• Title/Summary/Keyword: WOMAC Index

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Effects of game-based balance training with constraint-induced movement therapy on lower extremity function and balance confidence levels in women with total knee replacement

  • Choi, Ho-Suk;Shin, Won-Seob
    • 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.

Comparison of ultrasound guided pulsed radiofrequency of genicular nerve with local anesthetic and steroid block for management of osteoarthritis knee pain

  • Ghai, Babita;Kumar, Muthu;Makkar, Jeetinder Kaur;Goni, Vijay
    • The Korean Journal of Pain
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    • v.35 no.2
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    • pp.183-190
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    • 2022
  • Background: To compare ultrasound-guided pulsed radiofrequency (PRF) of the genicular nerve with the genicular nerve block using local anesthetic and steroid for management of osteoarthritis (OA) knee pain. Methods: Thirty patients with OA knee were randomly allocated to receive either ultrasound-guided PRF of the genicular nerve (PRF group) or nerve block with bupivacaine and methylprednisolone acetate (local anesthetic steroid [LAS] group). Verbal numeric rating scale (VNRS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scores were measured at pre-procedure and 1-, 4-, and 12-weeks post-procedure. Results: VNRS scores decreased significantly (P < 0.001) in both the groups at 12 weeks and other follow up times compared to baseline. Seventy-three percent of patients in the PRF group and 66% in the LAS group achieved effective pain relief (≥ 50% pain reduction) at 12 weeks (P > 0.999). There was also a statistically significant (P < 0.001) improvement in WOMAC scores in both groups at all follow up times. However, there was no intergroup difference in VNRS (P = 0.893) and WOMAC scores (P = 0.983). No complications were reported. Conclusions: Both ultrasound-guided PRF of the genicular nerve and blocks of genicular nerve with local anesthetic and a steroid provided comparable pain relief without any complications. However, PRF of the genicular nerve is a procedure that takes much more time and equipment than the genicular nerve block.

The Study on Correlation between the KL-Grade and Improvement of Knee Pain Treated by Korean Medicine Therapy (KL-Grade의 정도와 슬관절 통증의 한의학적 치료 효과의 상관성 연구)

  • Lee, Gi-eon;Huh, Suk-won;Lee, Hyun-ho;Jeong, Seong-hyun;Jo, Kyeong-sang;Han, Si-hoon;Choi, Ji-hoon;Roh, Ji-ae
    • 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).

Three cases meniscus injury treated with Shinbaro pharmacopuncture therapy

  • Lee, So Jin;Yoon, Tae Kyung;Shin, Soo Ji;Ahn, Sang Min;Lee, Seong Jin;Won, Jeong Yoon;Jang, Yeo Jin
    • Journal of Acupuncture Research
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    • v.34 no.3
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    • pp.109-119
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    • 2017
  • Objectives : The purpose of this report was to show that oriental therapy, specifically Shinbaro pharmacopuncture is effective for improvement of symptoms and and range of motion (ROM) in patients diagnosed with meniscus tears in the knee. Methods : Three patients were treated with herbal medicine, acupuncture, cupping, Shinbaro pharmacopuncture. The efficacies of the treatments in the three cases were assessed and the progress of the three cases were measured Numerical Rating Scale (NRS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), European Quality of Life five dimensions dimensions (EQ-5D), and range of motion (ROM) measurements. Results : After all the treatments, NRS, WOMAC, and EQ-5D decreased. Active and passive ROM of the knee increased. Conclusion : These reports show the effect of Shinbaro pharmacopucture on a meniscus tear. Due to the small number of cases in this study, further case reports are needed.

Rasch Analysis of the Korean Western Ontario McMaster (KWOMAC): In the Out-Patients Over 65 Years With Osteoarthritis of the Knee (한국판 Western Ontario MacMaster(WOMAC)의 Rasch분석)

  • Koh, Eun-Kyung;Yi, Chung-Hwi
    • Physical Therapy Korea
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    • v.14 no.1
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    • pp.82-89
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    • 2007
  • The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a valid and widely used instrument for the assessment of osteoarthritis patients. In this study, data was obtained from the out-patients with painful osteoarthritis of the knee. One hundred-three out-patients were interviewed by physical therapists. In an exploratory way, a Korean version of the KWOMAC was analyzed for unidimensionality, item separation, and item difficulty using the Winsteps programs. Ninety-five patients with osteoarthritis of the knee over 65 years were analyzed for Rash analysis. In the analysis several functional items poorly fit to the model. These items included "heavy domestic duties" and "standing". In the pain domain, one item ("at night while in bed") did not fit the model. In the stiffness domain one item ("after sitting, lying, or resting later in the day") did not fit the model. Although 4 items from the 3 domains (pain, stiffness, function domain) do not fit well, the KWOMAC domains were confirmed by Rasch analysis. Thus the KWOMAC needs to be further examined before it can be used to properly determine the health status of the elderly with OA.

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Effects of Dynamic Balance Training on Pain, Physical Function, and Balance Ability in Patients with Chronic Knee Osteoarthritis (동적 균형 훈련이 만성 슬관절 관절염 환자의 통증, 신체 기능과 균형 능력에 미치는 영향)

  • Bang, Dae-Hyouk;Bong, Soon-Young
    • PNF and Movement
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    • v.16 no.1
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    • pp.105-113
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    • 2018
  • Purpose: The aim of this study was to explore the effects of dynamic balance training on pain, physical function, and dynamic balance in individuals with knee osteoarthritis. Methods: Fourteen patients with knee osteoarthritis participated in this study. The patients were randomly assigned to two groups: an experimental group (n=7) or a control group (n=7). All the patients took part in a lower extremity strength program for 30 min. In addition, the experimental group participated in a 30-min dynamic balance program. Both groups performed the program five times a week for 3 weeks. Outcomes, including the numeric rating scale (NRS), Western Ontario and MacMaster Universities Arthritis Index (WOMAC), and Community Balance and Mobility Scale (CB&M), were measured at baseline and after 3 weeks. Results: Both groups showed pre-to-post intervention improvements on all outcome measures (p<0.05). The experimental group showed a significant improvement in WOMAC (p = 0.00; Z = -2.82) and CB&M (p = 0.03; Z = -2.20) scores after the intervention as compared with those of the control group. Conclusion: The results revealed that dynamic balance training improved physical function, as well as balance ability, in patients with knee osteoarthritis as compared with that of a control group with no balance training.

Comparison of Effects of Non-surgical Continuous and Intermittent Traction on Pain, Balance and Physical Function in the Treatment of Knee Osteoarthritis

  • Lee, Dong-Kyu;Jeong, Jin-Gyu
    • The Journal of Korean Physical Therapy
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    • v.32 no.6
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    • pp.348-353
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    • 2020
  • Purpose: This study examined the comparison of effects of non-surgical continuous and intermittent traction on pain, balance and physical function in the treatment of knee osteoarthritis. Methods: A total of 30 knee osteoarthritis patients were recruited and randomized to a continuous traction group (n=10), an intermittent traction group (n=10), and a control group (n=10). The continuous traction group and intermittent traction group received a non-surgical continuous and intermittent knee joint traction workout five times a week, for 4 weeks. All subjects were assessed with the numeric rating scale (NRS), timed up and go test (TUGT), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before and after the 4-week treatment. Results: As a result of comparison within groups, the continuous traction group, intermittent traction group, and control group showed a significant difference for NRS, TUGT, and WOMAC after the experiment (p<0.05). According to the comparison of the three groups, the continuous traction group showed a more effectively significant difference than the intermittent traction group and the control group in the balance and physical functions before and after the experiment (p<0.05). Conclusion: This study showed that non-surgical continuous traction treatment was effective in improving pain, balance ability, and physical function in knee osteoarthritis patients.

The Effect of Complex Korean Medical Treatment for Tibia, Fibula and Patellar Fractures in Patient with Sequelae of Poliomyelitis: A Case Report (경비골, 슬개골 동시 골절된 소아마비 후유증 환자에 대한 한방복합치료 1례)

  • Chae-Young Kim;Ji-Su Choi;Hee-Duk An
    • Journal of Korean Medicine Rehabilitation
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    • v.34 no.2
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    • pp.173-180
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    • 2024
  • Objectives The purpose of this study is to report the effects of Korean medicine treatment on tibia, fibula, and patellar fractures with sequelae of poliomyelitis. Methods A 64-year-old male patient was treated with acupuncture, herbal medicine, cupping, moxibustion, and exercise treatment for 59 days after open reduction and internal fixation and tension band wiring surgery. The effects were evaluated using a visual analog scale (VAS), manual muscle testing (MMT), range of motion (ROM), Western Ontario and McMaster Universities (WOMAC), and EuroQol-5 dimension (EQ-5D) index. Results After treatment, VAS decreased from 7 to 2. MMT, ROM, WOMAC, EQ-5D and walking ability were improved. Conclusions This case study suggests that Korean medicine treatment could be effective for tibia, fibula, patellar fractures in patients with sequelae of poliomyelitis.

Individualized Traditional Korean Acupuncture for Knee Osteoarthritis : a Protocol for a Randomized Controlled Trial

  • Byun, Hyuk;Baek, Seung-Tae;Park, In-Shik;Kim, Kap-Sung;Kim, Sun-Woong;Choi, Sun-Mi;Lee, Seung-Deok
    • The Journal of Korean Medicine
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    • v.27 no.4
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    • pp.225-232
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    • 2006
  • Objective : To test the hypotheses that individualized traditional Korean acupuncture improves pain and disability in patients with osteoarthritis of the knee and that benefits remain after stopping treatment more so than is the case for standardized minimal acupuncture. Design : Randomized single blind controlled trial with two intervention arms (individualized traditional Korean acupuncture, standardized minimal acupuncture) of six weeks' duration and three months follow-up. Setting : Acupuncture interventions were applied by two training doctors in the Department of Acupuncture and Moxibustion in a 1000-bed hospital. Assessment of the result was performed in a university-based laboratory. Participants : 50 patients with symptoms of knee osteoarthritis as diagnosed by an orthopedist. Intervention : Individualized traditional Korean acupuncture or standardized minimal acupuncture for six weeks. Main outcome measures: Primary outcome measure was pain as measured by the visual analogue scale. Secondary measures of pain and disability included the Western Ontario and McMaster Universities (WOMAC) index, Short Form-36 (SF-36), Lequesne Functional Index (LFI) score and Korean version of Health Assessment Questionnaire (KHAQ). Discussion : This paper presents detail on the rationale, design, methods and operational aspects of the trial.

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The Isokinetic exercise and effects of combined exercises on the change of postural control, functional status in patients with osteoarthritis of the knee (등속성 운동과 복합 운동이 퇴행성 슬관절염 여성의 근기능, 균형능력, 기능적 능력 및 관절기능상태에 미치는 영향)

  • Jo, Jean-Man;Kim, Jin-Woo
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.1
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    • pp.11-25
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    • 2007
  • Objective: The purpose of this study was to investigate the effects of combined exercise on the change of postural control, functional status in patients with osteoarthritis of the knee. Methods : The subjects were consisted of 24 women patients fifties and sixties with knee osteoarthritis. Each group had a exercise for 30 minutes per day and three times a week during 8 weeks period. Was used to measure muscular function(60, $180^{\circ}/sec$), postural control. functional capacity(15 M walking test, Rising form a chair test, stair climbing and descending test) and the functional state of a joint(WOMAC). Results: This study results in following 1. In case of muscular function have significantly increased in both groups. 2. There was no significant difference in the postural control of the bilateral between two groups. However, the postural control of a isokinetic exercise program group showed a significant difference in the bilateral side(overall, $M{\cdot}L$ stability index). Especially, the change of postural control in the isokinetic plus postural control exercise program group decreased more significantly in the bilateral(overall, $A{\cdot}P$ stability index). 3 It was significantly decreased in climbing and descending the stairs, and rising from the chair, although functional capacity decreased in lam walking in both groups. 4. The functional state of a joint(WOMAC) showed a significant decrease in both groups. Conclusion : In order to improve the functional status and postural control of patients with osteoarthritis of the knee, performing exercise programming of isokinetic plus balance will be more effective than the exercise program composed of only the isokinetic exercise program.

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