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Effect of Program for Pain Reduction in Patients with Rheumatoid Arthritis: A Systematic Review (류마티스 관절염 환자의 통증 감소를 위한 프로그램의 효과: 체계적 문헌고찰)

  • Jeon, Byeonghyeon;Lee, Chang Hoon;Chung, Chong Hyuk;Lee, Myeung Su
    • Journal of muscle and joint health
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    • v.28 no.2
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    • pp.200-208
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    • 2021
  • Purpose: The purpose of this study was to establish the foundations for the application of appropriate programs for pain reduction in patients with rheumatoid arthritis. Methods: The literature on patients with rheumatoid arthritis were found on an electronic search site for South Korean academic papers. The search terms "rheumatism" and "rheumatoid arthritis" were used independently. The combined terms "rheumatism and pain" and "rheumatoid arthritis and pain" were also used. For the meta-analysis, the R version 3.5.1 program was utilized. Results: The meta-analysis of eight papers showed a large effect size of -4.11. The programs were most effective in the order of aquatic exercise, aromatherapy, self-help education, muscle strength exercises, and tai chi. Conclusion: This study could provide the basis for presenting appropriate programs for pain management in patients with rheumatoid arthritis.

Psoriatic Temporomandibular Joint Arthritis Treated with Multidisciplinary Clinical Treatment : A case study (다학문적 임상 접근으로 치료된 건선 측두하악골관절염 증례)

  • Cho, Eunae;Ahn, Hyung Joon;Park, Ju Hyun;Kim, Seong Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.2
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    • pp.203-207
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    • 2013
  • Psoriatic arthritis is a chronic inflammatory form of arthritis that is associated with psoriasis. A 54-yr-old male with chronic psoriatic temporomandibular joint arthritis and myofascial pain was treated using methotrexate and a myofascial pain protocol. Jaw pain improved after 3 weeks, however, tenderness to palpation of muscles remained. Comprehensive evaluation and multidisciplinary clinical treatment is required for the treatment of patients with psoriatic temporomandibular joint arthritis.

The Preventive Effects of Nanopowdered Peanut Sprout-added Caciocavallo Cheese on Collagen-induced Arthritic Mice

  • Kim, Dong-Hwi;Chang, Yoon Hyuk;Kwak, Hae-Soo
    • Food Science of Animal Resources
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    • v.34 no.1
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    • pp.49-56
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    • 2014
  • The present study was carried out to investigate the effects of nanopowdered peanut sprout-added Caciocavallo cheese (NPCC) on the prevention and treatment of rheumatoid arthritis in DBA/IJ mice immunized with type II collagen. After the induction of arthritis, the mice were being divided into five groups: (1) normal, no immunization; (2) CIA, collagen-induced arthritis; (3) MTX, collagen-induced arthritis treated with methotrexate (0.3 mg/kg body weight); (4) CC, collagen-induced arthritis treated with Caciocavallo cheese (0.6 g/d); (5) NPCC, collagen-induced arthritis treated with nanopowdered peanut sprout-added Caciocavallo cheese (0.6 g/d). Nanopowdered peanut sprout was ranged from 300 to 350 nm, while regular powdered peanut sprouts were ranged from 50 to $150{\mu}m$. The NPCC group had considerable reductions of clinical scores and paw thicknesses at the end of experiment as compared to the CIA group. In the serum analysis, the TNF-${\alpha}$, IL-$1{\beta}$, IL-6 and $IgG_1$ levels in the NPCC group have decreased by 69.4, 75.9, 66.6, and 61.9%, respectively, when compared to the CIA group. The histological score and spleen index of the NPCC group were significantly lower than the CIA group. In conclusion, the feeding NPCC method could delay and/or prevent the rheumatoid arthritis in the collagen-induced arthritis mouse model. Based on this study, nanopowdered peanut sprouts could be applied to various functional cheeses.

Prediction Model of Fatigue in Women with Rheumatoid Arthritis (여성 류마티스 관절염 환자의 피로 예측 모형)

  • Lee, Kyung-Sook;Lee, Eun-Ok
    • Journal of muscle and joint health
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    • v.8 no.1
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    • pp.27-50
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    • 2001
  • Rheumatoid arthritis is a chronic systemic autoimmune disease. Although the joints are the major loci of the disease activity, fatigue is a common extraarticular symptom that exists in all gradations of rheumatoid arthritis. Fatigue is defined as a subjective sense of generalized tiredness or exhaustion and has multiple dimensions. Therefore fatigue is a common and frequent problem for those with rheumatoid arthritis. In fact, 88-100% of individuals with rheumatoid arthritis experience fatigue. Especially the degree of fatigue is higher in women than men with rheumatoid arthritis. Despite the importance of fatigue among the patients with rheumatoid arthritis, the mechanism that leads to fatigue in rheumatoid arthritis is not completely understood. This study was intended to test and validate a model to predict fatigue in women with rheumatoid arthritis. Especially it was intended to identify the direct and indirect effects of the variables of pain, disability, depression, sleep disturbance, morning stiffness, and symptom duration to fatigue. Data were collected by questionnaires including Multidimensional Assesment of Fatigue(Tack, 1991), numeric scale of pain, graphic scale of joints, Ritchie Articular Index, Korean Health Assessment Questionnaire(Bae, et al., 1998), Inventory of Function Status(Tulman, et al., 1991), Center for Epidemiologic Studies-Depression, and Korean Sleep Scale(Oh, et al 1998). The sample consisted of 345 women with a mean duration of rheumatoid arthritis for 10.06 years and a mean age of 49.64 years. SPSS win and Win LISREL were used for the data analysis. Structural equation modeling revealed the overall fit of the model. Pain predicted fatigue directly and indirectly through disability, depression, and sleep disturbance. Disability, sleep disturbance predicted fatigue only directly, while depression only indirectly through disability and sleep disturbance. Also morning stiffness and symptom duration predicted fatigue through disability and depression. All predictors accounted for 65% of the variance of fatigue. Depression, pain, and disability predicted sleep disturbance. Depression had reciprocal relationship with disability and they both were predicted by pain directly and indirectly. In summary, pain, depression, disability, sleep disturbance, morning stiffness, and symptom duration contributed to the fatigue of patients with rheumatoid arthritis. The best predictor of fatigue was pain. This finding indicates that the modification of pain, depression, disability, sleep disturbance, morning stiffness could be nursing intervention for relief or prevention of fatigue.

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A Study of TNF-${\alpha}$(G308A) Genetic Polymorphism and Risk Factors Associated with Rheumatoid Arthritis by Sasang Constitution (사상체질에 따른 류마티스 관절염의 위해요인 및 TNF-${\alpha}$(G308A) 유전자 다형성간의 연관성 연구)

  • Kim, Su-Young;Chun, Hyung-Jon;Lee, Doo-Ik;Lee, Yun-Ho;Choi, Do-Young;You, Yong-Gu;Lee, Jae-Dong
    • Journal of Acupuncture Research
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    • v.24 no.1
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    • pp.137-159
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    • 2007
  • Objectives: The purpose of this study is to examine the risk factors and the genetic polymorphism of TNF-alpha associated with rheumatoid arthritis by Sasang constitution Methods : This study was planned to detect the susceptibility of the patients diagnosed by rheumatoid arthritis to Sasang Constitution and to examine the risk factor such as life style and environmental stress (smoking, environmental tobacco smoke, alcohol intake and so on). The genetic polymorphism of TNF-alpha (G308A) were analyzed by PCR-RFLP in rheumatoid arthritis patients and controls. Rheumatoid arthritis patients and matched controls are assessed with QSCCII question for Sasang Typology. Then the genetic polymorphism of patients by Sasang constitution are compared to those of control, which are statistically analyzed and adjusted by age, sex, smoking status, alcohol intake, BMI, and econocmic status. Results: Differential effect of passive smoking on the association between Sasang constitution and rheumatoid arthritis risk was found. This study showed that the genetic polymorphism (TNF-${\alpha}$(G308A)) of rheumatoid arthritis patients and controls associated with the susceptibility to rheumatoid arthritis by sasang constitution was analyzed. Differential effects of TNF-${\alpha}$(G308) genetic polymorphism on the association between rheumatoid arthritis risk and Sasang constitution were found. Conclusion : It is suggested that the genetic polymorphism correlated with susceptibility to rheumatoid arthritis by specific sasang constitution used as its susceptibility marker and further as basic data to prevent the risk factors for rheumatoid arthritis. But larger studies will be needed to confirm these preliminary findings.

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A Study on the Effect of Aqua-acupuncture utilizing Lycopi Herba solution on Collagen II-induced Arthritis (택란약침(澤蘭藥鍼)이 Collagen으로 유발(誘發)시킨 관절염(關節炎)에 미치는 영향(影響))

  • Lee, Jun-ho;Lee, Byung-Ryul
    • Journal of Acupuncture Research
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    • v.17 no.1
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    • pp.287-318
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    • 2000
  • The purpose of this study is to observe the effect of Aqua-acupuncture utilizing Lycopi Herba Solution(LH-AS) on arthritis. For that purpose, we formed three experimental group, synovial cells of human body, normal BALB/C mice and DBA/1J mice with collagen II-induced arthritis, and measured the treatment effect of LH-AS on each group. The conclusions are as follows. 1. After the LH-AS treatment on synovial cells, there were no significant change in 1, 10, 50 and $100{\mu}g/m{\ell}$ whereas there was significant change in 200 and $400{\mu}g/m{\ell}$ in cytotoxicity. 2. IL-6, IL-$1{\beta}$, TNF-${\alpha}$ gene expression of synovial cells and the secretion amount of IL-6 and IL-$1{\beta}$ are significantly inhibited in treatment group with LH-AS. 3. The proliferation of synovial cells was significantly inhibited in treatment group with rIL-6, LH-AS 200 and rIL-6, $100{\mu}g/m{\ell}$. 4. After the DBA/1J mice with collagen II-induced arthritis were treated by LH-AS, the incidence of arthritis, hind paw edema, the index of arthritis and DTH were significantly inhibited. 5. After the DBA/1J mice with collagen II-induced arthritis were treated by LH-AS, splenetic weight was significantly increased and the number of leukocyte was significantly decreased. But there was no significant change in the number of platelet. 6. After the DBA/1J mice with collagen II-induced arthritis were treated by LH-AS, the number of $CD4^+$, $CD8^+$ activated cells and the surface-receptor expression were significantly increased whereas the number of $CD19^+$ activated cells and the surface-receptor expression were decreased. 7. After the DBA/1J mice with collagen II-induced arthritis were treated by LH-AS, total protein, LDH were significantly decreased, but there was no significant change in creatinine. 8. After the normal splenetic cells of BALB/C mice were treated by LH-AS and cultured, it was observed that the adherent cells were morphologically activated and IL-12 and IFN-${\gamma}$ gene expression were increased. 9. After the normal splenetic cells of BALB/C mice were treated by LH-AS and cultured, the number of $CD4^+$, $CD8^+$, $CD19^+$ activated cells and surface-receptor expression were inhibited when being compared with the control group. Taking all these observations into account, LH-AS injection is considered to be effective in treating arthritis and put to practical use in future arthritis clinic.

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Healing Effect of Cordyceps Militaris Extract Complex on Collagen II-Induced Arthritis Rats (콜라겐 유도 관절염 동물 모델에 대한 동충하초 복합추출물의 치료 효과)

  • Oh, Seung-Joon;Lee, Eun-Jung
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.3
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    • pp.1-11
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    • 2022
  • Objectives This study was designed to evaluate the healing effect of Cordyceps Militaris (CM) on collagen II-induced arthritis rats. Methods Sprague-Dawley rats were randomly divided into 6 groups (normal, control, positive control, CM with low/medium/high dosage each). Type II collagen mixed with complete Freund's adjuvant (with 1:1 v/v) was injected subcutaneously, and the mixture was injected in a same manner one week after the first injection to boost arthritis. Arthritis index, paw thickness and von Frey test were conducted to observe physical changes. hematoxylin and eosin (H&E) staining was performed to observe knee cartilage. The levels of messenger RNA (mRNA) expressions of interleukin (IL)-1𝛽, IL-6, tumor necrosis factor-alpha (TNF-𝛼) in spleen were assessed by real-time polymerase chain reaction. Results Rheumatoid arthritis is an autoimmune disease that occurs on multiple joints and can lead to temporary shape change of bones or organ failure in severe cases. Here, we aimed to determine the effect of CM extract on rheumatoid arthritis by measuring paw thickness, arthritis index, conducting von Frey test and H&E staining, and evaluating the level of IL-1𝛽, IL-6, TNF-𝛼. As a result, paw thickness, arthritis index significantly decreased in low concentration group, hind leg became less sensitive in all expermental groups. Also, histological analysis showed that the damage of knee cartilage was prevented in all experimental groups. The level of mRNA of IL-1𝛽, IL-6, and TNF-𝛼 in spleen was analyzed to decide the effectiveness of CM extract. IL-1𝛽 did not show significant change, but IL-6 and TNF-𝛼 showed significant decrease in at least one of the experimental groups. Conclusions CM showed protective effect on knee tissue destruction and improved the physical conditions of the leg involving arthritis. Also, it showed that CM has anti-inflammatory effect on specific cytokines inducing rheumatoid arthritis. In conclusion, this study demonstrated that the therapeutic potential of CM for the treatment rheumatoid arthritis, and set the foundation for the further studies.

The Impact of Arthritis Self-management Education on Changes in Arthritis-related Knowledge Levels and Arthritis-specific Self-efficacy of the Aged at a Senior Center (관절염 자가관리 교육이 경로당 노인의 관절염 관련 지식수준과 관절염 특이형 자기효능감 변화에 미치는 영향)

  • Soon-Gyo Yeoum;Jong-Hwa Lee;Sunah Park
    • The Journal of the Convergence on Culture Technology
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    • v.10 no.3
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    • pp.783-790
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    • 2024
  • This study aimed to investigate the impact of arthritis self-management education on changes in arthritis-related knowledge levels and arthritis-specific self-efficacy among elderly individuals at a senior center. This study was conducted with one group pre-test and post-test design. The participants included 48 elderly individuals who utilized four senior centers, and they received arthritis self-management education for three weeks. Data analysis used a paired t-test to compare the effects before and after education. The results of the study showed that arthritis self-management education significantly increased arthritis-related knowledge (t=9.17, p<0.001) and arthritis-specific self-efficacy (t=3.96, p<0.001). There were significant differences in knowledge and self-efficacy levels by age group, with the results varying among participants aged 85 and above. These findings suggest that a three-week education program is appropriate for improving arthritis-related knowledge and self-efficacy among the elderly, and that education should be tailored to different age groups.

Development of Health Promotion Program for Individuals With Arthritis -Application of Holistic Model- (관절염 환자를 위한 건강증진 프로그램의 개발 -총체적 모델의 적용-)

  • 오현수;김영란
    • Journal of Korean Academy of Nursing
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    • v.29 no.2
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    • pp.314-327
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    • 1999
  • In this study, domains, contents, and effects of pre-existed intervention programs for individuals with arthritis were meta-analyzed to develop arthritis health promotion program based on Holistic Model. The developed program includes strategies of cognition, environment, and behavior. and also generates positive changes in the physical, psychological, and social demensions. Then needs assessment on conveniently selected 153 women who visited a university hospital in Seoul or in Inchon are conducted to identify the objective domains of arthritis health promotion program According to the study results. target health problems of the arthritis health promotion program were shown as pain, disability, depression, and role impediment in social domain. These objectives could be achieved by including the strategies of changing cognition, the strategies of changing behavior through learning the skill related to the health promoting behavior. and the strategies of changing environment in the health promotion program. That is, it is analyzed that the contents of program are not exclusive one another in physical. psychological. and social demensions, and also are not exclusive one another in aspect of cognition, behavior, and environment. The necessary methods to achieve the desired objectives for the developed arthritis health promotion program and evaluation subjects are as follows : (1) In the arthritis health promotion program, knowledge on management of arthritis, efficacy related to arthritis management, skill for pain management, skill for exercise, establishment of positive self-concept, enhancement of positive thinking, stress management. skill for problem solving, skill for setting goals. skill for requesting help, and skill for communication are all included. Through the improvement of all those strategies, intermediate objectives, such as “joint protection, and maintenance of pain management behavior”, “maintenance of regular exercise”, and “promotion of coping skill in psychosocial dimension” are achieved. (2) These intermediate objectives are also the methods for achieving objectives in next stage. It implies that through the intermediate objectives. the final objectives such as “minimization of physical symptoms and signs”, “maximization of psychological function”, and “maximazation of role performance in social domain” could be achieved. Each of these final objectives reflects the different dimension of quality of life, respectively. When these objectives are achieved, the quality of life that client perceives is improved. Therefore, through evaluation of these final objectives, the level of achieving final outcome of arthritis health promotion such as quality of life is determined.

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Suppressing Effects of Sowhalrack-dan(Xiǎohuóluò-dān) on Freund's Complete Adjuvant Induced Arthritic Rats (Adjuvant 유발(誘發) 류마티스 관절염(關節炎)에 대한 소활락단(小活絡丹)의 억제(抑制) 효과(效果))

  • Yun, Sun-Mo;Jeong, Man-Jin;Kwon, O-Gon;Woo, Chang-Hoon;An, Hee-Duk
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.1
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    • pp.97-114
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    • 2011
  • Objectives : The object of this study is to observe the favorable anti arthritic effects of Sowhalrack-dan($Xi\check{a}ohu\acute{o}lu\grave{o}-d\bar{a}n$)(SWRD), which has been traditionally used in Korean medicine to treat rheumatoid arthritis on Freund's complete adjuvant(FCA) induced arthritic Wistar rats. Methods : Rheumatoid arthritis was induced by intradermal injection of FCA(10 mg in 1 ml paraffin oil 0.1 ml/rats). Each of 8 rats showing regular ankle circumferences per group were selected in 14 days after FCA treatment to confirm the induction of rheumatoid arthritis. 300, 150 or 75 mg/kg of SWRD was orally administered once a day for 14 days from 14 days after FCA treatments. Dexamethasone was intraperitoneally administered 15 mg/kg, once a day for 14 days from 14 days after FCA treatments. Rats were sacrificed after 14 days of continuous oral treatment of SWRD or intraperitoneal administration of dexamethasone, and changes were observed; the body weight, knee circumferences, gross arthritis score, inflammatory tissue $prostaglandin(PG)E_2$ levels and cartilage collagen, glucosaminoglycans compositions - chondroitin sulphate, heparin sulphate and hyaluronic acid in the present study. Results : As results of FCA treatment, classic rheumatoid arthritis featuring dramatical decreases on the body weights, cartilage collagen contents and bone glucosaminoglycans - chondroitin sulphate, heparin sulphate and hyaluronic acid contents. Also, it increases the knee circumferences, gross arthritis scores and inflammatory tissue $PGE_2$ levels. However, these changes from FCA induced rheumatoid arthritis were clearly reduced due to the dexamethasone and both two different dosages of SWRD, 300 and 150 mg/kg in the present study. Although FCA induced arthritis were more favorably inhibited by treatment of dexamethasone 15 mg/kg compared to SWRD 300 mg/kg, marked decreases of body weights were detected in dexamethasone 15 mg/kg treated rats. Conclusions : The results obtained in this study suggest that over 150 mg/kg of SWRD showed favorable anti-arthritic effects on the FCA induced arthritis mediated by suppression of $PGE_2$. However, detailed mechanism studies are needed with the screening of the biological active compounds in SWRD. Although FCA induced arthritis were more favorably inhibited by treatment of dexamethasone 15 mg/kg compared to SWRD 300 mg/kg, marked decreases of body weights were detected in dexamethasone 15 mg/kg treated rats, in the present study.