbal medication. We evaluated the improvement of knee pain and function by Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index), EuroQol-5 Dimension Index (EQ-5D Index). After treatment, we found that knee pain was reduced and joint function was improved by NRS and WOMAC index in all cases. In the evaluation of health-related quality of life through EQ-5D index, there was no significant difference in patients with degenerative knee osteoarthritis and severe meniscal injury. This results show that complex Korean Medicine may be an effective option for ACL injuries with meniscus tear. Further clinical studies are needed to clarify the effect of Korean Medicine therapy on ACL injuries with meniscus tear.

• Korean Journal of Acupuncture
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• v.30 no.1
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• pp.64-72
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• 2013

Objectives : The aim of this study was to investigate whether warm-needling is more effective than acupuncture in relieving the pain and improving the symptoms of knee osteoarthritis(OA). Methods : 76 volunteers with knee OA participated in the study. The subjects were randomly assigned to one of two groups. One group received warm-needling(n=38), while the other group received acupuncture(n=38). Sixteen sessions of warm-needling or acupuncture were conducted on the pain region of each problematic knee over a period of 8 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) scores, physical health score based on the 36-Item Short-Form Health Survey(SF-36) and the Global Assessment(PGA) was measured. Results : Compared to the acupuncture group, the warm-needling group showed a significant decrease in pain, function, and total WOMAC scores according to the Mann-Whitney U-test. The PGA scores of the warm-needling group also showed a significant improvement compared to the acupuncture group. Conclusions : Warm-needling showed a greater pain relief effect on knee OA compared to the acupuncture group. These findings suggest that warm-needling may be a promising alternative therapy for treating knee OA.

• Physical Therapy Rehabilitation Science
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• v.8 no.1
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• pp.8-14
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• 2019

Objective: Degenerative knee arthritis is the most common disease that occurs in older people. Constriction-induced movement therapy (CIMT) has been reported to be as an effective treatment for the impairments, such as asymmetric weight-bearing and reduced balance that occurs after receiving a total knee replacement (TKR). Game-based rehabilitation training for persons with TKR is interesting and provides a variety of feedback. Design: Randomized controlled trial. Methods: Thirty-six subjects with TKR were randomly assigned to either the CIMT game training (n=12), general game training (n=12), or the control (n=12) group. Each group underwent twelve sessions (30 min/d, 3 d/wk for 4 weeks). In the CIMT game training group, the application of CIMT adjusted the weight of the pressure delivered from the two boards used in Wii games. In the general game training group, the game was played without adjusting the weight of pressure. The game training used the Wii Fit's Ski Slalom application. Subjects were assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Activities-specific Balance Confidence (ABC) Scale. Results: All three groups showed significant improvements in pain, stiffness and physical function, total WOMAC scores, and ABC scores after the intervention (p<0.05). Significant differences were observed in physical function, total WOMAC scores, and ABC scores of the CIMT game training group compared with the other groups (p<0.05). Conclusions: The CIMT game training and general game training exhibited improvements on stiffness, but the CIMT game training exhibited a larger effect on lower extremity function and balance confidence levels.