• 제목/요약/키워드: knee stiffness

검색결과 108건 처리시간 0.026초

무릎 골관절염의 봉독 약침 치료에 대한 체계적 문헌 고찰 (A Systematic Review of Bee Venom Acupuncture for Knee Osteoarthritis)

  • 구지향;김은석;박양춘;정인철;이은정
    • 한방재활의학과학회지
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    • 제27권3호
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    • pp.47-60
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    • 2017
  • Objectives The aim of this research is to assess the effects of bee venom acupuncture for knee osteoarthritis. Methods For a systematic review, we constructed a key question as the effect of bee venom acupuncture for knee osteoarthritis and selected RCTs and nRCTs. We searched the following 15 databases without a language restriction: Pubmed, EMBASE, Cochrane CENTRAL (CENTRAL), CINAHL, AMED, seven Korean medical databases (KoreaMed, Kmbase, KISS, NDSL, KISTI, Koreantk, OASIS) and three Chinese databases including CNKI, Wanfang and VIP database. Results A total of 300 potentially relevant studies were identified; only 13 studies were selected for systematic review. Almost studies showed that bee venom acupuncture has significant effect on knee osteoarthritis. 5 studies comparing bee venom acupuncture with acupuncture were included in the meta-analysis. The effect size of standardized mean difference (SMD) was analyzed as 'small effect' with 0.47 (95% CI: 0.10~0.83, Z=2.49, p=0.01). Conclusions The research showed that bee venom acupuncture can significantly reduce pain, stiffness and improve the quality of life of patients with knee osteoarthritis. However, most of the studies included in the analysis were evaluated as methodologically high risk of bias. This suggests that there is limitation applying this study. In the future, more Randomized Controlled trial should be actively conducted.

무릎 골관절염의 도침 치료에 대한 연구 동향 : 체계적 문헌 고찰 (Research Trends on the Acupotomy Treatment for Knee Osteoarthritis : A Systematic Review)

  • 홍수민;윤광식
    • 동의생리병리학회지
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    • 제34권6호
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    • pp.285-298
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    • 2020
  • This study aimed to review clinical studies about Acupotomy used for Knee Osteoarthritis. We searched the following 12 online databases (KISS, NDSL, RISS, OASIS, Earticle, Kmbase, MEDLINE/Pubmed, Cochrane library, Ebscohost, Ovid, CNKI, Wanfang), to find randomized controlled trials that used Acupotomy for knee osteoarthritis. The methodological quality of randomized controlled trials were assessed by using the Cochrane risk of bias tool and meta-analyses were performed. 16 randomized controlled trials were included. Total number of patients was 1169. The average duration of treatment was 3.14 weeks and most of the patients were treated once a week. The major treatment sites were ligaments, muscles, and tender nodules and the most used evaluation tool was the efficiency. We selected 4 studies and meta-analyzed them. All of the studies performed Acupotomy+sodium hyaluronate injection as a treatment group, and sodium hyaluronate injection as a control group. Meta-analysis showed positive results for Acupotomy+sodium hyaluronate injection in terms of efficiency rate compared to sodium hyaluronate injection. Also Meta-analysis showed positive results for Acupotomy+sodium hyaluronate injection in terms of WOMAC (pain, stiffness, function) compared to sodium hyaluronate injection. In this study, we reviewed studies about Acupotomy used for knee osteoarthritis. The studies showed that Acupotomy can significantly effective on knee osteoarthritis. But according to Cochrane Risk of Bias (RoB) evaluation method, most of the study's risk of bias was unclear. Threrefore, more high-quality studies will be needed.

급성 화농성 슬관절염에서 관절경적 치료 후 결과 (Clinical Results after Arthroscopic Treatment in Acute Pyogenic Arthritis of the Knee)

  • 이정환;윤경호;배대경;김정원;박수연
    • 대한관절경학회지
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    • 제12권1호
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    • pp.53-57
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    • 2008
  • 목적: 슬관절에 발생한 급성 화농성 관절염의 관절경적 치료 후 결과에 대하여 분석하였다. 대상 및 방법: 2000년 7월에서 2005년 1월까지 16예(15명)의 관절경적 치료를 시행한 급성 화농성 슬관절염 환자를 대상으로 하였다. 환자의 평균 나이는 61.9세였고 평균 추시 기간은 30.5개월이었다. 당뇨병이나 퇴행성 관절염 등의 기존 질환이 있었던 경우가 8예 였으며 과거력상 슬관절에 침을 맞거나 관절내 주사를 시행 받은 경우가 14예였다. 결과: 원인균의 동정이 가능했던 예는 7예(43.8%)였다. 술 후 정맥 내 항생제를 평균 25.5일 사용하였으며 경구 항생제를 평균 22.5일 사용하였다. 슬관절 강직 5예, 이차성 관절염 2예, 슬관절 주위 만성 골수염 1예, 사망 3예 등 총 11예의 합병증이 발생하였다. 수술 후 3주 이상 부목 고정을 시행한 경우 슬관절 강직이 유의하게 많았으나(p=0.032) 증상 발현 후 1 주일을 기준으로 치료까지의 기간에 따른 합병증의 발생 빈도는 차이를 보이지 않았다(p=0.293). 배양 검사 상 원인균이 동정된 경우 더 많은 합병증이 발생하였다(p=0.034). 결론: 화농성 슬관절염의 관절경적 치료 후 관절 강직의 발생 빈도와 고정 기간과 상관 관계가 있었다. 합병증 발생 빈도는 증상 후 치료까지의 기간과는 연관이 없었으나 원인균의 동정된 여부와는 연관이 있었다.

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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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슬관절전치환술 환자의 일상생활동작 수행력에 관한 연구 (A Study of ADL Performance on Elderly Total Knee Replacement Patients)

  • 박창곤;박래준
    • The Journal of Korean Physical Therapy
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    • 제15권4호
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    • pp.151-179
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    • 2003
  • The purpose of this study was to examine the influence of total knee replacement to arthritis patients in pain intensity and functional impairment. For this study, over 50-year-old 30 patients who had osteoarthritis and 69 patients who got total knee replacement at the one of the departments of orthopedics in Daegu were interviewed from June, 2002 to March, 2003. The results of this study were as follows : First, pain intensity was decreased to experimental group after operation than control group(P<.01) And the presence of crepitation was also decreased to them(P<.05). On the other hand there's no significant difference was noted in the presence of stiffness, degree of flexion contracture and extension contracture between two groups. Second, over 91 days group after operation and visitor's group of physiotherapy unit were better than others in Level of knee function(P<.01). Third, over 91 days group after operation and visitor's group of physiotherapy unit were higher than others in Barthel Index of knee function(P<.01). Forth, over 91 days group after operation and visitor's group of physiotherapy unit were higher than others in Level of IADL(P<.05). Fifth, over 91 days group after operation and visitor‘s group of physiotherapy unit were higher than others in Katz Index of knee function(P<.01). Sixth, although Old Ages' Activity Index seemed to get better as time goes by, there's no statistical difference. Seventh, over 91 days group after operation and visitor's group of physiotherapy unit were higher than admission group and under 30 days group after operation in Social Activity Index(P<.05). Eighth, the function of the knee was connected with the abilities in the activity of the old and the social skill. The Barthel index was connected with the function of the knee joint and the activities of the old and Katz index. IADL function was connected with the activities of the old and the social activity. The Katz index was connected with the Barthel index. The activity of the old was connected with the Barthel index, the functional score of the knee joint andthe IADL score. The ability of social skill was connected with the activity of the old, IADL score and the function of the knee.

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일차 슬관절 전치환술 시내·외반 구속형 치환물이 필요했던 사례들의 원인 분석 (Review of the Reasons in Cases Requiring Varus/Valgus Constrained Prosthesis in Primary Total Knee Arthroplasty)

  • 공동의;박상훈;최충혁
    • 대한정형외과학회지
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    • 제56권3호
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    • pp.253-260
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    • 2021
  • 목적: 일차 슬관절 전치환술 시에는 일반적으로 가능한 한 구속력이 적은 치환물을 이용한 슬관절 전치환술이 권장된다. 그럼에도 불구하고 후방 십자인대 보존형 혹은 대치형 치환물로 적절한 슬관절 안정성을 얻기가 불가능한 경우에는 수술 중 내·외반 구속형 슬관절 치환물로 전환을 고려해야 한다. 내·외반 구속형 치환물이 항시 구비되어 있지 않는 국내 현실을 감안하여 일차 슬관절 전치환술의 효율적인 술 전 계획을 위해 내·외반 구속형 슬관절 치환물을 준비하는 적응증을 제시하고자 본 연구를 시행하였다. 대상 및 방법: 2003년 5월부터 2016년 2월까지 시행되었던 일차 슬관절 전치환술 1,797예 중 내·외반 구속형 슬관절 치환물로 일차 슬관절 전치환술이 시행되었던 27명(29예)를 대상으로 내·외반 구속형 슬관절 치환물로 최종 결정한 원인 등을 후향적으로 분석하였다. 결과: 일차 슬관절 전치환술 시 내·외반 구속형 슬관절 치환물이 사용된 경우는 전체 일차 슬관절 전치환술 중 29예로 1.6%의 빈도를 보였다. 남자 6명, 여자 21명이었으며, 2명에서 양측 모두 내·외반 구속형 치환물이 필요하였다. 환자의 나이는 평균 63.4세(34-79세)였고, 술 전 최대신전각도는 평균 16.2° (-20°-90°), 최대굴곡각도는 평균 111.7° (35°-145°)였다. 일차 슬관절 전치환술 시 내·외반 구속형 치환물이 필요하였던 원인으로는 심한 외반 변형으로 내·외반 불안정성을 보강하기 위한 경우가 10예, 심한 강직으로 인해 내·외반 구속형 치환물이 사용되었던 경우가 10예였으며, 과거력상 내측측부인대 4예, 외측측부인대 1예, 원위 대퇴골과의 무혈성 괴사로 인한 경우가 4예였다. 심한 외반 변형으로 수술을 시행한 10예 경우의 술 전 슬관절 전후방기립 사진상 해부학적 대퇴경골간각은 평균 25.7° (21°-43°)의 외반각을 보였고, 심한 강직으로 수술을 시행한 10예 경우의 굴곡 구축은 평균 37.5° (20°-90°), 관절운동범위는 평균 48.5° (10°-70°)였다. 결론: 20° 이상의 해부학적 대퇴경골간각의 외반 변형, 굴곡 구축 20° 이상 및 관절운동범위 70° 이하를 가진 관절운동 제한, 과거 측부인대 손상 병력이 의심되는 경우에는 일차슬관절 전치환술 시라도 술 전 계획 시 내·외반 구속형 치환물을 준비하는 것이 수술 중 발생할 수 있는 불안정성의 해결에 도움이 될 것으로 생각된다.

퇴행성 슬관절염에 대한 제통단의 안전성과 효능 임상연구 (Clinical Study of the Efficacy and. Safety of Jetongdan on Patients with Osteoarthritis of the Knee)

  • 서병관;류성룡;강중원;안경애;이상훈;최도영;김건식;이두익;이윤호;이재동
    • 대한한의학회지
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    • 제26권2호
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    • pp.231-240
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    • 2005
  • Objectives: In order to investigate the efficacy and safety of the newly developed herbal medicine Jetongdan, a placebo­controlled, randomized clinical trial of patients with osteoarthritis of the knee was undertaken. Methods: Data were obtained from 80 patients with OA of the knee. After enrollment, they were asked to answer a disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index) and analyzed with the erythrocyte sedimentation rate (ESR) in order to evaluate the efficacy of Jetongdan, and analyzed for aspartate transaminase (AST) level, alanine transaminase (ALT) level, blood mea nitrogen (BUN) level, and creatinine (Cr) level in order to evaluate the safety of Jetongdan. Results: The liver function and renal function did not deteriorate after treatment with Jetongdan. Composite WOMAC score and physical function subscale was improved, but pain subscale, stiffness subscale, and ESR were not improved by. This was possibly because the baseline characteristics of the two groups were not homogenized after randomization. Conclusions: Jetongdan could be a promising treatment option for osteoarthritis of the knee. Further study in a larger population with appropriate severity grades is recommended.

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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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PNF 하지 패턴 중 동적반전(dynamic reverse) 기법이 퇴행성 슬관절염 환자의 균형능력에 미치는 영향 (Effect on Balance Ability of Knee Osteoarthritis by Lower Extremity Patterns with dynamic reverse in Proprioceptive Neuromuscular Facilitation)

  • 정현성;전호영;배성수
    • PNF and Movement
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    • 제4권1호
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    • pp.27-36
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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 Lower Extremity Patterns with dynamic reverse in Proprioceptive Neuromuscular Facilitation(PNF). Methods : The subjects were consisted of 30 women patients with knee OA. All subjects were randomly assigned to PNF group. Each group had a treatment for 30 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 path, anterior-posterior. Results : This study results in following conclusons. 1. MAQ score was significantly decreased in PNF group(p<.05). 2. KWOMAC score was significantly decreased in PNF group(p<.05). 3. BPM were score was significantly decreased in PNF group(p>.05). Conclusion : From this result the PNF treatment retrogression characteristic will be effective in treatment of patient, with the arthritis and widely may be applied at a therapist.

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Effects of Electromagnetic Acupuncture Combined with Integrative Korean Medicine Treatment on Pain and Dysfunction in a Patient with Knee Osteoarthritis: A Case Report

  • Jihun Kim;Taewook Lee;Sookwang An;Geun Hyeong, An;Yoona Oh;Gi Young Yang
    • Journal of Acupuncture Research
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    • 제41권2호
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    • pp.129-134
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    • 2024
  • Knee osteoarthritis (KOA) is a prevalent degenerative joint disease causing significant pain and dysfunction. This case report presents the use of electromagnetic acupuncture utilizing a Whata 153 device generating a magnetic field to enhance acupuncture stimulation for the treatment of KOA. A 69-year-old female diagnosed with KOA experienced a reduction in pain (numerical rating scale score from 7 to 4), improved gait, and decreased stiffness and swelling after daily electromagnetic acupuncture treatments during hospitalization. In addition, the Korean Western Ontario and McMaster Universities Osteoarthritis Index scoreimproved from 20 to 14, and the patient rated her overall improvement as "significantly improved" on the patient's global impression of change scale. Although these findings suggest potential benefits of electromagnetic acupuncture for KOA, the case report design limits its generalizability. More controlled trials are warranted to confirm the efficacy and safety of electromagnetic acupuncture as a treatment of KOA.