• Journal of muscle and joint health
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• v.18 no.2
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• pp.137-146
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• 2011

Purpose: The purpose of the study was to compare the effects of Tai Chi exercise program on arthritic pain, difficulties in performing activities of daily living, and fear of falling in women with osteoarthritis (OA) and rheumatoid arthritis (RA). Method: A quasi-experimental design with two intervention groups was used. According to the inclusion criteria, 35 women with OA and 22 with RA were recruited and participated in the Tai Chi for arthritis program for 12 weeks. In 12 weeks, 21 in the OA group and 15 in the RA group completed both pretest and posttest measures. Outcome variables consisted of pain, difficulties in performing activities of daily living, and fear of falling for both groups. Results: The women with OA (64 years) were significantly older and perceived better health than those with RA (49 years) with more than 6 years of diagnosis. The pain scores and the performance of activities of daily living were significantly improved in the OA group at the completion of 12 week Tai Chi exercise, but RA group decreased pain only. The improvements in pain and activities of daily living were significantly more in women with OA than those with RA. No significant changes were found in fear of falling for both groups. Conclusion: The 12 week Tai Chi exercise was more effective on pain and activities of daily living for women with OA than those with RA. Considering that the women with RA perceived more pain and had limited activities of daily living, Tai Chi exercise should be applied slowly and gradually for longer period of time than those with OA.

• Korean Journal of Clinical Pharmacy
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• v.8 no.1
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• pp.1-12
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• 1998

Rheumatoid arthritis (RA) is a common systemic inflammatory disease which DMARDS have been widely used as a treatment modality both as monotherapy and combination therapy Bucillamine, one of newer DMARDS, has recently proven its efficacy as monotherapy in the treatment of RA. The objective of this study was to compare the efficacy and the safety of bucillamine monotherapy and bucillamine plus methotrexate combination therapy in the treatment of rheumatoid arthritis. Forty-nine mild RA patients were enrolled in this prospective, open-trial and were assigned to receive bucillamine 200 mg/day (n=18) or bucillamine 200 mg/day and methotrexate 7.5-15 mg/week (n=31) orally for 16 weeks. Concomitant use of NSAID and prednisolone <5 mg/day or equivalent dose of steroid were allowed. Both monotherapy group and combination therapy group have shown significant improvement in disease activities (Ritchie index, painful joints, swollen joints, morning stiffness, grip strength, ESR, RF, CRP, patient's self assessment of pain, physician's global assessment of disease activity) from the baseline. However, there was no statistically significant difference between two groups. The adverse effects were more frequently shown in combination therapy group than monotherapy group. In conclusion, in patients with mild RA monotherapy has shown to be equally efficacious as combination therapy with less side effects.

• Journal of muscle and joint health
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• v.3 no.1
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• pp.23-36
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• 1996

This study was undertaken to evaluate the effect of long-term(6 Month) aquatic exercise through home nursing care demonstration on body weight, body fat, pain, muscle strength, self-efficacy and quality of life. Twenty-one women with rheumatoid arthritis were enrolled in the study. The sample was restricted to women in order to increase homogeneity. All patients were stable medication regimens in rheumatism center. The data was collected from October, 1994 to November, 1995. The data were analyzed Mean, Standard Deviation, $x^2$ Test, Mann-Whitney U-Wilcoxon Rank Sum W Test, Wilcoxon Matched-pairs signed-ranks test using SPSS $pc^+$ program. The results of this study were as follows : 1. There was no significant difference between the control and the experimental group on body weight. 2. There was no significant difference between the control and the experimental group on body fat. 3. There was no significant difference between the control and the experimental group on pain(RAI). 4. There was no significant difference between the control and the experimental group on muscle strength. 5. There was no significant difference between the control and the experimental group on quality of life. But in the experimental group, finding from additional analysis showed significant difference in the score of quality of life between pre and post experiment. 6. There was no significant difference between the control and the experimental group on self-efficacy. The findings in this study were not support the positive effect of long-term aquatic exercise in women with rheumatoid arthritis. A further study is necessary to determine the pure effect of aquatic exercise except the effect of home nursing care.

• Journal of muscle and joint health
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• v.5 no.2
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• pp.174-190
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• 1998

Osteoporosis has been known as a common complication of rheumatoid arthritis and a major preventable health problem. Lots of studios have demonstrated that changes in life style can help delay or prevent osteoporosis. Therefore nursing intervention related osteoporosis prevention have consisted of education programs aimed at changing dietary and exercise habit. However knowledge gained from education haven't always leaded to behavior change. Therefore it is important to consider other psychological variables in effecting behavior change. Numerous research have found self efficacy and health belief to be an important factor in individual decision making behavior. The purpose of the study was to develop health belief and efficacy expectation promoting program based on Health Belief Model & Self Efficacy Model and to investigate its effects in women with rheumatoid arthritis. For this purpose, one group pretest-post design was used. The subject of the study were 16 women with rheumatoid arthritis in Pusan city and data collection was carried out from April, 1997 to May, 1998. The intervention program was consisted of educating on osteoporosis and enhancing and reinforcing self efficacy by verbal persuasion during the period of 4 weeks. The instruments were used to collect data in this study were Osteoporosis Health Belief Scale, Osteoporosis Self Efficacy Scale, and Osteoporosis Preventive Behavior Scale. Data was analyzed by Wilcoxon signed rank test using SPSS $PC^+$ program. The results are as follows : 1) The behavior should be increased after intervention was supported(Z=-3.5162, p=.0004, diet : Z=-3.2942, p=.0010, exercise). 2) The sub-hypothesis that perceived sensitivity should be increased after intervention was supported (Z=-2.3854, p=.0171). 3) The sub-hypothesis that perceived severity should be increased after intervention was rejected(Z=-1.4327, p=.1520). 4) The sub-hypothesis that perceived benefit should be increased after intervention was supported(Z=-2.6410, p=.0083). 5) The sub-hypothesis that perceived barrier should be decreased after intervention was supported (Z=-2.4138, p=.0158). 6) The sub-hypothesis that efficacy expectation should be increased after intervention was supported(Z=-3.5162, p=.0004). As a conclusion, it was found that health belief and self efficacy promoting program was an effective nursing intervention for preventing osteoporosis of rheumatoid arthritis.

• Journal of muscle and joint health
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• v.7 no.1
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• pp.89-101
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• 2000

This study was carried out to compare the bone mineral density and risk factors of osteoporosis between normal and rheumatoid arthritis in postmenopausal women. Sixty-eight postmenopausal patients with rheumatoid arthritis(RA) were compared with 124 postmenopausal normal women. Data were collected from october, 1998 to April, 1999 at Dong-a university hospital in Pusan. From all subjects, individual characteristics such as age, body weight, height, age of menarche, duration of menopause, gravity, parity, and breast feeding period and factors of life style such as milk consumption, exercise, alcohol intake, cigarette smoking, coffee consumption were identified as influencing factors of osteoporosis by questionnaire. From RA patients, health assessment score, Ritchie articular index, erythrocyte sedimentation rate, C-reactive protein and steroid dosage were measured by rheumatologist on measuring bone mineral density. Bone mineral density was measured at the Lumbar spine, femoral neck, femur Ward's triangle, and femur trochanter using dual x-ray absorptiometry. The data was analyzed by using a frequency, t-test, Chi-square, ANCOVA with SPSS PC program. The results could be summarized as follows : 1) There was a significant difference in age and breast feeding period between RA patients and normal women. 2) RA patients took less calcium in the past and practiced less regular exercise in past and present than normal women. 3) There was no difference in lumbar bone mineral density between RA patients and normal women. 4) There was a significant difference in femur Ward's triangle and femur trochanter between RA patients and normal women after adjustment for age and breast feeding period. 5) The prevalence of osteoporosis of all subjects was the highest in femur Ward's triangle. In summary, our findings suggest that the bone mineral densities of femur Ward's triangle and trochanter in postmenopausal women with RA is significantly lower than normal women. Also the exercise participation rate of postmenopausal women with RA is lower than normal women. For the further study, we recommend to develop exercise program that improve the bone mineral density in femur Ward's triangle and trochanter and to test the effect of that exercise program.

• Journal of muscle and joint health
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• v.7 no.2
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• pp.294-308
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• 2000

This study was conducted to test the effect of brisk walking & muscle strengthening exercise program on bone mineral density(BMD) of the lumbar & femur in rheumatoid arthritis women. Research design was a quasi-experimental study of non-equivalent control group pretest-posttest design(16 weeks). 14 for the experimental group and 14 for the control group were selected from the outpatients on rheumatoid arthritis clinic of Dong-A University Hospital. The experimental group underwent 16 weeks of brisk walking and muscle strengthening exercise. Bone mineral density was measured before and after 16 weeks of exercise by DXA at lumbar spine, femoral neck, Ward's triangle and trochanter. The results were summarized as follows : 1. BMD of the lumbar spine in experimental group who carried out the brisk walking and muscle strengthening exercise was not significantly increased after 16weeks and there was no significant difference between experimental and control group(U=70.00 p>.05). 2. BMD of the femoral neck in the experimental group who carried out the brisk walking and muscle strengthening exercises was significantly increased after 16 weeks(Z=-2.901 p<.01). But, there was no significant difference between experimental and control group(U=83.00 p>.05). 3. BMD of the femoral Ward's triangle in the experimental group who carried out the brisk walking and muscle strengthening exercises was significantly increased after 16 weeks (Z=-2.355 p<.05). But, there was no significant difference between experimental and control group(U=86.00 p>.05). 4. BMD of the femoral trochanter in experimental group who carried out the brisk walking and muscle strengthening exercise was not significantly increased after 16weeks and there was no significant difference between experimental and control group(U=75.00 p>.05). These results suggest that brisk walking and muscle strengthening exercise program has an effect on promoting bone mineral density of femoral neck and Ward's triangle in rheumatoid arthritis women.

• Journal of muscle and joint health
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• v.11 no.2
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• pp.165-175
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• 2004

Purpose: To describe the psychosocial adaptation, physical disability and social support, and to examine whether the physical disability and social support influence the psychosocial adaptation of women with Rheumatoid Arthritis(RA). Method: This survey was conducted with 102 women diagnosed as RA using a structured survey tool between April 12th and 30th 2004. Results: The Physical disability ranged from 0 to 51, the average was 9.89(${\pm}12.15$), appearing that less severe than previous studies. The social support ranged from 29 to 168, and the average was 91.73(${\pm}31.44$). The age, marital status, and monthly income were associated with patient's perceived social support. The psychosocial adaptation ranged from 77 to 186 and the average was 132.12(${\pm}24.13$). Entering physical disability and social support into the model significantly improved the prediction of psychosocial adaptation: 45.1% of the variance of psychosocial adaptation was attributed by the physical disability (Beta=-.325) and the social support (Beta=.204). Additionally, the religion (Beta=.231) and monthly income (Beta=.381) were significant predictors of the psychosocial adaptation. Conclusions: (1) Programs to improve physical disability of the clients are needed. (2) Marital status and age should be considered when the programs are developed. (3) More social support should be provided to the women with RA. (4) Adequate financial support is essential for the psychosocial adaptation of women with RA.

• Nutrition Research and Practice
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• v.9 no.2
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• pp.186-191
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• 2015

BACKGROUND/OBJECTIVES: Rheumatoid arthritis (RA) is associated with an excess mortality from cardiovascular disease which is likely attributed to an atherogenic lipid profile. Among nutritional factors vitamin K has been recently focused as a pivotal nutrient in improvement of lipid related markers. Thus, this study was designed to determine the effects of vitamin K on lipid profile in this disease. SUBJECTS/METHODS: Fifty eight patients with definitive RA were participated in the present double blind placebo controlled study. They were randomly allocated into two groups to receive vitamin $K_1$ as phylloquinone [10 mg/day] (n = 30) or placebo pills (n = 28), for eight weeks. In order to control the effects of probable confounders dietary intakes, anthropometric measurements including weight and height, clinical status using disease activity score-28 (DAS-28), physical activity and anxiety status were evaluated at baseline. Moreover, serum levels of lipid related markers including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) were measured at baseline and at the end of intervention. RESULTS: There were no significant differences between the two groups regarding any of the baseline characteristics. After adjusting for some relevant confounders, in comparison between two groups, we observed no significant changes in lipid related markers at the end of intervention. Also, there was no significant difference between before and after intervention values within groups (P > 0.05). CONCLUSIONS: Function of vitamin $K_1$ in lipid profile modification remains still controversial. This study showed that vitamin $K_1$ has no effect on lipid profile in women with rheumatoid arthritis. Further studies with a longer follow-up are required to determine the effects of vitamin K on atherogenic lipid profile.

• The Korean Journal of Rehabilitation Nursing
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• v.2 no.2
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• pp.193-205
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• 1999

This study was carried out to identify the important risk factors for reduced bone mass of postmenopausal RA patients and to develop discriminant function which can classify postmenopausal RA patients with either reduced or normal bone mass. Through the literature review, individual characteristics such as age, body weight, height, age of menarche, duration of menopause, gravity, parity, and breast feeding period and factors of life style such as milk consumption exercise habit, alcohol intake, cigarette smoking, coffee consumpt ion , disease activity, corticosteroid therapy were identified as influencing factors of reduced bone mass in RA patients Sixty eight postmenopausal women with rheumatoid arthritis aged between 42 and 76 were selected among those who checked bone mineral density in lumbar spine and femur from october, 1998 to Apr il, 1999 at Dong-a university hospital in Pusan. Assessment of disease activity, duration of disease and corticosteroid therapy were made by the same rheumatologist and included Ritchie articular index, erythrocyte sedimentation rate, and C-reactive protein on measuring bone mineral density. Cumulative steroid dosage was calculated from the daily dosage multiplied by t h e number of days received. The information of other risk factor including health assessment score, individual characteristics and life style factors were collected by questionnaire. Bone mineral density(BMD) was measured using DXA at lumbar spine and femoral Ward's triangle. Discriminant function(regression equation) was developed for estimating the likelihood of the presence or absence of reduced bone mass. The results are as follows: Among the subjects, thirteen(19.1%) exhibited osteoporosis in lumbar spine and twenty four(35.3%) exhibited osteoporosis in femoral Ward's triangle. For lumbar spine, the variables significant were age, body weight, health assessment score, while for femoral Ward's triangle, age, body weight, duration of disease. But disease activity and corticosteroid therapy were not signigicant to distinguish reduced bone mass from normal bone mass. When the discriminant function was evaluated by comparing the observed out come with predicted out come, the discriminant function correctly classified 85.4% of patients with reduce bone mass and 63.0% of patients with normal bone mass in the lumbar spine and 100% of patients with reduced bone mass and 9.1% of patients with normal bone mass in the femoral Ward's triangle. In summary, we found that osteoporosis in postmenopausal women with RA is more evident at the femur than the lumbar spine. Also the important discriminant factors of reduced bone mass postmenopausal women with RA were age, body weight , duration of disease and health disability. In nursing situation, the efforts to improve of functional capacity of postmenopausal women with rheumatoid arthritis should be considered to prevent osteoporosis and fractures. Also we recommend those postmenopausal women with RA who are classified as a group of the reduced bone mass in the discriminant function should examine the bone mineral density to further examine the usefulness of this discriminant function.

• Journal of muscle and joint health
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• v.7 no.2
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• pp.269-280
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• 2000

This study was conducted to clarify the effect of physical ability, pain, fatigue, depression, sexual satisfaction, and spouse criticism on the sexual intrusiveness of rheumatoid arthritis(RA)women. The subjects of the study were 89 RA outpatients who visited the department of rheumatology of Dong-A University Hospital in Pusan from March 2000 to April, 2000. Pain & Fatigue via graphic rating scale, depression via CES-D(Center for Epidemiologic Studies -Depression) scale and physical ability via the Health Assessment questionnaire(HAQ) were assessed. Also we used both Sexual satisfaction scale(Kim, et al, 1997) to measure sexual satisfaction and Spouse criticism scale(Kraaimaat et al. 1996) to measure spouse criticism. The Intrusiveness rating scale which was derived from Arthritis Impact Measurement Scale(AIMS) was used to measure illness intrusiveness in sexuality. The relationships between the variables such as pain, depression, fatigue, physical ability, spouse criticism, sexual satisfaction and illness intrusiveness on sexuality were analyzed by Pearson correlation. As a result, pain & depression were significantly positively related to illness intrusiveness and physical ability & sexual satisfaction was significantly negatively related to illness intrusiveness. But these variables were interrelated. So hierarchical regression was performed to examine the relative contribution of pain, depression, physical ability, and sexual satisfaction with regard to intrusiveness of RA on sexuality. It revealed that pain, depression & sexual satisfaction predicted significantly illness intrusiveness on sexuality. Therefore it is very important to reduce pain and depression and to increase sexual satisfaction for reducing illness intrusiveness.