The Journal of Korean Academy of Orthopedic Manual Physical Therapy
/
v.7
no.1
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pp.5-28
/
2001
Objectives: The objective of this study was to investigate analysis of bone mineral density according to Women with low back pain women. Methods: The data were collected from women who visited Physical Examination Center of a Catholic university hospital located in Daegu. Questionnaires were completed by 50 women during the period from July 20, 2000 to January 12, 2001. The sample was divided into three groups(the normal group of 16 cases and the osteopenia group of 12cases and the osteoporosis group of 22 cases). Bone mineral density(BMD) of lumbar spine was measured using energy absorptiometry. Results: The bone mineral density of the lumbar spine decreased with aging. The bone mineral density of the lumbar spine decreased with the serum Calcium and Phosphorus and Alkaline phosphatase increased. The mean bone mineral density of the lumbar spine of healthy women in age(50~59) was 0.87g/$cm^2$, the lumbar spine of women with low back pain in age(50~59) was 0.77g/$cm^2$. In the multiple regression of risk factors to bone mineral density(BMD) of lumbar spine were correlated with age, marriage existence, exercise time, the loving food of taste, calcium, bone mineral density standard T scores(p<0.05). The experience for LBP increased as weight increased(Odds ratio=999.000). The experience for LBP increased as number of Exercise decreased(Odds ratio=999.000). The experience for LBP increased as menopause existence increased(Odds ratio=999.000). The experience for LBP increased as serum Calcium and Phosphorus increased (Odds ratio=999.000). however all four variables had significant no relationship. The correlation in variables in relation to low back pain and bone mineral density, age showed contra-correlation with low back pain existence, Alkaline phosphatase(p<0.01). Weight showed contra-correlation with body mass index(BMI)(p<0.01). Exercise time showed correlation with number of exercise(p<0.01). The loving food of taste showed contra-correlation with Alkaline phosphatase(p<0.05). Bone mineral density showed correlation with menopause existence(p<0.05). Conclusions: Results from this study indicated that a statistically significant association between bone mineral density of the lumbar spin and age, marriage existence, exercise time, the loving food of taste, calcium, bone mineral density standard T scores. In logistic regression test, there were no related variables. The combination of bone mineral density measurement and assessment of the bone turnover rate by measuring biochemical would be helpful for the treatment of patients with risks of osteoporosis. The more precise study for risk factors to osteoporosis is essential.
Journal of Physiology & Pathology in Korean Medicine
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v.25
no.4
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pp.669-673
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2011
To prevent and treat the osteoporotic fracture, more attention should be paid in old age patients. Osteoclast which has ability to bone resorption is originated from hematopoietic cell line and plays a key role osteoporotic bone loss. Rubi Fructus has been widely used in Oriental medicine. Extracts of the leaves and fruit of Rubus species have been used in various countries as natural remedies to treat diabetes, infections, colic, and burns. However, the effect of extract of Rubi Fructus (fruit of Rubus coreanus Miq.) in osteoclast differentiation remains unknown. Thus, we evaluated the effect of Rubi Fructus on receptor activator of nuclear factor-kB ligand (RANKL)-induced osteoclast differentiation. Here we found that Rubi Fructus significantly inhibited osteoclast differentiation induced by RANKL. Rubi Fructus suppressed the activation of p38 pathway and NFkB in bone marrow macrophages (BMMs) treated with RANKL. Also, Rubi Fructus significantly inhibited the mRNA expression of c-Fos, tartrate-resistant acid phosphatase (TRAP), osteoclast-associated receptor (OSCAR), nuclear factor of activated T cells (NFAT)c1 and cathepsin K in BMMs treated with RANKL. Particularly, Rubi Fructus greatly inhibited the protein expression of c-fos and NFATc1. especially in the case of NFATc1 expression, a master transcription factor of the differentiation of osteoclasts is very important step for osteoclastogenesis. Taken together, our results demonstrated that Rubi Fructus may be useful treatment option of bone-related disease such as osteoporosis and rheumatoid arthritis.
This study was peformed to assess the relationships among bone mineral density(BMD), nutrient intake and lifestyle factors in postmenopausal women. A trained nutritionist examined the interviewed usual dietary intake and physical activity of 85 subjects in Chungnam with a questionnaire interview, and BMDs of the lumbar spines($L_2-L_4$), femoral necks(FN), ward's triangles(WT) and trochanters(TR) were measured by dual energy X-ray absorptiometry (DEXA). The BMDs(T-score) of $L_2-L_4$, FN, and WT were $0.996g/cm^2(-1.601),\;0.697g/cm^2(-1.697)$, and $0.793g/cm^2(-1.512)$, respectively, which were assessed as osteopenia by T-score,. and TR was normal at $0.718g/cm^2(-0.675)$. Subjects included 85 in Chungnam were divided into three groups according to the BMD measurement of the $L_2-L_4$ and FN assessed by T-score. The percentages of the osteoporosis, osteopenia, and normal groups were $32.9\%,\;42.4\%$ and $24.7\%$ respectively. The average age was significantly the highest of the osteoporosis group than in the other two osteopenia or normal groups(P<0.001). Among lifestyle factors, the BMD of lifestyles was significantly related with exercise but it was not significant with medication., salt. intake, bone fracture, coffee consumption, drinking and smoking. The nutrient intake of the subjects was most nutrient intake adequate to the Korean RDA level for most nutrients excepting energy intakes and calcium. The BMD of lumbar spines $L_2-L_4$ showed significant positive association with the intake of most nutrients except carbohydrate, especially in the normal group. The Higher BMD levels were found for those with high intake of protein and vitamin B1. The BMDs of $L_2-L_4$, and FN were positively correlated with showed energy expenditure, exercise, miscellaneous activity, per weekend and week(P<0.05) in normal group but that was showed negatively correlated in the osteopenia group. Therefore, this study confirmed that one of the most effective ways to minimize bone less in postmenopausal women is to maintain an adequate intake of calcium and other nutrients and regular physical activity.
The Journal of Korean society of community based occupational therapy
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v.9
no.1
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pp.35-45
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2019
Objective : The purpose of this study was to investigate the factors influencing stroke in community-dwelling adults. Methods : This study used raw data from the community health survey in 2016. Among the 228,452 subjects who participated in the survey, 225,003 (98.5%) of them were included in the analysis of this study. The sociodemographic characteristics were selected as gender, age, region, income, marital status, and comorbidity was selected as osteoporosis, hypertension, diabetes, dyslipidemia, myocardial infarction and arthritis. Health-related quality of life was assessed by EuroQol-5 Dimension(EQ-5D) and the subcategory of EQ-5D (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) were included in the analysis. Dependent variables were stroke, and the independent variables were the 16 variables described above. Statistical analysis was performed using binomial logistic regression analysis. Results : In sociodemographic variables, stroke was predicted by men, aging, and lower income levels. In comorbidity variables, stroke was predicted by hypertension, diabetes mellitus, hyperlipidemia, and myocardial infarction. In sub-domains of health-related quality of life, stroke was predicted by self-care, usual activities, mobility, anxiety/depression, and pain/discomfort. Conclusion : These finding suggest that it is needed development of a customized health promotion program for the improvement of self-care and activities of daily living in community-dwelling stroke survivors.
There can be little dissension that the ultimate goal of all physical therapy interventions with the elderly is to restore or maintain the highest level of function possible for the individual. Whenever physical therapists take on this challenge, they assist elders in maintaining their identities as competent adults. Advancing age is associated with profound changes in body composition, including increased fat mass, decreased fat-free mass(particularly muscle), decreased total body water and decreased bone density. Along with these changes in body compositions, and perhaps as a direct result of them, elderly people have lower energy needs, reduced strength and functional capacity and a greatly increased risk for such diseases as noninsulin-dependent diabetes mellitus and osteoporosis. Resistance training is considered a promising intervention for reversing the loss of muscle function and the deterioration of muscle structure that is associated with advanced age. This reversal is thought to result in improvements in functional abilities and health status in the elderly by increasing muscle mass, strength and power and by increasing bone mineral density. In the past couple of decades, many studies have examined the effects of Resistance training on risk factors for age-related diseases or disabilities. We have explored the positive and negative aspects of older adults' participation in resistance training programs. The benefits to older adults are reported to be increased strength, endurance, muscle capacity, and flexibility; more energy; and improved self-image and confidence. The negative aspects include some pain or stiffness and other nonspecific problems. The positive and negative aspects of resistance training are therefore very similar to those in younger populations. Scientific investigations over the past 10 years have demonstrated that resistance training can be safely and successfully implemented in older populations. Even the frail and very sick elderly can benefit and improve their quality of life. Proper design and progression of a resistance training program for older adults is vital to optimal benefits from resistance exercise. The results of data provided by this research on resistance training for health shows that there is enough existing evidence to conclude that resistance training, particularly when incorporated into a comprehensive fitness program, can offer substantial health benefits which can be obtained by persons of all ages. These benefits, including improvements in functional capacity, translate into an improved quality of life.
Dental surgical procedures are potentially stress-inducing to not only patients but clinicians especially in case of medically compromised patients. The body response to dental stress involves the cardiovascular, respiratory and the endocrine system. To minimize the stress to the medically compromised patients, the stress reduction protocols should be established. The protocols include (1) Recognize the patient's degree of medical risk (2) Medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative, perioperative and postoperative vital signs (5) Intra-venous sedation during surgical procedures (6) Adequate pain control during therapy (7) Short length of appointment time (8) Contact the patients on the same day. Two cases of Bisphosphonate-related osteonecrosis of the jaws were analyzed. There were 2 women, and the mean age was 70 years (range, 64~74 years). both are medically compromised, with steroids. Both patients were taking an oral bisphosphonate for several years. BRONJ is defined as an area of exposed bone of more than 8 weeks - duration in a patient taking a bisphosphonate for bone disease. Bisphosphonates have been widely prescribed over the last decade for a range of bone diseases, mainly intravenously for bone cancers and orally for osteoporosis. Although it is still controversial as to precisely how the bisphosphonates work, generally it is accepted that they prevent osteoclast action, with consequent cessation of osteoblast activity, so that the bone turnover is markedly reduced or ceased. The aim of this study is to informed the clinicians how to prepare and recognize in case of the BRONJ with medically compromised patients.
Journal of Physiology & Pathology in Korean Medicine
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v.21
no.1
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pp.322-327
/
2007
The purpose of this study was to investigate the change of female's Bone Mineral Density after taking herbal medicine. We examined age, sex, marriage, alcohol, smoking, and job of 76 female and their life style related with Osteoporosis. Bone Mineral Density was examined after 1 month (one herbal medicine), 2 months (two herbal medicine), and 3 months (three herbal medicine) between Group I (taking pear extract) and Group II (taking herbal medicine). Bone Mineral Density of Group II after 1 month was increased, but insignificant. Bone Mineral Density was not significantly different between the Group I and Group II after 2 and 3 months. In this study, we can conclude that Bone Mineral Density was increased after 1 month of taking herbal medicine. But we had inaccurate results due to limitations of this study: period of test, accuracy of instrument, impossibility of use young antlers of the deer, and etc. More detailed study should be conducted to yield more concrete results.
BACKGROUND/OBJECTIVES: The nutrition of the elderly depends on various factors. Oral health, especially oral dryness, can be an important risk factor. In this study, we attempted to determine whether dry mouth is associated with compromised nutrient intakes. SUBJECTS/METHODS: A total of 120 participants aged 65-86 yrs (mean age: 69 ± 1 y) were included in this study. Demographic and health-related characteristics, living status, meals, number of medications, medical conditions, chewing ability, and quality of life, the Oral Health Impact Profile (the OHIP-14) were assessed. We performed one day 24-hr recall assessment for nutrient analyses. The differences of the means between the dry-mouth and non-dry-mouth groups were analyzed. Elderly subjects with xerostomia-induced dry mouth were classified as those who reported at least one dryness symptom on a questionnaire. RESULTS: A significant difference in population distribution was observed among the elderly who took medications for hypertension, diabetes and osteoporosis and was significantly higher in the dry-mouth group (70.2%) than in the non-dry-mouth group (44.4%) (P = 0.005). Compared with the non-dry-mouth group (50.8%), a significantly higher proportion (73.7%) of participants in the dry-mouth group took multiple medicines (≥ 4 medications) (P = 0.019). The intakes of vegetable fat, vitamin E, folate and water in the dry-mouth group were lower than in the non-dry-mouth group. The intakes of fluoride and ω-3 fatty acids were significantly lower in the dry-mouth group than in the non-dry-mouth group. CONCLUSION: The participants in the dry-mouth group exhibited low nutrient and water intakes. It is recommended that the elderly with dry mouth should drink sufficient water and receive targeted and specific nutritional guidance to prevent malnutrition.
Kim, Hyeun-Sung;Park, In-Ho;Ryu, Jae-Kwang;Kim, Seok-Won;Shin, Ho
Journal of Korean Neurosurgical Society
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v.42
no.1
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pp.6-10
/
2007
Objective : The purpose of this study was to determine the effect of bone cement augmentation of pedicular screwing in severe osteoporotic spondylolisthetic patients. Methods : Twenty patients with spondylolisthesis (8 : spondylolytic spondylolisthesis 12 : degenerative spondylolisthesis) who had undergone pedicular screwing and interbody fusion for osteoporotic lumbar spine (T-score on bone mineral density<-3.0) from 2002 to 2005 were reviewed. Mean age was 62.3 years with 3 male and 17 female patients. Average follow-up period was 14 months. Average T-score on bone mineral density (BMD) was -3.62. After decompression of neural elements, about 6cc of polymethylmethacrylate (PMMA) was injected into the each vertebral body through transpedicular route. All patients underwent one level interbody fusion and pedicular screw fixation. Clinical outcome was assessed using Oswestry Disability Index (ODI) on the last clinical follow-up. In addition, a modified MacNab's grading criteria was used to objectively assess patient's outcome postoperatively. Radiographic analysis of sagittal contour was assessed preoperatively, immediately postoperatively, and at final follow-up including fusion rate. Results : Eighteen of 20 patients were graded as excellent or good according to the modified MacNab's criteria. An significant improvement of ODI was achieved in both groups. Mean sagittal angle at the preoperative state, postoperative state and at the last follow-up state was $11.0^{\circ},\;20.1^{\circ}$ and $18.3^{\circ}$, respectively, with mean sagittal angle correction gain $7.3^{\circ}$. Firm fusion was achieved in all patients. There were one compression fracture above the fused segment after 6 months follow-up and one case of seroma. But there were no postoperative complications related to bone cement leakage and pedicular screwings such as screw pullout or screw cut-up. Conclusion : Bone cement augmentation of pedicular screwing can be an effective procedure for osteoporotic lumbar spine in spondylolisthetic patients.
Kim, Do Keun;Kim, Ji Yong;Kim, Do Yeon;Rhim, Seung Chul;Yoon, Seung Hwan
Journal of Korean Neurosurgical Society
/
v.60
no.2
/
pp.174-180
/
2017
Objective : Proximal junctional kyphosis (PJK) is radiologic finding, and is defined as kyphosis of >$10^{\circ}$ at the proximal end of a construct. The aim of this study is to identify factors associated with PJK after segmental spinal instrumented fusion in adults with spinal deformity with a minimum follow-up of 2 years. Methods : A total of 49 cases of adult spinal deformity treated by segmental spinal instrumented fusion at two university hospitals from 2004 to 2011 were enrolled in this study. All enrolled cases included at least 4 or more levels from L5 or the sacral level. The patients were divided into two groups based on the presence of PJK during follow-up, and these two groups were compared to identify factors related to PJK. Results : PJK was observed in 16 of the 49 cases. Age, sex and mean follow-up duration were not statistically different between two groups. However, mean bone marrow density (BMD) and mean back muscle volume at the T10 to L2 level was significantly lower in the PJK group. Preoperatively, the distance between the C7 plumb line and uppermost instrumented vertebra (UIV) were no different in the two groups, but at final follow-up a significant intergroup difference was observed. Interestingly, spinal instrumentation factors, such as, receipt of a revision operation, the use of a cross-link, and screw fracture were no different in the two groups at final follow-up. Conclusion : Preoperative BMD, sagittal imbalance at UIV, and thoracolumbar muscle volume were found to be strongly associated with the presence of PJK.
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