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Hussain I, Kim SE, Kwon C, Hoon SK, Kim HC, Ku Y, Ro DH. Estimation of patient-reported outcome measures based on features of knee joint muscle co-activation in advanced knee osteoarthritis. Sci Rep 2024; 14:12428. [PMID: 38816528 PMCID: PMC11139965 DOI: 10.1038/s41598-024-63266-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 05/27/2024] [Indexed: 06/01/2024] Open
Abstract
Electromyography (EMG) is considered a potential predictive tool for the severity of knee osteoarthritis (OA) symptoms and functional outcomes. Patient-reported outcome measures (PROMs), such as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS), are used to determine the severity of knee OA. We aim to investigate muscle activation and co-contraction patterns through EMG from the lower extremity muscles of patients with advanced knee OA patients and evaluate the effectiveness of an interpretable machine-learning model to estimate the severity of knee OA according to the WOMAC (pain, stiffness, and physical function) and VAS using EMG gait features. To explore neuromuscular gait patterns with knee OA severity, EMG from rectus femoris, medial hamstring, tibialis anterior, and gastrocnemius muscles were recorded from 84 patients diagnosed with advanced knee OA during ground walking. Muscle activation patterns and co-activation indices were calculated over the gait cycle for pairs of medial and lateral muscles. We utilized machine-learning regression models to estimate the severity of knee OA symptoms according to the PROMs using muscle activity and co-contraction features. Additionally, we utilized the Shapley Additive Explanations (SHAP) to interpret the contribution of the EMG features to the regression model for estimation of knee OA severity according to WOMAC and VAS. Muscle activity and co-contraction patterns varied according to the functional limitations associated with knee OA severity according to VAS and WOMAC. The coefficient of determination of the cross-validated regression model is 0.85 for estimating WOMAC, 0.82 for pain, 0.85 for stiffness, and 0.85 for physical function, as well as VAS scores, utilizing the gait features. SHAP explanation revealed that greater co-contraction of lower extremity muscles during the weight acceptance and swing phases indicated more severe knee OA. The identified muscle co-activation patterns may be utilized as objective candidate outcomes to better understand the severity of knee OA.
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Affiliation(s)
- Iqram Hussain
- Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea
- Department of Anesthesiology, Weill Cornell Medicine, Cornell University, New York, NY, 10065, USA
| | - Sung Eun Kim
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Chiheon Kwon
- Medical Device Research Center, Department of Biomedical Research Institute, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Seo Kyung Hoon
- Department of Biomedical Engineering, College of Medicine, Chungnam National University, Daejeon, 35015, Republic of Korea
| | - Hee Chan Kim
- Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea
- Interdisciplinary Program in Bioengineering, Graduate School, Seoul National University, Seoul, 08826, Republic of Korea
| | - Yunseo Ku
- Medical Device Research Center, Department of Biomedical Research Institute, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.
- Department of Biomedical Engineering, College of Medicine, Chungnam National University, Daejeon, 35015, Republic of Korea.
| | - Du Hyun Ro
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
- CONNECTEVE Co., Ltd, Seoul, 06224, Republic of Korea.
- Innovative Medical Technology Research Institute, Seoul National University Hospital, Seoul, 03080, Republic of Korea.
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Lee JH, Song JY, Park KS, Lee J, Ha IH, Lee YJ. Long-term follow-up of inpatients with meniscus tears who received integrative Korean medicine treatment: A retrospective analysis and follow-up survey. Medicine (Baltimore) 2024; 103:e36917. [PMID: 38335386 PMCID: PMC10860960 DOI: 10.1097/md.0000000000036917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/22/2023] [Accepted: 12/19/2023] [Indexed: 02/12/2024] Open
Abstract
Evidence regarding the use of Korean medicine (KM) for the conservative treatment of meniscus tears remains lacking. We aimed to evaluate clinical effectiveness and long-term follow-up outcomes in patients undergoing integrative KM treatment for meniscus tears. We analyzed the electronic medical records (EMRs) of 86 patients with meniscus tears and administered a follow-up survey. Patients treated at 1 of 4 KM hospitals between June 1, 2015, and June 30, 2020, were reviewed. KM treatment comprised herbal medicine, acupuncture, pharmacopuncture, bee venom pharmacopuncture, Chuna therapy, and KM physiotherapy. The primary outcome was the numeric rating scale (NRS) score for knee pain; secondary outcomes were the Western Ontario and McMaster Universities Arthritis Index (WOMAC), EuroQol 5-dimension (EQ-5D) score, range of motion, and patient global impression of change. The NRS for knee pain was reduced by an average of 2.49 (95% confidence interval [CI]: 2.03-2.95) at discharge and 1.97 (95% CI: 2.03-2.95) at follow-up. The WOMAC decreased by an average of 15.52 (95% CI: 10.14-20.89) during hospital stay and 30.72 (95% CI: 24.58-36.87) at follow-up. The EQ-5D score increased by an average of 0.06 (95% CI: -0.14 to 0.02) at discharge and 0.19 (95% CI: -0.29 to -0.09) at follow up. KM treatment effectively reduced knee pain, improved knee joint function, and enhanced the quality of life in patients with a meniscus tear for a relatively long period after treatment.
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Affiliation(s)
- June Haeng Lee
- Jaseng Hospital of Korean Medicine, Gangnam-gu, Seoul, Republic of Korea
| | - Jin Young Song
- Jaseng Hospital of Korean Medicine, Gangnam-gu, Seoul, Republic of Korea
| | - Kyoung Sun Park
- Jaseng Hospital of Korean Medicine, Gangnam-gu, Seoul, Republic of Korea
| | - Jinho Lee
- Jaseng Hospital of Korean Medicine, Gangnam-gu, Seoul, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Gangnam-gu, Seoul, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Gangnam-gu, Seoul, Republic of Korea
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Kim SE, Yun KR, Lee JM, Lee MC, Han HS. Preserving coronal knee alignment of the knee (CPAK) in unicompartmental knee arthroplasty correlates with superior patient-reported outcomes. Knee Surg Relat Res 2024; 36:1. [PMID: 38167246 PMCID: PMC10763258 DOI: 10.1186/s43019-023-00204-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The optimal alignment target for unicompartmental knee arthroplasty (UKA) remains controversial, and literature suggests that its impact on patient-reported outcome measures (PROMs) varies. The purpose of this study was to identify the relationship between changes in the coronal plane alignment of the knee (CPAK) and PROMs in patients who underwent UKA. METHODS A retrospective analysis of 164 patients who underwent UKA was conducted. The types of CPAK types categorized into unchanged, minor (shift to an adjacent CPAK type, e.g., type I to II or type I to IV), and major changes (transitioning to a nearby diagonal CPAK type or two types across, such as type I to V or type I to III). PROMs were assessed preoperatively and 1 year postoperatively using the Hospital for Special Surgery (HSS) scores, Knee Society (KS) scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Forgotten Joint Scores (FJS). Comparison was performed between patients who experienced and who did not experience any changes in the CPAK. RESULTS Patients with preserved native CPAK alignment demonstrated significantly superior 1 year postoperative outcomes, with higher HSS, KS knee, and WOMAC pain scores (p = 0.042, p = 0.009, and p = 0.048, respectively). Meanwhile, the degree of change in CPAK did not significantly influence the PROMs, and patients who experienced minor and major changes in the CPAK showed comparable outcomes. CONCLUSION Preserving the native CPAK in UKA procedures is important for achieving favorable clinical outcomes at 1 year postoperative. The extent of change in the CPAK type exerted a limited impact on PROMs, thus emphasizing the importance of change in alignment itself.
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Affiliation(s)
- Sung Eun Kim
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea
| | - Kuk-Ro Yun
- Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Jae Min Lee
- Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Myung Chul Lee
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea
- Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Hyuk-Soo Han
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea.
- Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea.
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Kim GW. Patient-Reported Outcome Measure of Knee Function: Knee Injury and Osteoarthritis Outcome Score (KOOS). Ann Rehabil Med 2023; 47:441-443. [PMID: 38164003 PMCID: PMC10767216 DOI: 10.5535/arm.230009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/21/2023] [Accepted: 11/24/2023] [Indexed: 01/03/2024] Open
Affiliation(s)
- Gi-Wook Kim
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
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Kim SE, Lee MH, Cho CH, Lee JI, Han HS, Lee MC, Ro DH. Risk Factors and Clinical Outcomes of Osteotomy Plane Violation by D-Hole Screws in Medial Open Wedge High Tibial Osteotomy: A Simulation and Comparative Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2104. [PMID: 38138208 PMCID: PMC10745056 DOI: 10.3390/medicina59122104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/14/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Stable fixation is essential for successful healing after medial open wedge high tibial osteotomy (MOWHTO) to minimize the risk of non-union and correction loss. In Asians, potential complications such as D-hole screw osteotomy plane violation (D-hole violation) and inadequate plate fitting arise due to improper plate size. This study aimed to evaluate the risk factors for D-hole violation and compare the conventional anatomic (CA) plate with an individualized anatomic (IA) plate in MOWHTO procedures. Materials and Methods: A simulation study on D-hole violation using the CA plate was conducted, involving preoperative radiographs and CT scans of 64 lower extremities from 47 MOWHTO patients. Additionally, a randomized controlled study compared CA and IA plates in MOWHTO procedures with 34 patients (17 in the CA plate group; 18 in the IA plate group). Patient demographics, patient-reported outcome measures (PROMs), and radiological measures were analyzed. Results: In the simulation study, the rates of D-hole violation ranged from 20.3% to 59.4%, with an increase observed as the plate was distalized from 5 mm to 10 mm away from the joint line. Short stature was identified as an independent risk factor for D-hole violation (p < 0.001), with a cutoff value of 155.3 cm. In the randomized controlled study, no significant difference in PROMs and D-hole violation was observed between the CA plate and IA plate groups. However, the IA plate group showed better plate fitting compared to the CA plate group (p = 0.041). Conclusions: This study identified a high risk of D-hole screw osteotomy plane violations in MOWHTO procedures, particularly when the plate is positioned more distally and in individuals with a stature below 155.3 cm. It also revealed that individualized plates provide better tibial fitting compared to conventional anatomic plates, particularly in Asian populations where tibial morphology tends to be shorter than in Western populations. Therefore, evaluating patient stature and selecting tailored plates are essential to optimize plate positioning and minimize plate-related complications in MOWHTO procedures.
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Affiliation(s)
- Sung Eun Kim
- Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 110-744, Seoul 03080, Republic of Korea; (S.E.K.)
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Myung Ho Lee
- Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 110-744, Seoul 03080, Republic of Korea; (S.E.K.)
| | - Chan Hee Cho
- Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 110-744, Seoul 03080, Republic of Korea; (S.E.K.)
| | - Jung-In Lee
- Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 110-744, Seoul 03080, Republic of Korea; (S.E.K.)
| | - Hyuk-Soo Han
- Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 110-744, Seoul 03080, Republic of Korea; (S.E.K.)
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Myung Chul Lee
- Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 110-744, Seoul 03080, Republic of Korea; (S.E.K.)
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Du Hyun Ro
- Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 110-744, Seoul 03080, Republic of Korea; (S.E.K.)
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
- CONNECTEVE Co., Ltd., Seoul 06249, Republic of Korea
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Akinpelu AO, Omosanya OJ, Odole AC, Adegoke BOA, Oyewole OO. Cross-cultural adaptation and psychometric testing of the Yoruba lequesne algofunctional index of knee osteoarthritis among patients with knee osteoarthritis. BMC Musculoskelet Disord 2023; 24:897. [PMID: 37980475 PMCID: PMC10657015 DOI: 10.1186/s12891-023-07032-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 11/10/2023] [Indexed: 11/20/2023] Open
Abstract
BACKGROUND The Lequesne Algofunctional Index of Knee Osteoarthritis (LAIKOA) is a widely used knee osteoarthritis (KOA) outcome measure and is recommended by many international authorities. It has been cross-culturally adapted to many languages, excluding indigenous Nigerian languages. The aim of this study was to cross-culturally adapt and validate the LAIKOA into Yoruba language. METHODS This was a validation study. Yoruba LAIKOA was translated and culturally adapted from English version following Beaton's guidelines (including cognitive debriefing). The Yoruba LAIKOA was psychometrically tested for test-retest reliability, standard error of measurements (SEM), smallest detectable change (SDC), internal consistency, and construct validity among 108 Yoruba-speaking patients with KOA recruited from selected hospitals in Ibadan, Nigeria. Participants completed the Yoruba and English versions of LAIKOA, and the Yoruba version of Ibadan Knee/Hip Osteoarthritis Outcome Measure (IKHOAM). RESULTS The mean age of participants was 63.60 ± 11.77 years. Acceptable internal consistency was observed for the global index and function domain (α = 0.63-0.82) and good test-retest for items and domains (ICC = 0.81-0.995). Item-to-scale correlation was significant (r = 0.28-0.69). Its three domains demonstrated structural validity when subjected to confirmatory factor analysis (CFI = 0.99, TLI = 0.99, RMSEA = 0.02). Construct validity was supported by the correlation between Yoruba LAIKOA and IKHOAM (r = -0.39, p = 0.011). The overall scores and domain scores of the Yoruba and English versions of LAIKOA did not differ significantly. The Yoruba LAIKOA has no floor or ceiling effects. CONCLUSION The Yoruba LAIKOA is reliable and valid, and it is recommended for use in clinical settings in southwestern Nigeria and other Yoruba-speaking populations.
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Affiliation(s)
| | | | - Adesola C Odole
- Physiotherapy Department, University of Ibadan, Ibadan, Nigeria
| | | | - Olufemi O Oyewole
- Physiotherapy Department, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
- College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, South Africa.
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Kim MK, Park KS, Choi GC, Yu JE, Lee HW, Kwon YS, Huh HS, Kim S, Kim ES, Lee J, Ha IH, Lee YJ. Long-term follow-up of inpatients with traumatic fractures who received integrative Korean Medicine treatment: A retrospective analysis and questionnaire survey study. Medicine (Baltimore) 2023; 102:e34530. [PMID: 37832058 PMCID: PMC10578701 DOI: 10.1097/md.0000000000034530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 06/28/2023] [Indexed: 10/15/2023] Open
Abstract
Previous studies have reported pain reduction after Korean medicine (KM) treatment in patients with fractures. However, these studies were limited by small sample sizes and short observation periods. To address these limitations, we aimed to analyze the outcomes of patients with traumatic fractures who received integrative KM treatment and investigate their long-term progress through follow-up observations. This study was a retrospective analysis and questionnaire survey conducted at a multi-center inpatient care setting in Korea. A total of 1150 patients who had traumatic fractures and received at least 5-day inpatient care at one of 5 KM hospitals. Finally, 339 patients completed the follow-up survey. The questionnaire survey was administered 3 months post discharge. The primary outcome was the difference in numeric rating scale (NRS) scores at admission and discharge for fracture-related pain. The secondary outcomes were EuroQol 5-Dimension 5-Level (EQ-5D-5L) score, Oswestry Disability Index, Neck Disability Index, Western Ontario and McMaster Universities Arthritis Index, Shoulder Pain and Disability Index, and Patient Global Impression of Change (PGIC) score. The follow-up questionnaire survey included questions on surgery and imaging before admission and after discharge and treatment within the past 3 months. The mean NRS score at follow-up showed a significant decrease of 4.41 points compared with that at admission (P < .001). The mean EQ-5D-5L score at follow-up showed a significant increase of 0.18 points compared with that at admission (P < .05). In the follow-up survey on PGIC, 307 participants (90.56%) were "minimally improved" or better. Integrative KM treatment can help improve pain, functional impairment, and long-term quality of life in patients with traumatic fractures.
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Affiliation(s)
- Min Kyung Kim
- Daejeon Jaseng Hospital of Korean Medicine, Daejeon, Korea
| | | | - Gyu Cheol Choi
- Daejeon Jaseng Hospital of Korean Medicine, Daejeon, Korea
| | - Jae Eun Yu
- Daejeon Jaseng Hospital of Korean Medicine, Daejeon, Korea
| | - Hee Won Lee
- Daejeon Jaseng Hospital of Korean Medicine, Daejeon, Korea
| | - Yong Su Kwon
- Daejeon Jaseng Hospital of Korean Medicine, Daejeon, Korea
| | - Hyo Seung Huh
- Daejeon Jaseng Hospital of Korean Medicine, Daejeon, Korea
| | - Suna Kim
- Daejeon Jaseng Hospital of Korean Medicine, Daejeon, Korea
| | - Eun-San Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundations, Seoul, Korea
| | - Jinho Lee
- Jaseng Hospital of Korean Medicine, Seoul, Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundations, Seoul, Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundations, Seoul, Korea
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Bashekah KA, Zagzoug ME, Banaja AW, Alghamdi AA, Mishiming OS, Jan MA, Kemawi OA, Alharbi BA, Althagafi AA, Aljifri SM. Prevalence and Characteristics of Knee Osteoarthritis Among the General Public in Saudi Arabia. Cureus 2023; 15:e47666. [PMID: 38021677 PMCID: PMC10670982 DOI: 10.7759/cureus.47666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Knee osteoarthritis (OA) is a chronic and progressive knee joint condition that is influenced by multiple factors. This research aims to examine the prevalence and characteristics of knee OA among the general public in Saudi Arabia. Methodology This cross-sectional online survey was conducted in September 2023 in Saudi Arabia. This research used a previously developed questionnaire to validate the diagnosis of OA, which was performed in accordance with the diagnostic criteria established by the American College of Rheumatology (ACR). The Western Ontario and McMaster Universities Arthritis Index questionnaire (WOMAC) was used to examine the severity and characteristics of knee OA patients. A binary logistic regression analysis was conducted to determine the variables that influence the severity of knee OA and the likelihood of developing OA. Results A total of 1,019 individuals participated in this study. Around one-third of the participants (34.5%) fulfilled the ACR criteria for knee OA diagnosis. Overall, the mean WOMAC score was 34.1 (18.8) out of 96, which represents 35.5% of the maximum obtainable score and demonstrates a low degree of knee OA severity. The mean pain sub-scale score was 7.4 (3.8) out of 20, which represents 37.0% of the maximum obtainable score and demonstrates a low level of pain intensity. The mean stiffness sub-scale score was 2.7 (1.8) out of 8, which represents 33.8% of the maximum obtainable score and demonstrates a low degree of stiffness in joints. The mean physical function sub-scale score was 24.0 (14.0) out of 68, which represents 35.3% of the maximum obtainable score and demonstrates a low level of physical function difficulty. Females, older participants (above 40 years), those with high body mass index (28.8 kg/cm2 and higher), non-smokers, those with comorbidities, those who did not practice daily physical activity, those who had a family history of knee OA, and those who suffered from flat feet, rheumatoid arthritis, gout, lupus, or back or hip pain were more likely to develop knee OA and have severe OA (p < 0.05). Conclusions The findings of this study demonstrated a significant prevalence rate of knee OA and highlighted a discrepancy between the rates obtained by diagnostic criteria and those determined through clinical diagnosis. Several significant factors that contribute to the development of OA encompass lifestyle choices such as food and exercise, familial predisposition, genetic influences, and the presence of comorbidities. To effectively tackle this intricate matter, it is imperative to adopt a patient-centered strategy and prioritize early intervention.
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Abstract
BACKGROUND Total knee replacement (TKR) is a common intervention for people with end-stage symptomatic knee osteoarthritis, resulting in significant improvements in pain, function and quality of life within three to six months. It is, however, acutely associated with pain, local oedema and blood loss. Post-operative management may include cryotherapy. This is the application of low temperatures to the skin surrounding the surgical site, through ice or cooled water, often delivered using specialised devices. This is an update of a review published in 2012. OBJECTIVES To evaluate the effect of cryotherapy in the acute phase after TKR (within 48 hours after surgery) on blood loss, pain, transfusion rate, range of motion, knee function, adverse events and withdrawals due to adverse events. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, six other databases and two trials registers, as well as reference lists, related links and conference proceedings on 27 May 2022. SELECTION CRITERIA We included randomised controlled trials or controlled clinical trials comparing cryotherapy with or without other treatments (such as compression, regional nerve block or continuous passive motion) to no treatment, or the other treatment alone, following TKR for osteoarthritis. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies for inclusion, extracted data and assessed risk of bias and certainty of evidence using GRADE. We discussed any disagreements and consulted another review author to resolve them, if required. Major outcomes were blood loss, pain, transfusion rate, knee range of motion, knee function, total adverse events and withdrawals from adverse events. Minor outcomes were analgesia use, knee swelling, length of stay, quality of life, activity level and participant-reported global assessment of success. MAIN RESULTS We included 22 trials (20 randomised trials and two controlled clinical trials), with 1839 total participants. The mean ages reflected the TKR population, ranging from 64 to 74 years. Cryotherapy with compression was compared to no treatment in four studies, and to compression alone in nine studies. Cryotherapy without compression was compared to no treatment in eight studies. One study compared cryotherapy without compression to control with compression alone. We combined all control interventions in the primary analysis. Certainty of evidence was low for blood loss (downgraded for bias and inconsistency), pain (downgraded twice for bias) and range of motion (downgraded for bias and indirectness). It was very low for transfusion rate (downgraded for bias, inconsistency and imprecision), function (downgraded twice for bias and once for inconsistency), total adverse events (downgraded for bias, indirectness and imprecision) and withdrawals from adverse events (downgraded for bias, indirectness and imprecision). The nature of cryotherapy made blinding difficult and most studies had a high risk of performance and detection bias. Low-certainty evidence from 12 trials (956 participants) shows that cryotherapy may reduce blood loss at one to 13 days after surgery. Blood loss was 825 mL with no cryotherapy and 561 mL with cryotherapy: mean difference (MD) 264 mL less (95% confidence interval (CI) 7 mL less to 516 mL less). Low-certainty evidence from six trials (530 participants) shows that cryotherapy may slightly improve pain at 48 hours on a 0- to 10-point visual analogue scale (lower scores indicate less pain). Pain was 4.8 points with no cryotherapy and 3.16 points with cryotherapy: MD 1.6 points lower (95% CI 2.3 lower to 1.0 lower). We are uncertain whether cryotherapy improves transfusion rate at zero to 13 days after surgery. The transfusion rate was 37% with no cryotherapy and 79% with cryotherapy (risk ratio (RR) 2.13, 95% CI 0.04 to 109.63; 2 trials, 91 participants; very low-certainty evidence). Low-certainty evidence from three trials (174 participants) indicates cryotherapy may improve range of motion at discharge: it was 62.9 degrees with no cryotherapy and 71.2 degrees with cryotherapy: MD 8.3 degrees greater (95% CI 3.6 degrees more to 13.1 degrees more). We are uncertain whether cryotherapy improves function two weeks after surgery. Function was 75.4 points on the 0- to 100-point Dutch Western Ontario and McMaster Universities Arthritis Index (WOMAC) scale (lower score indicates worse function) in the control group and 88.6 points with cryotherapy (MD 13.2 points better, 95% CI 0.5 worse to 27.1 improved; 4 trials, 296 participants; very low-certainty evidence). We are uncertain whether cryotherapy reduces total adverse events: the risk ratio was 1.30 (95% CI 0.53 to 3.20; 16 trials, 1199 participants; very low-certainty evidence). Adverse events included discomfort, local skin reactions, superficial infections, cold-induced injuries and thrombolytic events. We are uncertain whether cryotherapy reduces withdrawals from adverse events (RR 2.71, 95% CI 0.42 to 17.38; 19 trials, 1347 participants; very low-certainty evidence). No significant benefit was found for secondary outcomes of analgesia use, length of stay, activity level or quality of life. Evidence from seven studies (403 participants) showed improved mid-patella swelling between two and six days after surgery (MD 7.32 mm less, 95% CI 11.79 to 2.84 lower), though not at six weeks and three months after surgery. The included studies did not assess participant-reported global assessment of success. AUTHORS' CONCLUSIONS The certainty of evidence was low for blood loss, pain and range of motion, and very low for transfusion rate, function, total adverse events and withdrawals from adverse events. We are uncertain whether cryotherapy improves transfusion rate, function, total adverse events or withdrawals from adverse events. We downgraded evidence for bias, indirectness, imprecision and inconsistency. Hence, the potential benefits of cryotherapy on blood loss, pain and range of motion may be too small to justify its use. More well-designed randomised controlled trials focusing especially on clinically meaningful outcomes, such as blood transfusion, and patient-reported outcomes, such as knee function, quality of life, activity level and participant-reported global assessment of success, are required.
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Affiliation(s)
- Ashwin Aggarwal
- School of Clinical Medicine, UNSW Medicine & Health, South West Sydney Clinical School, Sydney, Australia
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Sam Adie
- School of Clinical Medicine, UNSW Medicine & Health, St George & Sutherland Clinical Campuses, Sydney, Australia
| | - Ian A Harris
- School of Clinical Medicine, UNSW Medicine & Health, South West Sydney Clinical School, Sydney, Australia
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Justine Naylor
- School of Clinical Medicine, UNSW Medicine & Health, South West Sydney Clinical School, Sydney, Australia
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, Australia
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10
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Hill WS, Dohnalek MH, Ha Y, Kim SJ, Jung JC, Kang SB. A Multicenter, Randomized, Double-Blinded, Placebo-Controlled Clinical Trial to Evaluate the Efficacy and Safety of a Krill Oil, Astaxanthin, and Oral Hyaluronic Acid Complex on Joint Health in People with Mild Osteoarthritis. Nutrients 2023; 15:3769. [PMID: 37686801 PMCID: PMC10490060 DOI: 10.3390/nu15173769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Osteoarthritis is a significant global health problem. Many patients seek more effective alternatives to nonsteroidal anti-inflammatory medicines or commercial supplements to manage joint pain and inflammation. FlexPro MD® (FP-MD) combines krill oil, astaxanthin, and lower molecular weight hyaluronic acid to support joint health. A 12-week, randomized, double-blind, placebo-controlled trial compared the efficacy and safety of FP-MD and placebo once daily in participants (n = 100) with mild osteoarthritis of the knee or hip joint. For the primary endpoint of joint pain score, per-protocol participants (n = 75) in the FP-MD group (n = 37) had a statistically significantly greater mean reduction from baseline in the Korean Visual Analog Scale (K-VAS) at week 12 compared with participants in the placebo group (n = 38) (20.8 ± 16.16 mm vs. 10.6 ± 17.58, p = 0.0105). The Korean Western Ontario and McMaster Universities Osteoarthritis Index (K-WOMAC) total score was also significantly improved in the FP-MD group at week 12 compared with placebo (-13.0 ± 13.62 vs. -5.5 ± 18.08, p = 0.0489), especially an improvement in pain score (-2.5 ± 2.92 vs. -1.3 ± 3.94, p = 0.02635). FP-MD group had greater improvement in joint function scoring by investigator assessment (p = 0.0127) and by group participants (p = 0.0070). A statistically significantly greater number of patients reported adverse events in the placebo group compared with the FP-MD group (16% vs. 4%, p = 0.0455), most commonly gastrointestinal disorders in both of the groups. These findings suggest that FP-MD is well tolerated and can be effectively used to address joint pain in patients diagnosed with mild osteoarthritis, the main symptom of this condition.
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Affiliation(s)
- W. Stephen Hill
- US Nutraceuticals, Inc. d/b/a Valensa International, Eustis, FL 32726, USA; (W.S.H.); (M.H.D.)
| | - Margaret H. Dohnalek
- US Nutraceuticals, Inc. d/b/a Valensa International, Eustis, FL 32726, USA; (W.S.H.); (M.H.D.)
| | - Yejin Ha
- NOVAREX Co., Ltd., 80, Osongsaengmyeong 14-ro, Osong-eup, Chueongju-si 28220, Republic of Korea;
| | - Seok-Jung Kim
- Department of Orthopedic Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Cheonbo-ro, Uijeongbu-si 11765, Republic of Korea;
| | - Jae-Chul Jung
- NOVAREX Co., Ltd., 80, Osongsaengmyeong 14-ro, Osong-eup, Chueongju-si 28220, Republic of Korea;
| | - Seung-Baik Kang
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Boramae Hospital, Seoul 07061, Republic of Korea
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11
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Lee JE, Akimoto T, Chang J, Lee HS. Effects of joint mobilization combined with acupuncture on pain, physical function, and depression in stroke patients with chronic neuropathic pain: A randomized controlled trial. PLoS One 2023; 18:e0281968. [PMID: 37616239 PMCID: PMC10449141 DOI: 10.1371/journal.pone.0281968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/04/2023] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVE To investigate the effectiveness of joint mobilization (JM) combined with acupuncture (AC) for the treatment of pain, physical function and depression in poststroke patients. METHODS A total of 69 poststroke patients were randomly assigned to the JM+AC group (n = 23), the JM group (n = 23), and the control group (n = 23). Patients in the JM+AC group and the JM group received JM for 30 minutes, twice a week for 12 weeks, and the JM+AC group received AC for 30 minutes separately once a week. The control group did not receive JM or AC. Pain (visual analog scale, shoulder pain and disability index, Western Ontario and McMaster universities osteoarthritis index), physical function (range of motion, 10-m walking speed test, functional gait assessment, manual function test, activities of daily living scale, instrumental activities of daily living scale), and depression (center for epidemiologic studies depression scale, Beck depression inventory) were assessed for each patient before and after the 12 weeks of intervention. RESULTS Pain and physical function were improved significantly in the JM+AC group compared with the JM and control groups. Physical function and depression were improved significantly in the JM+AC and JM groups compared with the control group. CONCLUSION The treatment of JM combined with AC improved pain, depression, and physical function of poststroke patients with chronic neuropathic pain in this study. This valuable finding provides empirical evidence for the designing therapeutic interventions and identifying potential therapeutic targets.
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Affiliation(s)
- Ji-Eun Lee
- Department of Exercise and Medical Science, Dankook University, Cheonan, Republic of Korea
| | - Takayuki Akimoto
- Laboratory of Muscle Biology, Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Jisuk Chang
- Department of Sports Management, Dankook University, Cheonan, Republic of Korea
| | - Ho-Seong Lee
- Department of Exercise and Medical Science, Dankook University, Cheonan, Republic of Korea
- Institute of Medical-Sports, Dankook University, Cheonan, Republic of Korea
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12
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Zhang Y, Ren J, Zang Y, Guo W, Disantis A, Martin RL. Cross-Culturally Adapted Versions of Patient Reported Outcome Measures for the Lower Extremity. Int J Sports Phys Ther 2023; V18:653-686. [PMID: 37425110 PMCID: PMC10324371 DOI: 10.26603/001c.74528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 03/08/2023] [Indexed: 07/11/2023] Open
Abstract
Background A large number of patient reported outcome measures (PROMs) have been developed in the English language for various lower extremity orthopaedic pathologies. Twenty different PROMs were recommended for 15 specific musculoskeletal lower extremity pathologies or surgeries. However, the availability of cross-culturally adapted versions of these recommended PROMs is unknown. Purpose The purpose of this study was to identify the cross-culturally adapted versions of recommended PROMs for individuals experiencing orthopedic lower extremity pathologies or undergoing surgeries, and to identify the psychometric evidence that supports their utilization. Study design Literature Review. Methods PubMed, Embase, Medline, Cochrane, CINAHL, SPORTDisucs and Scopus were searched for cross-culturally adapted translated studies through May 2022. The search strategy included the names of the 20 recommended PROMs from previous umbrella review along with the following terms: reliability, validity, responsiveness, psychometric properties and cross-cultural adaptation. Studies that presented a non-English language version of the PROM with evidence in at least one psychometric property to support its use were included. Two authors independently evaluated the studies for inclusion and independently extracted data. Results Nineteen PROMS had cross-culturally adapted and translated language versions. The KOOS, WOMAC, ACL-RSL, FAAM, ATRS, HOOS, OHS, MOXFQ and OKS were available in over 10 different language versions. Turkish, Dutch, German, Chinese and French were the most common languages, with each language having more than 10 PROMs with psychometric properties supporting their use. The WOMAC and KOOS were both available in 10 languages and had all three psychometric properties of reliability, validity, and responsiveness supporting their use. Conclusion Nineteen of the 20 recommended instruments were available in multiple languages. The PROM most frequently cross-culturally adapted and translated were the KOOS and WOMAC. PROMs were most frequently cross-culturally adapted and translated into Turkish. International researchers and clinicians may use this information to more consistently implement PROMs with the most appropriate psychometric evidence available to support their use. Level of evidence 3a.
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Affiliation(s)
- Yongni Zhang
- Rangos School of Health Sciences Duquesne- China Health Institute
| | - Jiayi Ren
- Shuguang Hospital of Shanghai University of Traditional Chinese Medicine
| | - Yaning Zang
- Department of Kinesiology Shanghai University of Sport
| | - Wenhao Guo
- Rangos School of Health Sciences Duquesne- China Health Institute
| | - Ashley Disantis
- Department of Physical Therapy Duquesne University
- UPMC Children's Hospital of Pittsburgh
| | - Robroy L Martin
- Department of Physical Therapy Duquesne University
- UPMC Center for Sports Medicine
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13
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Kappenschneider T, Maderbacher G, Weber M, Greimel F, Holzapfel D, Parik L, Schwarz T, Leiss F, Knebl M, Reinhard J, Schraag AD, Thieme M, Turn A, Götz J, Zborilova M, Pulido LC, Azar F, Spörrer JF, Oblinger B, Pfalzgraf F, Sundmacher L, Iashchenko I, Franke S, Trabold B, Michalk K, Grifka J, Meyer M. Special orthopaedic geriatrics (SOG) - a new multiprofessional care model for elderly patients in elective orthopaedic surgery: a study protocol for a prospective randomized controlled trial of a multimodal intervention in frail patients with hip and knee replacement. BMC Musculoskelet Disord 2022; 23:1079. [PMID: 36494823 PMCID: PMC9733347 DOI: 10.1186/s12891-022-05955-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/04/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Due to demographic change, the number of older people in Germany and worldwide will continue to rise in the coming decades. As a result, the number of elderly and frail patients undergoing total hip and knee arthroplasty is projected to increase significantly in the coming years. In order to reduce risk of complications and improve postoperative outcome, it can be beneficial to optimally prepare geriatric patients before orthopaedic surgery and to provide perioperative care by a multiprofessional orthogeriatric team. The aim of this comprehensive interventional study is to assess wether multimorbid patients can benefit from the new care model of special orthopaedic geriatrics (SOG) in elective total hip and knee arthroplasty. METHODS The SOG study is a registered, monocentric, prospective, randomized controlled trial (RCT) funded by the German Federal Joint Committee (GBA). This parallel group RCT with a total of 310 patients is intended to investigate the specially developed multimodal care model for orthogeriatric patients with total hip and knee arthroplasty (intervention group), which already begins preoperatively, in comparison to the usual orthopaedic care without orthogeriatric co-management (control group). Patients ≥70 years of age with multimorbidity or generally patients ≥80 years of age due to increased vulnerability with indication for elective primary total hip and knee arthroplasty can be included in the study. Exclusion criteria are age < 70 years, previous bony surgery or tumor in the area of the joint to be treated, infection and increased need for care (care level ≥ 4). The primary outcome is mobility measured by the Short Physical Performance Battery (SPPB). Secondary outcomes are morbidity, mortality, postoperative complications, delirium, cognition, mood, frailty, (instrumental) activities of daily living, malnutrition, pain, polypharmacy, and patient reported outcome measures. Tertiary outcomes are length of hospital stay, readmission rate, reoperation rate, transfusion rate, and time to rehabilitation. The study data will be collected preoperative, postoperative day 1 to 7, 4 to 6 weeks and 3 months after surgery. DISCUSSION Studies have shown that orthogeriatric co-management models in the treatment of hip fractures lead to significantly reduced morbidity and mortality rates. However, there are hardly any data available on the elective orthopaedic care of geriatric patients, especially in total hip and knee arthroplasty. In contrast to the care of trauma patients, optimal preoperative intervention is usually possible. TRIAL REGISTRATION German Clinical Trials Register DRKS00024102. Registered on 19 January 2021.
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Affiliation(s)
- Tobias Kappenschneider
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Günther Maderbacher
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Markus Weber
- Department of Orthopaedic and Trauma Surgery, Hospital Barmherzige Brüder Regensburg, Regensburg, Germany
| | - Felix Greimel
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Dominik Holzapfel
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Lukas Parik
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Timo Schwarz
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Franziska Leiss
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Michael Knebl
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Jan Reinhard
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Amadeus Dominik Schraag
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Max Thieme
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Agathe Turn
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Julia Götz
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Magdalena Zborilova
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Loreto C. Pulido
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Fady Azar
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Jan-Frederik Spörrer
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Britta Oblinger
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Frederik Pfalzgraf
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Leonie Sundmacher
- grid.6936.a0000000123222966Department of Health Economics, Technical University of Munich, Munich, Germany
| | - Iryna Iashchenko
- grid.6936.a0000000123222966Department of Health Economics, Technical University of Munich, Munich, Germany
| | - Sebastian Franke
- grid.6936.a0000000123222966Department of Health Economics, Technical University of Munich, Munich, Germany
| | - Benedikt Trabold
- Department of Anaesthesiology, Asklepios Klinikum Bad Abbach, Bad Abbach, Germany
| | - Katrin Michalk
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Joachim Grifka
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Matthias Meyer
- grid.411941.80000 0000 9194 7179Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
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14
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Kim KY, Huh YG, Ma SH, Yoon JH, Jeong KY, Park DY, Yoon SH. Efficacy of Adductor Canal Block on Medial Knee Pain in Patients with Knee Osteoarthritis: A Randomized Single-Blind Placebo-Controlled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15419. [PMID: 36430138 PMCID: PMC9696118 DOI: 10.3390/ijerph192215419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND This study aimed to confirm the efficacy of ultrasound-guided adductor canal block (ACB) as a treatment option for medial knee pain caused by knee osteoarthritis (KOA). METHODS In total, 31 participants with medial knee pain due to KOA were randomized to either the ACB (ultrasound-guided ACB, n = 15) or placebo group (1 mL of 1% lidocaine, n = 16). The primary outcome was a numerical rating scale (NRS) for knee pain intensity comparing before and 4 weeks after injection. The secondary outcomes were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), average daily number of analgesics consumed, average daily opioid consumption, and Timed Up and Go (TUG) test results before and 4 weeks after injection. RESULTS Participants' baseline characteristics were not significantly different between the groups, except for age. At 4 weeks post-injection, the NRS score in the ACB group significantly improved compared to that in the placebo group (p = 0.009). However, the WOMAC, average daily number of analgesics consumed, average daily opioid consumption, and TUG test results did not show significant differences. CONCLUSION ACB can be an effective treatment for reducing medial knee pain in patients with KOA.
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Affiliation(s)
- Ki-Yong Kim
- Department of Physical Medicine and Rehabilitation, Ajou University Medical Center, Suwon 16499, Republic of Korea
| | - Yool-Gang Huh
- Department of Physical Medicine and Rehabilitation, Ajou University Medical Center, Suwon 16499, Republic of Korea
| | - Sang Hyeok Ma
- Department of Physical Medicine and Rehabilitation, Ajou University Medical Center, Suwon 16499, Republic of Korea
| | - Jong Hyeon Yoon
- Department of Physical Medicine and Rehabilitation, Ajou University Medical Center, Suwon 16499, Republic of Korea
| | - Kil-Yong Jeong
- Department of Physical Medicine and Rehabilitation, Ajou University Medical Center, Suwon 16499, Republic of Korea
| | - Do Young Park
- Department of Orthopedic Surgery, Ajou University Medical Center, Suwon 16499, Republic of Korea
| | - Seung-Hyun Yoon
- Department of Physical Medicine and Rehabilitation, Ajou University Medical Center, Suwon 16499, Republic of Korea
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15
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Lee C, Park H. Effects of a Fall Prevention Program Based on Goal Attainment Theory for Homebound Older Adults With Osteoarthritis of the Lower Extremities. Orthop Nurs 2022; 41:414-427. [PMID: 36413667 DOI: 10.1097/nor.0000000000000898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This study implemented and evaluated a community-based fall prevention program based on goal attainment theory that targeted older adults with osteoarthritis. The program included education, exercise, and one-on-one counseling during which the participant and the provider set individual fall prevention goals. This study used a nonequivalent control group pre-/posttest design. Participants were older adults in senior centers with lower extremity osteoarthritis. A fall prevention program in the experimental group included group (70 minutes, once/week; education and exercise) and individual counseling (10 minutes, twice/week; emotional support and goal setting). Data analysis was conducted using SPSS/WIN 22.0 with the χ2 test, Fisher's exact test, independent t test, and Mann-Whitney U test. The experimental group experienced significantly fewer falls, less stiffness, less difficulty performing activity; more muscular strength, walking ability, and balance; as well as less fear of falling and higher falls efficacy in comparison with the control group. However, pain did not improve in either of the two groups. Fall prevention programs need to include the active involvement of carers in ensuring environmental changes to reduce fall risks. In addition, health professionals who care for community patients with osteoarthritis could strengthen interactions and exchanges to prevent falls and actively modify home hazards.
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Affiliation(s)
- Chunhee Lee
- Chunhee Lee, PhD, RN , PhD Student, Graduate School, Keimyung University, Daegu, South Korea, and Assistant Professor, Department of Nursing, Pohang University, Pohang, South Korea
- Heeok Park, PhD, RN , Associate Professor, College of Nursing, Research Institute of Nursing Science, Keimyung University, Daegu, South Korea
| | - Heeok Park
- Chunhee Lee, PhD, RN , PhD Student, Graduate School, Keimyung University, Daegu, South Korea, and Assistant Professor, Department of Nursing, Pohang University, Pohang, South Korea
- Heeok Park, PhD, RN , Associate Professor, College of Nursing, Research Institute of Nursing Science, Keimyung University, Daegu, South Korea
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16
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Moon JY, Kim J, Lee JY, Ko Y, Park HJ, Jeon YH. Comparison of polynucleotide, sodium hyaluronate, and crosslinked sodium hyaluronate for the management of painful knee osteoarthritis: a multi-center, randomized, double-blind, parallel-group study. PAIN MEDICINE 2022; 24:496-506. [PMID: 36255262 DOI: 10.1093/pm/pnac155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 10/07/2022] [Accepted: 10/12/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To compare the clinical effectiveness of sodium polynucleotide, classic hyaluronic acid, and crosslinked hyaluronic acid for the management of painful knee osteoarthritis. DESIGN Randomized, double-blind, parallel-group clinical trial. SETTING Multicenter study. SUBJECTS Patients with chronic painful knee osteoarthritis. METHODS Ninety patients were selected and randomized into polynucleotide, classic hyaluronic acid, and crosslinked hyaluronic acid groups (30 per group). Intra-articular injections of the viscosupplement for each group were administered to the patients three times at one-week intervals. The primary outcome was differences in changes of weight-bearing pain scores at 16 weeks between the groups. The secondary outcomes were changes in the intensity of knee pain during weight-bearing, walking, and rest, and functional disability, quality of life, and adverse events during the 16-week follow-up period. RESULTS At 16 weeks, the polynucleotide group showed a higher reduction in pain score using a Visual Analog Scale score (0-100) than the classic hyaluronic acid (-17.6 [95% CI = -35.1 to -0.1]; P = 0.048) and crosslinked hyaluronic acid (-22.4 [95% CI = -41.5 to -3.3]; P = 0.016) groups. The polynucleotide and crosslinked hyaluronic acid groups showed an early-onset reduction in knee pain during weight-bearing, walking, and rest. All three groups showed reductions in functional disability and improved quality of life at 16 weeks without inter-group differences. No severe adverse events were reported throughout the study period. CONCLUSION Polynucleotide significantly relieves pain more and relieves pain faster in patients with knee osteoarthritis than classic and crosslinked hyaluronic acid, with improved health-related quality of life. CLINICAL TRIAL NUMBER AND REGISTRY URL Clinical Research Information Service (https://cris.nih.go.kr/cris/index.jsp; Identifier: KCT0005308).
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Affiliation(s)
- Jee Youn Moon
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jeongsoo Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin Young Lee
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
| | - Youngkwon Ko
- Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Heu Jung Park
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young Hoon Jeon
- Department of Anesthesiology and Pain Medicine, Kyugpook National University College of Medicine, Daegu, Republic of Korea
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Shoji T, Inoue T, Kato Y, Fujiwara Y, Sumii J, Shozen H, Adachi N. Associations between implant alignment or position and patient-reported outcomes after total hip arthroplasty. Clin Biomech (Bristol, Avon) 2022; 97:105701. [PMID: 35696828 DOI: 10.1016/j.clinbiomech.2022.105701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 05/18/2022] [Accepted: 06/01/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND We aimed to evaluate the associations between implant alignment/position and patient-reported outcomes following total hip arthroplasty using CT-based simulation software. METHODS We reviewed hips of 137 patients (27 males, 110 females, mean age: 67.3 years old) who underwent total hip arthroplasty. Radiographic evaluations were based on the software for evaluation of the parameters related to implant alignment/position and femoral/3-dimensional offset using post-operative CT data. Pre-operative and one-year post-operative patient-reported outcomes using Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire scores were evaluated. FINDINGS The total and movement scores of normal combined anteversion and stem anteversion angle groups were significantly higher than those of lower and higher groups. The pain and movement scores of decreased femoral offset group were significantly lower than those of restored and increased femoral offset group. There were no significant differences in all scores in cup inclination and anteversion angle, stem coronal alignment, and 3-dimensional femoral offset among groups. Moreover, investigation of the associations between combined anteversion angle/stem anteversion/femoral offset and movement scores revealed that combined anteversion angle and stem anteversion were significantly associated with the movement that needs deep hip flexion and occasionally deep abduction, and high femoral offset was also associated with the movement that needs deep hip flexion. INTERPRETATION Surgeons should consider the stem anteversion, stem sagittal alignment, and combined anteversion, in addition to the femoral offset to achieve patient's post-operative satisfaction, although the surgeon may have a relatively larger choice for the implant positioning, especially on the cup side.
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Affiliation(s)
- Takeshi Shoji
- Department of Artificial Joints and Biomaterials, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
| | - Tadashi Inoue
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Yuichi Kato
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Yusuke Fujiwara
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Junichi Sumii
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Hideki Shozen
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
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18
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Lee BC, Moon CW, Choi WS, Kim YM, Joo YB, Lee DG, Lee SJ, Choi ES, Ji JH, Suh DW, Cho KH. Clinical evaluation of usefulness and effectiveness of sitting type continuous passive motion machines in patients with total knee arthroplasty: a study protocol for a single-blinded randomized controlled trial. BMC Musculoskelet Disord 2022; 23:565. [PMID: 35689278 PMCID: PMC9188049 DOI: 10.1186/s12891-022-05507-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/01/2022] [Indexed: 11/26/2022] Open
Abstract
Background Total knee arthroplasty (TKA) is an important management strategy for patients with knee osteoarthritis (OA) refractory to conservative management. Postoperative range of motion (ROM) exercise is important to recover patients’ activities of daily living. Continuous passive motion (CPM) is a machine that provides passive ROM exercises of the knee joint in a pre-defined arc of motion. The short- and long-term effects of CPM exercise are controversial. We hypothesized that the inconsistent results of the CPM exercise are due to poor fitting of CPM machines and measurement errors. This study aims to present a protocol for investigating a new type of CPM machine that could be applied in a sitting position in comparison with the conventional type of CPM machine for patients with unilateral TKAs. Methods This study presents the protocol of a prospective, multicenter, single-blinded, three-armed randomized controlled trial (RCT). One hundred and twenty-six patients receiving unilateral TKAs will be recruited at the physical medicine and rehabilitation clinics of two urban tertiary medical hospitals. The patients were randomly divided into three groups with a 1:1:1 allocation. The intervention group will receive two weeks of post-operative rehabilitation using a new type of CPM machine. The control group will receive 2 weeks of post-operative rehabilitation using conventional CPM machines. The third group will receive post-operative rehabilitation with both types of CPM machines. The primary outcome will be the change in the passive ROM of the affected knee joint from baseline to 2 weeks after baseline assessment. The secondary outcomes will be pain and functional measurements, and will include patient-reported outcomes and performance tests surveyed at multiple time points up to 3 months after TKA. Discussion This is the first RCT to investigate the effect of a new type of CPM machine. The results of this RCT will determine whether the position of the patients during CPM exercise is important in post-operative rehabilitation protocols after TKAs and will provide evidence for the development of proper rehabilitation guidelines after TKAs. Trial registration Clinical Research Information Service of Republic of Korea, KCT0005520, Registered on 21 October 2020, https://cris.nih.go.kr/cris/search/detailSearch.do/21750 Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05507-2.
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Affiliation(s)
- Byung Chan Lee
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine, 266 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea
| | - Chang Won Moon
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine, 266 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea.,Department of Biomedical Institute, Chungnam National University, Daejeon, Korea
| | - Woo Sung Choi
- Department of Biomedical Institute, Chungnam National University, Daejeon, Korea
| | - Young Mo Kim
- Department of Orthopedic Surgery, Chungnam National University College of Medicine, Daejeon, Korea
| | - Yong Bum Joo
- Department of Orthopedic Surgery, Chungnam National University College of Medicine, Daejeon, Korea
| | - Da Gyo Lee
- Catholic University of Korea Industry Academic Cooperation Foundation. The Catholic University of Korea, Seoul, Korea
| | - Sook Joung Lee
- Department of Rehabilitation Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun Seok Choi
- Department of Rehabilitation Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong Hun Ji
- Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Whan Suh
- Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kang Hee Cho
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine, 266 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea. .,Department of Biomedical Institute, Chungnam National University, Daejeon, Korea.
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Park J, Lee J, Lee H, Kim S, Kim CO, Park CG. Physical resilience as a moderator of the relationship between frailty and disability in older adults with osteoarthritis. J Adv Nurs 2022; 78:2085-2094. [PMID: 34990022 DOI: 10.1111/jan.15135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/13/2021] [Accepted: 12/09/2021] [Indexed: 11/28/2022]
Abstract
AIMS Frailty is a leading cause of deteriorating physical function of older adults with osteoarthritis. This study examined a model of frailty with the goals of (1) exploring the direct effect of osteoarthritic symptoms on disability and the mediating effect of frailty on disability and (2) determining whether both effects are moderated by physical resilience. DESIGN A cross-sectional descriptive study. METHODS Data collection was conducted among patients 65-92 years of age (N = 235) who visited primary medical centres for the management of chronic arthritic pain between July and December 2019. Participants completed a questionnaire measuring osteoarthritic symptoms, frailty, physical resilience, and disability. SPSS 25.0 was used to analyse the conditional process model. This study was reported following the STROBE guidelines. RESULTS Frailty was shown to be a mediator between osteoarthritic symptoms and disability. Furthermore, physical resilience played a role as a moderator in both the direct and indirect pathways of this mediating relationship. CONCLUSION The findings emphasize the detrimental effects of osteoarthritic symptoms on disability through frailty, and the moderated mediation results suggest that these effects were conditional on physical resilience, which is a modifiable internal resource of individuals. When planning nursing interventions for older adults with osteoarthritis, nurses need to consider physical resilience as a moderator to prevent frailty and disability.
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Affiliation(s)
- Jungah Park
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
| | - JuHee Lee
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Hyangkyu Lee
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Sanghee Kim
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Chang Oh Kim
- Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chang Gi Park
- College of Nursing, University of Illinois, Chicago, Chicago, Illinois, USA
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The Relationship Between Lower Urinary Tract Symptoms and Osteoarthritis Symptoms Among Vendors in a Conventional Market. Int Neurourol J 2021; 26:37-44. [PMID: 34922425 PMCID: PMC8984692 DOI: 10.5213/inj.2142146.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 06/03/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose This study aimed to investigate lower urinary tract symptoms (LUTS) and the correlation between LUTS and osteoarthritis (OA) symptoms in the vendors working in a conventional market. Methods This cross-sectional study was conducted on 153 vendors aged 40 and over from August 10th to September 8th, 2020, in a conventional market. Data were collected via the self-reported questionnaires. We assessed LUTS by International Prostate Symptom Score (IPSS) and OA symptoms by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results The mean age of 153 subjects was 61.31±9.92 years old. The mean score of IPSS and WOMAC was 5.37±5.68 (range, 0–35) and 16.89±19.61 (range, 0–96). Fifty-one percent of subjects had urinary incontinence at least monthly. Twenty-four point two percent of subjects had moderate-to-severe LUTS which were defined as a score of IPSS ≥8. LUTS were positively correlated with OA symptoms (r=0.41, P<0.001). Conclusions The results showed that LUTS were associated with OA symptoms, and it also emphasized the need for vendors to be provided with a health education program to manage and prevent their LUTS and OA symptoms.
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21
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Work-related factors of knee osteoarthritis in Korean farmers: a cross-sectional study. Ann Occup Environ Med 2021; 32:e37. [PMID: 34754458 PMCID: PMC7779842 DOI: 10.35371/aoem.2020.32.e37] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 10/23/2020] [Indexed: 11/20/2022] Open
Abstract
Background Several studies have reported a high prevalence of osteoarthritis (OA) of the knee among agricultural workers. We investigated work-related factors that increase the risk of knee OA among Korean farmers. Methods Data were extracted from the Jeonnam Center for Farmer's Safety and Health survey, conducted between 2013 and 2015. The sample included 489 farmers (man 240, woman 249). We defined knee OA as radiographic knee OA (≥ Kellgren-Lawrence grade 2) with symptoms (≥ Western Ontario and McMaster Universities Osteoarthritis, Korean version score 29.5). We considered covariates such as cumulative squatting working time (CSWT), cumulative heavy lifting working time (CLWT), body mass index (BMI), and history of knee injury. Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were calculated for knee OA and adjusted for relevant covariates. Results The results of multivariate logistic regression analysis indicated that knee OA was correlated by factors such as sex, age, BMI, history of knee injury, CSWT, and CLWT. Particularly, CSWT > 20,000 hours (OR: 2.83; 95% CI: 1.35-5.92; reference < 10,000 hours) and CLWT > 5,000 hours (OR: 2.62; 95% CI: 1.14-6.06; reference < 2,000 hours) were associated with an increased risk of knee OA after adjustment for covariates. Conclusions Squatting posture and heavy lifting associated with farm work might increase the risk of knee OA among Korean farmers.
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Oh SL, Kim DY, Bae JH, Lim JY. Effects of rural community-based integrated exercise and health education programs on the mobility function of older adults with knee osteoarthritis. Aging Clin Exp Res 2021; 33:3005-3014. [PMID: 32020485 DOI: 10.1007/s40520-020-01474-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 01/03/2020] [Indexed: 12/18/2022]
Abstract
AIM To examine the effects of a rural community-based program integrating health education and self-directed home-based resistance training on the mobility function of older women with knee osteoarthritis (OA). METHODS Participants were assigned to the control (CON) or intervention (INT) group. Participants completed a mobility function assessment and questionnaire evaluation. The CON group received only the health education program and the INT group also participated in resistance training for 5 months. Primary outcomes were mobility function measured using a timed chair stand (TCS), timed up & go (TUG), gait speed (GS), and knee extensor strength (KES). We evaluated body composition and questionnaire results (WOMAC score, SARC-F scale, and SOF index) as secondary outcomes. RESULTS There were significant differences in the interactions of group-by-time effects for TCS (p < 0.001), TUG (p = 0.006), GS (p = 0.020), and knee strength (p = 0.010). In the CON group, TCS (p = 0.003) and TUG (p = 0.005) increased compared with baseline, while in the INT group, TCS decreased significantly (p < 0.001) and TUG tended to decrease after the intervention. The INT group showed improvement in GS (p < 0.001) and KES (p = 0.003) after the intervention. By contrast, the CON group showed decreasing GS (p = 0.021) and KES (p = 0.011) compared with baseline. The SARC-F scale differed significantly in the interaction of group-by-time effects (p = 0.030), while the body composition, SOF index, and WOMAC score did not differ. CONCLUSION These results suggest that an integrated intervention program combining self-directed home-based resistance training with health education effectively improves the mobility function of older adults with knee OA dwelling in rural areas.
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Affiliation(s)
- Seung-Lyul Oh
- Aging & Mobility Biophysics Laboratory, Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Day-Young Kim
- Aging & Mobility Biophysics Laboratory, Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jun-Hyun Bae
- Aging & Mobility Biophysics Laboratory, Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jae-Young Lim
- Aging & Mobility Biophysics Laboratory, Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
- Institute on Aging, Seoul National University, Seoul, South Korea.
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Kim JS, Kim CJ, Schlenk EA. Psychometric Properties of the Korean Version of the Patient Knowledge Questionnaire-Osteoarthritis. Clin Nurs Res 2021; 31:69-79. [PMID: 33749315 DOI: 10.1177/10547738211001964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined the psychometric properties of the Korean version of the Patient Knowledge Questionnaire-Osteoarthritis (PKQ-OA-K). A cross-sectional survey was conducted with 157 adults with osteoarthritis from the outpatient clinic at a university hospital in Korea. The overall correct answer rate for the PKQ-OA-K was 60.4%; notably, the drug therapy subscale had the lowest median score percentage (42.9%). For structural validity, exploratory factor analysis identified the PKQ-OA-K as two-dimensional, explaining 52.4% of the total variance. Confirmatory factor analysis showed that the two-factor model adequately fit the data. The PKQ-OA-K was positively correlated with education level (r = 0.24) and osteoarthritis outcomes (r = 0.17), thus verifying the hypotheses of construct validity. The intraclass correlation coefficient for test-retest reliability was 0.52; alpha was 0.44. The PKQ-OA-K has excellent validity but imperfect reliability for adults with osteoarthritis. This study recommends cautious use of the PKQ-OA-K to assess Korean patients' knowledge of osteoarthritis.
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Kim JY, Kim YN, Lee YJ, Sim SE, Ko YR, Shim JW, Lee KS, Joo M, Park HJ. Pilot Study to Evaluate the Efficacy of Polynucleotide Sodium Compared to Sodium Hyaluronate and Crosslinked Sodium Hyaluronate in Patients with Knee Osteoarthritis. J Clin Med 2021; 10:jcm10051138. [PMID: 33803080 PMCID: PMC7963169 DOI: 10.3390/jcm10051138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/26/2021] [Accepted: 03/03/2021] [Indexed: 12/18/2022] Open
Abstract
Degenerative arthritis of the knee joint has become a major social problem worldwide due to population aging. There are several treatment options for knee osteoarthritis, and the intraarticular injection of sodium hyaluronate is commonly selected by many clinicians as a nonsurgical treatment. However, the efficacy of the treatment is controversial. In this pilot study, we aimed to compare polynucleotide sodium (Conjuran®) with sodium hyaluronate (Hyruan Plus®) and 1,4-butanediol diglycidyl ether-crosslinked sodium hyaluronate (Synovian®) in terms of analgesic efficacy after intraarticular injection in patients with knee osteoarthritis. One of the three intraarticular agents was selected according to what agents were available for outpatients when each patient was enrolled in the study. The 15 enrolled patients were subdivided into 3 groups of 5 patients each. Three injections were performed under ultrasound guidance at a 1-week intervals over a total of 3 weeks. The visual analog scale (VAS) score, the Korean version of the Western Ontario and McMaster Universities Arthritis Index (K-WOMAC), the EuroQol five-dimension scale (EQ-5D) score, and the Korean version of the painDETECT Questionnaire (K-PDQ) score were evaluated before injection and at 1, 2, and 6 weeks after the start of the treatment protocol. The primary endpoint was the change in weight-bearing pain at 4 weeks after the last injection. Secondary endpoints included pain at rest and during walking and the K-WOMAC, EQ-5D, and K-PDQ scores. Weight-bearing pain decreased significantly more from pretreatment to 6 weeks after the start of the treatment protocol in the polynucleotide sodium-treated patients than in the patients who were treated with other agents (p = 0.006, one-way ANOVA). There were no significant between-group differences in the other secondary endpoints. No adverse events occurred. In conclusion, polynucleotide sodium could effectively reduce weight-bearing pain in the patients with knee osteoarthritis compared to standard hyaluronic acid viscosupplementation.
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Affiliation(s)
- Ji Yeong Kim
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (J.Y.K.); (S.E.S.); (Y.R.K.); (J.W.S.); (K.S.L.); (M.J.)
| | - Yoo Na Kim
- Mapo Hapjung Bone Orthopedics, Seoul 06591, Korea;
| | | | - Sung Eun Sim
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (J.Y.K.); (S.E.S.); (Y.R.K.); (J.W.S.); (K.S.L.); (M.J.)
| | - Yu Ri Ko
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (J.Y.K.); (S.E.S.); (Y.R.K.); (J.W.S.); (K.S.L.); (M.J.)
| | - Jin Woo Shim
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (J.Y.K.); (S.E.S.); (Y.R.K.); (J.W.S.); (K.S.L.); (M.J.)
| | - Ku Sang Lee
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (J.Y.K.); (S.E.S.); (Y.R.K.); (J.W.S.); (K.S.L.); (M.J.)
| | - Mina Joo
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (J.Y.K.); (S.E.S.); (Y.R.K.); (J.W.S.); (K.S.L.); (M.J.)
| | - Hue Jung Park
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (J.Y.K.); (S.E.S.); (Y.R.K.); (J.W.S.); (K.S.L.); (M.J.)
- Correspondence: ; Tel.: +82-2-2258-2236 (ext. 6157)
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Comparative Observational Study on the Effects of Intra-articular Hominis Placenta Pharmacopuncture and Acupoint Hominis Placenta Pharmacopuncture for Knee Osteoarthritis Patients. JOURNAL OF ACUPUNCTURE RESEARCH 2021. [DOI: 10.13045/jar.2020.00451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The aim of this case report was to observe the effects of intra-articular hominis placenta pharmacopuncture (HPP). Based on the medical records patients who received intra-articular treatment or received acupoint pharmacopuncture treatment, a comparison was made. There were 35 patients who were hospitalized for degenerative osteoarthritis of the knee joint from the 1<sup>st</sup> October 2019 to 26<sup>th</sup> September 2020. There were 14 patients who were treated with HPP in the intra-articular joint space (Group A), and 14 patients who were treated with HPP at specific acupoints (Group B). The outcome effects were measured using the Korean Western Ontario and Mc (KWOMAC) the visual analog scale (VAS) before the first treatment, and after the fifth treatment. The KWOMAC (<i>p</i> < 0.001) and the VAS scores (<i>p</i> < 0.001) in Groups A and B significantly improved after treatment compared with before treatment. When comparing Group A improvement with Group B improvement using the KWOMAC there was no statistically significant difference however, when using the VAS scores, Group A treatment was statistically more effective compared with Group B (<i>p</i> = 0.002). This study indicated that HPP may be an effective treatment for knee osteoarthritis. Moreover, intra-articular HPP may be more effective than acupoint HPP for knee osteoarthritis.
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Kim JS, Kim CJ. [Effect of a Physical Activity Promoting Program Based on the IMB Model on Obese-Metabolic Health Outcomes among Obese Older Adults with Knee Osteoarthritis]. J Korean Acad Nurs 2021; 50:271-285. [PMID: 32376814 DOI: 10.4040/jkan.2020.50.2.271] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/19/2019] [Accepted: 01/19/2020] [Indexed: 11/09/2022]
Abstract
PURPOSE This study examined the effects of a physical activity promoting program based on the Information-Motivation-Behavioral Skills (IMB) model on physical activity and health outcomes among obese older adults with knee osteoarthritis. METHODS This study utilized a randomized controlled trial with a convenience sample of 75 obese older adults with knee osteoarthritis in a university hospital. The older adults in the intervention group participated in a 12-week program involving weekly group sessions and monitoring calls with education booklets and video clips for exercise dances, while those in the control group received an usual care. Outcomes were measured using self-report questionnaires, anthropometrics, and blood analyses. The intervention effects were analyzed using Mann-Whitney U test and ANCOVA. RESULTS The mean age of participants was 74.9 years with 84.0% women. The intervention group at 12 weeks showed significantly greater improvements in self-efficacy for physical activity (F=81.92, p<.001), physical activity amounts (Z=-2.21, p=.044), knee joint function (F=15.88, p<.001), and health-related quality of life (F=14.89, p<.001) compared to the control group. Among obese-metabolic outcomes, the intervention group at 12 weeks showed a significant decrease in visceral fat mass (F=7.57, p=.008) and improvement in high-density level cholesterol (F=9.51, p=.003) compared to the control group. CONCLUSION Study findings support the need for an IMB based physical activity program for promoting physical activity, knee function and health outcomes in obese older adults with knee osteoarthritis. Longitudinal studies are warranted to confirm the persistence of obese-metabolic effects in clinical settings.
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Affiliation(s)
- Jung Suk Kim
- College of Nursing · The Research Institute of Nursing Science, Ajou University, Suwon, Korea
| | - Chun Ja Kim
- College of Nursing · The Research Institute of Nursing Science, Ajou University, Suwon, Korea.
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Baek S, Kim G, Park HW. A mobile delivered self-exercise program for female farmers. Medicine (Baltimore) 2020; 99:e23624. [PMID: 33350739 PMCID: PMC7769339 DOI: 10.1097/md.0000000000023624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 11/12/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Female farmers commonly experience musculoskeletal pain in the back, knee, and shoulder. Despite their obvious advantages in reducing musculoskeletal pain, face-to-face exercise programs are limited by geographical and physical barriers. Thus, we decided to introduce eHealth technology to farmers' musculoskeletal health care. Using a mobile application (app), we aim to provide a tailored self-exercise program for shoulder, knee, and back pain in female farmers in rural areas after a musculoskeletal health check-up. METHODS This study is planned as 2 randomized control studies (MObile Delivered self-Exercise [MODE] phase I and phase II). We plan to recruit 200 female farmers aged 41 to 70 years. Initially, the shoulders, knees, and low back will be evaluated to provide individualized exercise programs. In MODE-I (single-blinded: evaluator), the subjects will be randomly allocated to experimental (n = 100) and control (n = 100) groups using a computer-generated sequence. Both groups will perform a 3-month self-exercise using a smartphone app or physical education data (booklets), respectively. Outcomes including exercise completion will be assessed at 3 months. In MODE-II, after subject random allocation, the experimental and control groups will perform exercise using a smartphone app with and without real-time feedback, respectively. Every 3 months, the level of the exercise program will be evaluated and the difficulty level will be adapted accordingly. After MODE-II is completed, all subjects will undergo close-out assessment. DISCUSSION This will be the first attempt to compare methods using booklets and apps to identify effective ways of providing personalized self-exercise programs according to musculoskeletal health stages by evaluating female farmers (MODE-I). This will help clarify whether the mobile app is effective for self-exercise compared to a conventional booklet. The MODE-II study will help to assess the effect of providing feedback through the mobile app. Finally, we will evaluate musculoskeletal health according to the degree of participation over 12 months to confirm the effect of self-exercise. Our study should aid in managing musculoskeletal health for farmers living in rural areas and help promote health in the "untact" era. TRIAL REGISTRATION Clinical Research Information Service of the Korean National Institutes of Health (KCT0005245). Registered July 17, 2020.
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Affiliation(s)
- Sora Baek
- Center for Farmers’ Safety and Health and Department of Rehabilitation Medicine, Kangwon National University Hospital
- Department of Rehabilitation Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Gangwon-do, Chuncheon, Republic of Korea
| | - Gowun Kim
- Center for Farmers’ Safety and Health and Department of Rehabilitation Medicine, Kangwon National University Hospital
- Department of Rehabilitation Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Gangwon-do, Chuncheon, Republic of Korea
| | - Hee-won Park
- Center for Farmers’ Safety and Health and Department of Rehabilitation Medicine, Kangwon National University Hospital
- Department of Rehabilitation Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Gangwon-do, Chuncheon, Republic of Korea
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Kim MS, Koh IJ, Kim CK, Choi KY, Kim CY, In Y. Cross-cultural adaptation and validation of the Korean version of the Central Sensitization Inventory in patients undergoing total knee arthroplasty for knee osteoarthritis. PLoS One 2020; 15:e0242912. [PMID: 33259513 PMCID: PMC7707521 DOI: 10.1371/journal.pone.0242912] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 11/11/2020] [Indexed: 11/18/2022] Open
Abstract
The purpose of this study was to establish a Korean version of the Central Sensitization Inventory (CSI-K) for Korean-speaking patients facing total knee arthroplasty (TKA) for knee osteoarthritis (OA) and to investigate the psychometric characteristics of the CSI-K. We recruited a total of 269 patients with knee OA who were scheduled to undergo TKA for the study. CSI-K and pain-related outcomes, including the pain visual analog scale (VAS) and the Western Ontario and McMaster Universities OA Index (WOMAC) pain sub-scores, were measured. Since central sensitization (CS) is closely related to the quality of life (QOL) and limited functionality as well as pain, the patient's function was measured using the WOMAC function sub-scores, and QOL was measured using the EuroQol five-dimension test (EQ-5D). Reliability and validity were evaluated. Exploratory factor analysis (EFA) was conducted to begin the data reduction to validate the existing questionnaire translation. The internal consistency was excellent, with a Cronbach's alpha of 0.941. The test-retest reliability was acceptable-to-excellent with an ICC of 0.888. As expected, the CSI scores correlated strongly with the WOMAC pain scores (r = 0.524, p < 0.001) and moderately with the pain VAS (r = 0.496, p < 0.001), the WOMAC function (r = 0.408, p < 0.001), and the EQ-5D scores (r = 0.437, p < 0.001). EFA resulted in a six-factor model. The findings demonstrate that the CSI was successfully trans-culturally adapted into a simplified Korean version (CSI-K) that was reliable and valid for Korean-speaking patients who awaiting TKA for knee OA.
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Affiliation(s)
- Man Soo Kim
- Department of Orthopaedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - In Jun Koh
- Department of Orthopaedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chul Kyu Kim
- Department of Orthopaedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Keun Young Choi
- Department of Orthopaedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chang Yeon Kim
- Department of Orthopaedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong In
- Department of Orthopaedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- * E-mail:
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Kim MS, Koh IJ, Kim CK, Choi KY, Yang JS, In Y. Patient Expectations and Satisfaction After Medial Opening Wedge High Tibial Osteotomy. J Arthroplasty 2020; 35:3467-3473. [PMID: 32684398 DOI: 10.1016/j.arth.2020.06.076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/31/2020] [Accepted: 06/24/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The objective of this study is to assess preoperative patient expectations of medial opening wedge high tibial osteotomy (MOWHTO) and related postoperative fulfillment, to increase understanding of associated factors of postoperative satisfaction. METHODS One hundred fifteen patients who underwent MOWHTO were enrolled. Patients' expectations were measured using the Hospital for Special Surgery-Knee Replacement Expectations Survey. Fulfillment of expectations and satisfaction was evaluated using the Hospital for Special Surgery Knee Replacement Fulfillment of Expectations Survey and a 5-point Likert scale at 2 years, postoperatively. The discrepancies between preoperative expectation and postoperative fulfillment score were also assessed. Preoperative and postoperative patient-reported outcomes were evaluated using Western Ontario and McMaster Universities Arthritis Index (WOMAC) score. Univariate and multivariate analyses were performed to model predictions for satisfaction. RESULTS The most expected items were "pain relief," "walking ability," and "perform daily activities." The top 3 items with the biggest discrepancies between expectation and fulfillment scores were "kneeling," "squatting," and "pain relief." Ninety patients (78.3%) were satisfied and 25 (21.7%) were dissatisfied at 2 years postoperative. Multivariate logistic regressions showed that patient expectations did not affect satisfaction. Small discrepancies between expectation and fulfillment scores (odds ratio [OR] 105.304, 95% confidence interval 20.974-528.714, P < .001), high postoperative fulfillment scores (OR 1.198, 95% CI 1.110-1.293, P < .001), and low postoperative Western Ontario and McMaster Universities Arthritis Index total scores (OR 0.932, 95% CI 0.894-0.971, P < .001) were significantly associated with patient satisfaction. CONCLUSION The small discrepancy between preoperative expectations and postoperative fulfillment of expectations was a major contributor to patients' satisfaction following MOWHTO.
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Affiliation(s)
- Man Soo Kim
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - In Jun Koh
- Department of Orthopaedic Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chul Kyu Kim
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Keun Young Choi
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jun Seo Yang
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong In
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Gyejigachulbutang (Gui-Zhi-Jia-Shu-Fu-Tang, Keishikajutsubuto, TJ-18) in Degenerative Knee Osteoarthritis Patients: Lessons and Responders from a Multicenter Randomized Placebo-Controlled Double-Blind Clinical Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:2376581. [PMID: 33178309 PMCID: PMC7647757 DOI: 10.1155/2020/2376581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/19/2020] [Accepted: 10/14/2020] [Indexed: 02/07/2023]
Abstract
Background Gyejigachulbutang (GUI-ZHI-JIA-SHU-FU-TANG, GCB) is an herbal formula widely prescribed in traditional East Asian medicine practice for arthritis and muscle pain. We evaluated the efficacy and safety of GCB for degenerative knee osteoarthritis (KOA). Methods Eighty patients with KOA were randomly assigned to the GCB group or the placebo group in a 1 : 1 ratio in two Korean medicine hospitals. Patients took GCB or placebo three times a day for 4 weeks. Primary outcome was the change in the visual analogue scale (VAS) score for knee pain from baseline to 4th week. Secondary outcomes were the change in the VAS score from baseline to 2nd week and 8th week, Korean Western Ontario and McMaster Universities Osteoarthritis Index (K-WOMAC), European Quality of Life Five Dimensions questionnaire (EQ-5D), and safety. Results There was no significant difference between the compared indicators of the GCB and placebo groups. However, in subgroup analysis, GCB was effective for subjects with a BMI lower than 25 kg/m2. The dose of pain medication was significantly lower in the GCB group than in the placebo group after four weeks (p=0.016). There were no serious adverse events in the GCB group. Conclusions GCB was not effective in primary outcome analysis. In exploratory subgroup analysis, GCB might be effective for individuals with BMI lower than 25 kg/m2 for the treatment of degenerative KOA. GCB may also help reduce the consumption of pain medication. Furthermore, research is required for our hypothesis. This trial is registered with KCT0003024.
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Weick JW, Bullard J, Green JH, Gagnier JJ. Measures of Hip Function and Symptoms. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:200-218. [PMID: 33091262 DOI: 10.1002/acr.24231] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 04/21/2020] [Indexed: 12/28/2022]
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McHugh M, Droy E, Muscatelli S, Gagnier JJ. Measures of Adult Knee Function. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:219-249. [DOI: 10.1002/acr.24235] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/21/2020] [Indexed: 12/23/2022]
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Mahmood T, Choudhury MR, Islam MN, Haq SA, Shahin MA, Ali SMM, Ahmed S, Shazzad MN, Hasan ATMT, Azad MAK, Rasker JJ. Translation, cross-cultural adaptation and validation of the English Lequesne Algofunctional index in to Bengali. Health Qual Life Outcomes 2020; 18:343. [PMID: 33076904 PMCID: PMC7574420 DOI: 10.1186/s12955-020-01583-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 09/28/2020] [Indexed: 11/12/2022] Open
Abstract
Background This study was focused on translation and cultural adaptation of the English Lequesne Algofunctional index (LAI) into Bengali for patients with primary knee osteoarthritis (OA) and testing reliability and validity of the Bengali version of the LAI. Methods This study was carried out in the Department of Rheumatology, BSM Medical University, Dhaka, Bangladesh. Using the forward–backward method the English LAI was translated into Bengali including cultural adaptation. For pretesting, A sample of 40 patients with primary knee osteoarthritis were screened using the Bengali version of LAI. Following the pretest, 130 consecutive patients with symptomatic knee OA completed the interviewer administered Bengali LAI, the validated Bengali version of SF-36, Visual Analogue Scale for Pain, Distance Walked and Activities of Daily Living. For the retest 60 randomly selected patients from the cohort were administered the Bengali LAI 7 days later. An item by item analysis was performed. Internal consistency was assessed by Cronbach’s alpha, test–retest reliability by intraclass correlation coefficient (ICC) and Kappa coefficient, construct validity was measured using the Spearman rank correlation coefficient. Results It took 3.25 ± 0.71 min to complete the Bengali LAI and the mean score was 9.23 ± 4.58. For the Bengali LAI Cronbach’s alpha score was 0.88, test–retest reliability assessed by ICC was 0.97. For construct validity, excellent convergent validity was achieved (ρ = 0.93) but the divergent validity was moderate (ρ = 0.43). Conclusions The Bengali LAI showed excellent convergent validity, internal consistency and test–retest reliability, only the divergent validity was moderate. So, the Bengali LAI can be applied as a HRQoL assessment tool for primary knee OA patients.
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Affiliation(s)
- Tarek Mahmood
- Department of Medicine, Patuakhali Medical College, Patuakhali, Bangladesh.
| | - Minhaj Rahim Choudhury
- Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Md Nazrul Islam
- Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Syed Atiqul Haq
- Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Md Abu Shahin
- Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | | | - Shamim Ahmed
- Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Md Nahiduzzamane Shazzad
- Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - A T M Tanveer Hasan
- Department of Rheumatology, Enam Medical College and Hospital, Savar, Dhaka, Bangladesh
| | - Mohammad Abul Kalam Azad
- Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Johannes Jacobus Rasker
- Department of Psychology, Health and Technology, Faculty of Behavioural Sciences, University of Twente, Enschede, The Netherlands
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Shin JY, Chang MJ, Kim MK, Kang SB, Kim KI, Park HG, Lee S, Kim SH, Han SB, Lee HJ, Moon YW, Yoo JD. Efficacy and safety of short-term use of a pelubiprofen CR and aceclofenac in patients with symptomatic knee osteoarthritis: A double-blinded, randomized, multicenter, active drug comparative, parallel-group, phase IV, non-inferiority clinical trial. PLoS One 2020; 15:e0238024. [PMID: 32991606 PMCID: PMC7523996 DOI: 10.1371/journal.pone.0238024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 08/07/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION At present, information about clinical efficacy and adverse events of controlled release (CR) form of pelubiprofen, a prodrug of 2-arylopropionic acid with relatively selective effects on cyclooxygenase-2 activity, remains scarce. In this study, we sought to determine non-inferiority of pelubiprofen CR 90 mg/day compared to aceclofenac 200 mg/day regarding clinical efficacy and adverse events after a 4-week course of medication in the patients with symptomatic knee osteoarthritis. MATERIALS AND METHODS A total of 191 patients were randomly assigned to take either pelubiprofen CR 90 mg (n = 95) or aceclofenac 200 mg (n = 96). The primary outcome variable was non-inferiority of pain reduction between baseline and week 4 when assessed using a 100 mm pain visual analogue scale (VAS). Pelubiprofen was considered non-inferior to aceclofenac if the upper limit of the one-sided 97.5% confidence interval for the difference in terms of pain VAS was above 15 mm (the average change of pain VAS in the pelubiprofen group-pain VAS reduction in the aceclofenac group). Secondary outcome variables were the changes in 100 mm pain VAS at week 2 versus baseline, K-Western Ontario, and McMaster University Arthritis Index (K-WOMAC) changes at weeks 2 and 4 as compared to baseline, patient global assessment at weeks 2 and 4. The frequency and amount of rescue medicine usage at weeks 2 and 4 were also evaluated as the secondary outcome variable. For safety analysis, adverse events, clinical laboratory tests, vital signs, and physical examinations were assessed and conducted at each follow-up visit. RESULTS At week 4, the pain VAS values were significantly reduced in both groups receiving either pelubiprofen CR 90 mg or aceclofenac 200 mg as compared to the baseline. However, the pelubiprofen group and the aceclofenac group respectively showed the pain VAS changes of -22 and -21.9 in the pre-protocol set and -20.8 and -21.7 in the full analysis set, confirming non-inferiority. The pelubiprofen CR 90 mg showed a reduced incidence of adverse events compared to the aceclofenac 200 mg (p = 0.005). CONCLUSIONS Pelubiprofen CR 90 mg is as effective as aceclofenac 200 mg with reduced adverse events for the treatment of symptomatic knee osteoarthritis.
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Affiliation(s)
- Joung Youp Shin
- Department of Orthopaedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Moon Jong Chang
- Department of Orthopaedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Myung Ku Kim
- Department of Orthopaedic Surgery, Inha University Hospital, Incheon, Republic of Korea
- * E-mail:
| | - Seung-Baik Kang
- Department of Orthopaedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kang-Il Kim
- Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Hee Gon Park
- Department of Orthopaedic Surgery, Dankook University Hospital, Cheonan-si, Chungcheongnam-do, Republic of Korea
| | - Sahnghoon Lee
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sung-Hwan Kim
- Department of Orthopaedic Surgery, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea
| | - Seung-Beom Han
- Department of Orthopaedic Surgery, Korea University Medical Center, Seoul, Republic of Korea
| | - Han Jun Lee
- Department of Orthopaedic Surgery, Chung-Ang University, School of Medicine, Seoul, Republic of Korea
| | - Young-Wan Moon
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae-Doo Yoo
- Department of Orthopaedic Surgery, Ewha Womans University School of Medicine, Ewha Medical Research Center, Seoul, Republic of Korea
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Kwon SB, Ku Y, Han HS, Lee MC, Kim HC, Ro DH. A machine learning-based diagnostic model associated with knee osteoarthritis severity. Sci Rep 2020; 10:15743. [PMID: 32978506 PMCID: PMC7519044 DOI: 10.1038/s41598-020-72941-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 09/09/2020] [Indexed: 11/17/2022] Open
Abstract
Knee osteoarthritis (KOA) is characterized by pain and decreased gait function. We aimed to find KOA-related gait features based on patient reported outcome measures (PROMs) and develop regression models using machine learning algorithms to estimate KOA severity. The study included 375 volunteers with variable KOA grades. The severity of KOA was determined using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). WOMAC scores were used to classify disease severity into three groups. A total of 1087 features were extracted from the gait data. An ANOVA and student's t-test were performed and only features that were significant were selected for inclusion in the machine learning algorithm. Three WOMAC subscales (physical function, pain and stiffness) were further divided into three classes. An ANOVA was performed to determine which selected features were significantly related to the subscales. Both linear regression models and a random forest regression was used to estimate patient the WOMAC scores. Forty-three features were selected based on ANOVA and student's t-test results. The following number of features were selected from each joint: 12 from hip, 1 feature from pelvic, 17 features from knee, 9 features from ankle, 1 feature from foot, and 3 features from spatiotemporal parameters. A significance level of < 0.0001 and < 0.00003 was set for the ANOVA and t-test, respectively. The physical function, pain, and stiffness subscales were related to 41, 10, and 16 features, respectively. Linear regression models showed a correlation of 0.723 and the machine learning algorithm showed a correlation of 0.741. The severity of KOA was predicted by gait analysis features, which were incorporated to develop an objective estimation model for KOA severity. The identified features may serve as a tool to guide rehabilitation and progress assessments. In addition, the estimation model presented here suggests an approach for clinical application of gait analysis data for KOA evaluation.
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Affiliation(s)
- Soon Bin Kwon
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul, Korea
| | - Yunseo Ku
- Department of Biomedical Engineering, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Hyuk-Soo Han
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea
| | - Myung Chul Lee
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea
| | - Hee Chan Kim
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul, Korea
- Institute of Medical & Biological Engineering, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea
| | - Du Hyun Ro
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.
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A Self-Efficacy Reinforcement Stretching Exercise Program for Community-Dwelling Older Women With Osteoarthritis: A Pilot Study. Rehabil Nurs 2020; 46:11-23. [PMID: 32932424 DOI: 10.1097/rnj.0000000000000290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study evaluated the effectiveness of the Self-Efficacy Reinforcement Stretching Exercise Program to improve osteoarthritis (OA)-related symptoms in older women with OA. DESIGN A quasi-experimental design was used in this study. METHODS The experimental group participated in the Self-Efficacy Reinforcement Stretching Exercise Program, a 6-week program composed of stretching exercises and self-efficacy reinforcement strategies, whereas the control group did not. All participants were assessed on pain; joint stiffness; physical function disability; body mass index; depression; and quality of life at the beginning, end, and 4 weeks after the program ended. FINDINGS After participation, the experimental group had significantly less joint stiffness, physical function disability, and depression scores and significantly higher self-efficacy and quality of life than the control group. CONCLUSIONS This intervention program led to an improvement in OA-related symptoms, self-efficacy, and quality of life in older women with OA. CLINICAL RELEVANCE The sustained effects of acquired exercise behaviors that persisted up to 4 weeks after the program ended could be of interest to rehabilitation nurses and other healthcare professionals.
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Effectiveness and safety of electrical moxibustion for knee osteoarthritis: A multicenter, randomized, assessor-blinded, parallel-group clinical trial. Complement Ther Med 2020; 53:102523. [PMID: 33066857 DOI: 10.1016/j.ctim.2020.102523] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 06/25/2020] [Accepted: 07/18/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The prevalence of knee osteoarthritis (KOA) is increasing, and it has emerged as a major health issue. Studies have been reported that moxibustion is effective for treating KOA, but conventional moxibustion is difficult to control the intensity of stimulation and causes smoke, harmful gases, or odors. An electrical moxibustion (EM) device was developed to solve these problems, so we conducted this study to evaluate the effectiveness and safety of EM as a treatment for KOA. METHODS This is a multicenter, randomized, assessor-blinded, parallel-group clinical trial. Participants with KOA were randomly allocated into EM, traditional indirect moxibustion (TIM), or usual care groups. The moxibustion groups were received 12 sessions of moxibustion treatment at six acupuncture points (ST36, ST35, ST34, SP9, EX-LE4, SP10) over a period of 6 weeks. The usual care group was received usual treatment and self-care. The primary outcome was the degree of pain measured by numerical rating scale (NRS). The second outcomes were measured using visual analog scale, Korean version of the Western Ontario and McMaster Universities osteoarthritis index, patient global assessment, European quality of life five dimension five level scale, and warm sense threshold and heat pain threshold. For safety assessment, laboratory test and adverse events (AEs) were recorded. RESULTS A total of 138 participants were assigned. While there was no significant NRS change in the usual care, EM and TIM showed significant decrease after treatment. Compared to the usual care, the mean change of NRS in the EM and TIM was significantly different, but there was no significance between two groups. Regarding secondary outcomes, EM and TIM also showed significant difference compared to the usual care, but there was no significance between two groups. Regarding safety assessment, while usual care showed significant safety among three groups, EM showed seven treatment-related AEs by four participants compared TIM's 10 events by 10 participants. In addition, there was no blister caused by burns in the EM, which occurred four cases in the TIM. CONCLUSION This study shows that EM is effective to improve the pain and function by KOA with a certain level of safety.
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Lee YJ, Han CH, Jeon JH, Kim E, Kim JY, Park KH, Kim AR, Lee EJ, Kim YI. Effectiveness and safety of polydioxanone thread-embedding acupuncture (TEA) and electroacupuncture (EA) treatment for knee osteoarthritis (KOA) patients with postoperative pain: An assessor-blinded, randomized, controlled pilot trial. Medicine (Baltimore) 2020; 99:e21184. [PMID: 32791693 PMCID: PMC7387022 DOI: 10.1097/md.0000000000021184] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/08/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Degenerative knee osteoarthritis (KOA) shows an increase in morbidity with improvement in the living conditions and extended lifespans. Treatment for degenerative KOA has been gaining attention since it significantly affects the life of the elderly population and is also associated with increased expenses for medical services and high socioeconomic costs. Treatments for degenerative KOA include nondrug therapy, drug therapy, and surgical treatment. For cases that show little response to conservative treatment but have not involved severe deformation of the knee, procedures such as arthroscopic surgery, autologous chondrocyte implantation, or autologous osteochondral transplantation can be performed. However, effective treatment is required for patients experiencing sustained knee pain after surgery. Although studies confirming the therapeutic effects of acupuncture or thread-embedding acupuncture (TEA) treatment for degenerative KOA have been reported, clinical studies on a combination of TEA and electroacupuncture (EA) in patients complaining of knee pain after arthroscopic surgery, autologous chondrocyte implantation, or autologous osteochondral transplantation have not yet been reported. Therefore, this study aimed to evaluate the effectiveness and safety of this combination treatment in patients with persistent knee pain after arthroscopic surgery, autologous chondrocyte implantation, or autologous osteochondral transplantation. METHODS/DESIGN This study has been designed as a 2-group, parallel, single-center, randomized, controlled, assessor-blinded trial. Thirty-six patients with degenerative KOA who complained of pain even after arthroscopic surgery, autologous chondrocyte implantation, or autologous osteochondral transplantation will be randomized to either the (TEA + EA + Usual care) group or the (Usual care only) group in a 1:1 ratio. The patients in the (TEA + EA + Usual care) group will receive TEA treatment once a week for 4 weeks for a total of 4 sessions and EA twice a week for a total of 8 sessions while continuing usual care. The (Usual care only) group will only receive usual care for 4 weeks. To assess the efficacy of the TEA and EA combination treatment, the visual analogue scale, the Korean version of the Western Ontario and McMaster Universities Osteoarthritis Index, the EuroQol 5-Dimension 5-Level, and the doses of the rescue drug taken will be evaluated at baseline (1W) and weeks 2 (2W), 4 (4W), 6 (6W), and 8 (8W). The primary efficacy endpoint is the mean change in visual analogue scale at week 4 (4W) compared to baseline. Adverse events will be assessed at every visit. DISCUSSION This study will provide useful data for evaluating the clinical efficacy and safety of TEA and electroacupuncture combination treatment for improving pain and quality of life after surgery for degenerative KOA. TRIAL REGISTRATION Clinical Research Information Service of Republic of Korea (CRIS- KCT0004804), March 6, 2020.
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Affiliation(s)
- Ye Ji Lee
- Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Daejeon University
| | - Chang-Hyun Han
- Clinical Medicine Division, Korea Institute of Oriental Medicine
- Korean Medicine Life Science, University of Science and Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon
| | - Ju Hyun Jeon
- Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Daejeon University
| | - Eunseok Kim
- Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Daejeon University
| | - Jin Youp Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul
| | - Ki Hyun Park
- Clinical Medicine Division, Korea Institute of Oriental Medicine
| | - Ae Ran Kim
- Clinical Medicine Division, Korea Institute of Oriental Medicine
| | - Eun Jung Lee
- Department of Korean Medicine Rehabilitation, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Young Il Kim
- Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Daejeon University
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Ko Y, Kim HJ, Kim H, Choi JB, Kwon YD, Jung WS, Jang BH, Kim N, Song YK, Ko SG. Exploring the efficacy and safety of herbal medicine on Korean obese women with or without metabolic syndrome risk factors: A study protocol for a double-blind, randomized, multi-center, placebo-controlled clinical trial. Medicine (Baltimore) 2020; 99:e21153. [PMID: 32664149 PMCID: PMC7360330 DOI: 10.1097/md.0000000000021153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The prevalence of obesity among women is increasing. Obesity is associated with various metabolic syndromes; conventional treatments are limited and may induce serious adverse events due to polytherapy regimens. Currently, demands for complementary and alternative medicine that has a proven safety profile for the treatment of obesity with or without metabolic risk factors are increasing.Our team of preclinical experts reported a significant anti-obesity effect of the Korean herbal medicine, Galgeun-tang (GGT). Thus, we designed this trial to explore the effects of GGT among obese women to accumulate optimal clinical evidence.Obesity is not only a component of metabolic syndrome and a factor associated with an increased risk of cardiovascular disease but is also related to insulin resistance. Previous research has confirmed that an increasing body mass index is highly related with increased risk of metabolic syndrome among overweight and obese individuals. The effectiveness of the Korean medicine herbal formula, GGT on obesity has been previously reported. The objective of this study is to assess the efficacy and safety of GGT for weight loss among obese Korean women with or without high risk for metabolic syndrome. METHODS/DESIGN This study is a randomized, double-blinded, placebo-controlled, multi-center clinical trial. A total of 160 participants will be randomly distributed in 2 groups, the GGT group or the placebo group in a 1:1 ratio using a web-based randomization system. Each group will be administered GGT or placebo 3 times a day for 12 weeks. The primary endpoint is to assess the change in weight from baseline. The secondary endpoints are the following: the changes in body composition measurements, anthropomorphic measurements, obesity screening Laboratory tests, patient self-reported questionnaires, and economic evaluation outcomes. Adverse events will also be reported. DISCUSSION The findings of this study will confirm methodologies regarding the efficacy and safety of GGT for weight loss among obese Korean women with or without metabolic risk factors.
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Affiliation(s)
- Youme Ko
- Department of Korean Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul
- Institute of Safety and Effectiveness Evaluation for Korean Medicine, Kyung Hee University, Seoul
| | - Hyun-Ju Kim
- Oriental Medicine Research Institute, College of Korean Medicine, Gachon University, Seongnam
| | - Hojun Kim
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Dongguk University, Seoul
| | - Jin-Bong Choi
- Department of Oriental Rehabilitation Medicine, Gwangju Oriental Hospital of Dongshin University, Gwangju
| | - Young-Dal Kwon
- Department of Korean Medicine Rehabilitation, Gwangju Medical Center, College of Korean Medicine, Wonkwang University, Gwangju
| | - Won-Seok Jung
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul
| | - Bo-Hyoung Jang
- Department of Korean Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul
- Institute of Safety and Effectiveness Evaluation for Korean Medicine, Kyung Hee University, Seoul
| | - NamKwen Kim
- Center for Comparative Effectiveness Research & Economic Evaluation in Korean Medicine, Pusan National University, Yangsan
| | - Yun-Kyung Song
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Gachon University, Seongnam, Republic of Korea
| | - Seong-Gyu Ko
- Department of Korean Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul
- Institute of Safety and Effectiveness Evaluation for Korean Medicine, Kyung Hee University, Seoul
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Effect of Dynamic Balance Exercises Based on Visual Feedback on Physical Function, Balance Ability, and Depression in Women after Bilateral Total Knee Arthroplasty: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093203. [PMID: 32380679 PMCID: PMC7246741 DOI: 10.3390/ijerph17093203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/02/2020] [Accepted: 05/03/2020] [Indexed: 01/14/2023]
Abstract
The aim of this study was to compare the effects of dynamic balance exercises with and without visual feedback on recovery from total knee arthroplasty. The participants were 30 women who underwent total knee arthroplasty more than one week before the study, and were randomly allocated into two groups. The average ages of the experimental and control groups were 70.13 and 69.00 years, respectively. The dynamic balance exercise with visual feedback (VF) group practiced dynamic balance exercises using a laser pointer for five 30-min sessions over a 4-week period. The dynamic balance exercise without visual feedback (control) group practiced dynamic balance exercises for five 30 min sessions over a 4 week period. The following clinical measures were used for assessing physical function, balance ability, and depression. Compared with the control group, the VF group showed significant improvements in the physical performance test, Western Ontario and McMaster Universities Arthritis Index (WOMAC), confidence ellipse area (CEA), path length (PL), average velocity (AV), and Timed Up and Go test (TUG test) (p < 0.05). Furthermore, the VF group showed significant improvements in all post-surgery outcome measures compared with the pre-surgery values (p < 0.05). The above results indicated that the dynamic balance exercises based on visual feedback improved physical function and balance ability in patients following total knee arthroplasty, suggesting the need for effective rehabilitation programs for patients with total knee arthroplasty.
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Association of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) with Muscle Strength in Community-Dwelling Elderly with Knee Osteoarthritis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072260. [PMID: 32230913 PMCID: PMC7177915 DOI: 10.3390/ijerph17072260] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/19/2020] [Accepted: 03/23/2020] [Indexed: 12/15/2022]
Abstract
Purpose: The purpose of this study was to evaluate the correlation between muscle strength and knee symptoms (pain, stiffness, and functional limitation) regardless of the presence of radiologic knee osteoarthritis (RKOA) in community-dwelling elderly. Patients and methods: This cross-sectional study used data from the Namgaram-2 cohort. The Namgaram-2 cohort consisted of participants living in three rural communities. Such participants were included for studies on activity limitation due to age-related musculoskeletal disorders including knee osteoarthritis, osteoporosis, and sarcopenia. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), a health assessment tool for patients with arthritis in lower extremities, was used to assess health-related quality of life (HRQOL). Muscle strengths were measured by knee strength (by using the isokinetic dynamometer) and hand grip strength. Results: The WOMAC pain of Kallgren–Lawrence (K/L) grade < 2 was correlated with age, grip strength, nutrition status, and knee extension 180 peak torque. The WOMAC pain of K/L grade ≥ 2 was correlated with age, nutrition status, and knee extension 60 peak torque. The WOMAC stiffness of K/L grade < 2 was correlated with having a spouse, nutrition status, and knee extension 60 peak torque. The WOMAC stiffness of K/L grade ≥ 2 was correlated with knee extension 60 peak torque. The WOMAC function of K/L grade < 2 was correlated with age, grip strength, osteoporosis, nutrition status, and knee extension 180 peak torque. The WOMAC function of K/L grade ≥ 2 was correlated with age, nutrition status, and knee extension 60 peak torque. Conclusion: Muscle strength as measured by grip strength and knee extension was statistically significantly correlated with the WOMAC scores in patients with knee symptoms regardless of whether radiologic signs of knee osteoarthritis were observed.
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Park SH, Kang BH, Kim MJ, Kim B, Lee GY, Seo YM, Yoo JI, Park KS. Validation of the Western Ontario and McMaster Universities Arthritis Index Short Form (WOMAC-SF) and Its Relevance to Disability and Frailty. Yonsei Med J 2020; 61:251-256. [PMID: 32102126 PMCID: PMC7044687 DOI: 10.3349/ymj.2020.61.3.251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/07/2020] [Accepted: 02/10/2020] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study aimed to evaluate the validity of the Western Ontario and McMaster Universities Arthritis Index Short Form (WOMAC-SF) for the assessment of musculoskeletal disorders. We evaluated whether WOMAC-SF correlated with the World Health Organization Disability Assessment Schedule 12 (WHODAS-12) and Kaigo-Yobo questionnaires for assessing health-outcomes in Korea. MATERIALS AND METHODS This cross-sectional study used data from the Namgaram-2 cohort. WOMAC, WOMAC-SF, WHODAS-12, and Kaigo-Yobo questionnaires were administered to patients with musculoskeletal disorders, including radiology-confirmed knee osteoarthritis (RKOA), sarcopenia, and osteoporosis. The relationships among WOMAC-SF, WHODAS-12, and Kaigo-Yobo scores were analyzed by stepwise multiple regression analysis. RESULTS WOMAC-SF was associated with the WOMAC questionnaire. The results of confirmatory factor analysis for the hypothesized model with two latent factors, pain and function, provided satisfactory fit indices. WOMAC-SF pain and function were associated with RKOA. Kaigo-Yobo was associated with WOMAC-SF pain (B=0.140, p=0.001) and WOMAC-SF function (B=0.042, p=0.004). WHODAS-12 was associated with WOMAC-SF pain (B=0.679, p=0.003) and WOMAC-SF function (B=0.804, p<0.001). CONCLUSION WOMAC-SF was validated for the evaluation of low extremity musculoskeletal disorders and health-related quality of life in a community-based population. Furthermore, we confirmed that WOMAC-SF were reflective of disability and frailty, which affect health outcomes.
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Affiliation(s)
- Soo Hyun Park
- Department of Preventive Medicine, College of Medicine and Institute of Health Science, Gyeongsang National University, Jinju, Korea
| | - Byeong Hun Kang
- Department of Orthopedic Surgery, Gyeongsang National University Hospital, Jinju, Korea
| | - Mi Ji Kim
- Department of Preventive Medicine, College of Medicine and Institute of Health Science, Gyeongsang National University, Jinju, Korea
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
| | - Bokyoung Kim
- Department of Preventive Medicine, College of Medicine and Institute of Health Science, Gyeongsang National University, Jinju, Korea
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
| | - Gyeong Ye Lee
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
| | - Young Mi Seo
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
| | - Jun Il Yoo
- Department of Orthopedic Surgery, Gyeongsang National University Hospital, Jinju, Korea.
| | - Ki Soo Park
- Department of Preventive Medicine, College of Medicine and Institute of Health Science, Gyeongsang National University, Jinju, Korea
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea.
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Jeong H, Lee Y. Sex-Based Differences in the Quality of Life of Elderly Koreans with Chronic Musculoskeletal Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E743. [PMID: 31979306 PMCID: PMC7038106 DOI: 10.3390/ijerph17030743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 01/16/2020] [Accepted: 01/18/2020] [Indexed: 11/18/2022]
Abstract
In this study, we constructed a structural equation model (SEM) for predicting the quality of life (QOL) in elderly Koreans with chronic musculoskeletal pain (CMP) and examined the differences between sexes. Data were earlier collected in a prior study of 307 participants (101 men and 206 women) with CMP, aged 65 years and above, who used geriatric welfare centers located in two cities. The effects of pain, functional limitation, perceived health status, pain coping, and social support on the QOL were estimated with a multigroup SEM. For both men and women, the results show sequential causality from pain to functional limitation, perceived health status, and QOL. However, the relationships among pain, pain coping, functional limitation, and QOL differ between men and women. The multigroup SEM provides a better understanding of the sex differences in the QOL of elderly with CMP. The results suggest that in order to improve QOL among the elderly with CMP, a customized strategy should be applied that takes into account differences between the sexes.
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Affiliation(s)
- Hyesun Jeong
- Department of Nursing, Graduate School, Pusan National University, Yangsan 50612, Korea;
| | - Yoonju Lee
- College of Nursing, Pusan National University, Yangsan 50612, Korea
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Longo UG, Ciuffreda M, Candela V, Berton A, Maffulli N, Denaro V. Hip scores: A current concept review. Br Med Bull 2019; 131:81-96. [PMID: 31436810 DOI: 10.1093/bmb/ldz026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/16/2019] [Accepted: 07/18/2019] [Indexed: 11/13/2022]
Abstract
INTRODUCTION During the past decades, several rating scales have been developed to assess the functional status of patients with hip pain. SOURCE OF DATA A search in Medline, PubMed, Cochrane and CINAHL was performedusing combinations of the following'hip', 'scoring system', 'scale', 'scores', 'outcome assessment', 'arthroplasty', 'arthroscopy' and 'clinical evaluation'. AREAS OF AGREEMENT A total 16 scoring systems are currently available for the evaluation of the hip. AREAS OF CONTROVERSY Two types of questionnaires are available: physician-rated and patient-rated questionnaires. GROWING POINTS Each hip score consists of different domains. Interpreting these domains becomes sometimes difficult, because, even though they can be common to more than one scoring system, each stresses them in a different way. AREAS TIMELY FOR DEVELOPING RESEARCH Although many scoring systems have been used to evaluate hip function, we are still far from a single outcome evaluation system which is reliable, valid and sensitive.
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Affiliation(s)
- Umile Giuseppe Longo
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy
| | - Mauro Ciuffreda
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy
| | - Vincenzo Candela
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy
| | - Alessandra Berton
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy
| | - Nicola Maffulli
- Department of Musculoskeletal Disorder, Faculty of Medicine and Surgery, University of Salerno, Salerno Italy.,Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London E1 4DG, England.,Institute of Science and Technology in Medicine, Keele University School of Medicine, Thornburrow Drive, Stoke on Trent, England
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy
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Bilateral Quadriceps Muscle Strength and Pain Correlate With Gait Speed and Gait Endurance Early After Unilateral Total Knee Arthroplasty. Am J Phys Med Rehabil 2019; 98:897-905. [DOI: 10.1097/phm.0000000000001222] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yoon S, Kang JJ, Kim J, Park S, Kim JM. Efficacy and Safety of Intra-articular Injections of Hyaluronic Acid Combined With Polydeoxyribonucleotide in the Treatment of Knee Osteoarthritis. Ann Rehabil Med 2019; 43:204-214. [PMID: 31072087 PMCID: PMC6509584 DOI: 10.5535/arm.2019.43.2.204] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 10/25/2018] [Indexed: 12/16/2022] Open
Abstract
Objective To assess the clinical efficacy and safety of intra-articular injection of hyaluronic acid (HA) combined with polydeoxyribonucleotide (PDRN) in patients with knee osteoarthritis in comparison with that of HA alone. Methods The current single-center, prospective, randomized, double-blind, controlled study was conducted in 36 patients with knee osteoarthritis at our medical institution. All the eligible patients (n=30) were equally assigned to two treatment arms (trial group ‘HA+PDRN’ and control group ‘HA’). For efficacy assessment, the patients were evaluated for the visual analogue scale (VAS) scores, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Knee Society Scores (KSS), all of which served as efficacy outcome measures. We monitored time-dependent changes in efficacy outcome measures at baseline and 1, 3 and 6 months. Subsequently, we compared differences in changes in efficacy outcome measures at 6 months from baseline between the two groups. Moreover, we assessed the safety based on the treatment-emergent adverse events (TEAEs), adverse drug reactions (ADRs) and any other complications serving as safety outcome measures. Results There were significant differences in changes in the VAS scores, the WOMAC scores in all domains, except ‘Stiffness’, the total WOMAC scores, and the KSS scores in all the domains at 6 months from baseline between the two groups (p<0.05). In our series, there were no TEAEs, ADRs, and any other complications. Conclusion Intra-articular injections of HA combined with PDRN can also be considered in the treatment of knee osteoarthritis. However, further large-scale and multi-center studies are required to demonstrate the potential of the proposed combination.
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Affiliation(s)
- Seihee Yoon
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
| | - Jung Joong Kang
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
| | - Jungin Kim
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
| | - Seunghun Park
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
| | - Jong Moon Kim
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
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Kim TH, Kang JW. Acupuncture for symptoms management in Korean breast cancer survivors: a prospective pilot study. Acupunct Med 2019; 37:164-174. [DOI: 10.1177/0964528419832610] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: There is an unmet need for effective treatment of the various treatment-related symptoms experienced by breast cancer survivors. These symptoms could be alleviated by acupuncture. Although several lines of evidence in Western countries suggest that acupuncture has a beneficial effect on symptoms in breast cancer survivors, few relevant studies have been conducted in Korean patients. This pilot study assessed the feasibility of acupuncture for a variety of treatment-related symptoms in Korean breast cancer survivors. Method: From October 2015 to March 2016, we recruited patients who had undergone treatment for breast cancer and subsequently reported symptoms, including aromatase inhibitor-related knee pain, vasomotor symptoms, insomnia, sexual dysfunction and post-mastectomy pain in the chest wall or shoulder. The women received 4 weeks of symptom-specific acupuncture followed by a further 4 weeks of follow-up to evaluate the feasibility of acupuncture for this indication, and its impact on common and symptom-specific outcome variables. Results: Eight study participants were recruited over a period of 6 months, six of whom completed the planned acupuncture treatment and follow-up assessments. A total of 78 acupuncture sessions were performed. We found that acupuncture was feasible, with only six minor self-limiting acupuncture-related adverse events. Most of the women felt that they had benefitted from participation in the study. The preliminary analysis indicated improvement in common symptom-specific outcomes. Conclusion: Our findings suggest that acupuncture is feasible, but low recruitment rates should be considered when considering future acupuncture research in Korean breast cancer survivors. Rigorous evaluation of this symptomatic treatment strategy is now needed in the Korean population.
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Affiliation(s)
- Tae-Hun Kim
- Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University, Seoul, South Korea
| | - Jung Won Kang
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
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Sul JU, Kim MK, Leem J, Jo HG, Yoon SH, Kim J, Lee EJ, Yoo JE, Park SJ, Kim YI, Kim E, Jung IC, Jeon JH, Park YC. Efficacy and safety of gyejigachulbutang (Gui-Zhi-Jia-Shu-Fu-Tang, Keishikajutsubuto, TJ-18) for knee pain in patients with degenerative knee osteoarthritis: a randomized, placebo-controlled, patient and assessor blinded clinical trial. Trials 2019; 20:140. [PMID: 30782208 PMCID: PMC6381693 DOI: 10.1186/s13063-019-3234-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 01/29/2019] [Indexed: 01/04/2023] Open
Abstract
Background Degenerative knee osteoarthritis is a leading cause of disability in the elderly. If patients do not respond to pharmacological or nonpharmacological intervention, total knee replacement surgery is recommended. However, owing to the contraindications and adverse effects of surgery, the need for a new treatment strategy is emerging. Traditional herbal medicine is a widely used intervention in east Asia to treat knee osteoarthritis. Gyejigachulbutang is one of the frequently prescribed herbal formulae. The aim of our study is to evaluate the efficacy and safety of gyejigachulbutang for knee osteoarthritis. Methods This study is a randomized, placebo-controlled, patient and assessor blinded, superiority clinical trial. A total of 80 patients with knee osteoarthritis will be enrolled. The participants will be randomly assigned to the gyejigachulbutang or placebo group in a 1:1 ratio in two Korean medical hospitals. Every participant will take gyejigachulbutang or placebo at a dose of 2.5 g three times a day for 4 weeks. Additional follow-up will be conducted 4 weeks after treatment completion. Any concomitant treatment to relive knee pain will not be allowed except for rescue medicine (acetaminophen). The primary outcome will be a comparison of the change in the visual analogue scale score for knee pain from baseline to visit 3 (week 4) for both the treatment and placebo groups. Secondary outcomes include clinical relevance, minimal clinically important difference, disability, quality of life, and safety. Discussion This protocol presents a research methodology for clinical trials of gyejigachulbutang for knee osteoarthritis. Various secondary outcomes make this trial more informative. Our trial will provide fundamental evidence for knee osteoarthritis management via herbal medicine treatment. Trial registration Clinical Research Information Service (CRIS), KCT0003024. Registered on 25 July 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3234-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jae-Uk Sul
- Chung-Yeon Central Institute, 64, Sangmujungang-ro, Seo-gu, Gwangju, 61949, South Korea.,Chung-Yeon Korean Medicine Hospital, 64, Sangmujungang-ro, Seo-gu, Gwangju, 61949, South Korea
| | - Myung Kwan Kim
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, South Korea
| | - Jungtae Leem
- Chung-Yeon Central Institute, 64, Sangmujungang-ro, Seo-gu, Gwangju, 61949, South Korea.,Dongshin Korean Medicine Hospital, 351, Omok-ro, Yangcheon-gu, Seoul, 07999, South Korea
| | - Hee-Geun Jo
- Chung-Yeon Central Institute, 64, Sangmujungang-ro, Seo-gu, Gwangju, 61949, South Korea.,Chung-Yeon Korean Medicine Hospital, 64, Sangmujungang-ro, Seo-gu, Gwangju, 61949, South Korea
| | - Sang-Hoon Yoon
- Chung-Yeon Central Institute, 64, Sangmujungang-ro, Seo-gu, Gwangju, 61949, South Korea.,Chung-Yeon Korean Medicine Hospital, 64, Sangmujungang-ro, Seo-gu, Gwangju, 61949, South Korea
| | - Jeeyong Kim
- Chung-Yeon Central Institute, 64, Sangmujungang-ro, Seo-gu, Gwangju, 61949, South Korea.,Chung-Yeon Korean Medicine Hospital, 64, Sangmujungang-ro, Seo-gu, Gwangju, 61949, South Korea
| | - Eun-Jung Lee
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, South Korea
| | - Jeong-Eun Yoo
- Department of Korean Medicine Obstetrics & Gynecology, College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, South Korea
| | - So Jung Park
- East West Cancer Center, Dunsan Korean Medicine Hospital of Daejeon University, 75, 176 Bun-gil, Daedeok-daero, Seo-gu, Daejeon City, 35235, South Korea
| | - Young Il Kim
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, South Korea
| | - Eunseok Kim
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, South Korea
| | - In Chul Jung
- Department of Neuropsychiatry, Dunsan Korean Medicine Hospital of Daejeon University, 75, Daedeok-daero 176 beon-gil, Seo-gu, Daejeon, 35235, South Korea
| | - Ju-Hyun Jeon
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, South Korea.
| | - Yang-Chun Park
- Department of Internal Medicine, Dunsan Korean Medicine Hospital of Daejeon University, 75, Daedeok-daero 176 beon-gil, Seo-gu, Daejeon, 35235, South Korea.
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Jang M, Lim YM, Park H. Effects of Auricular Acupressure on Joint Pain, Range of Motion, and Sleep in the Elderly with Knee Osteoarthritis. ACTA ACUST UNITED AC 2019. [DOI: 10.12799/jkachn.2019.30.1.79] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Minjin Jang
- Doctoral Student, Graduate School, College of Nursing, Ewha Womans University, Seoul, Korea
| | - Yun-Mi Lim
- Doctoral Student, Graduate School, College of Nursing, Ewha Womans University, Seoul, Korea
| | - Hyojung Park
- Professor, College of Nursing, Ewha Womans University, Seoul, Korea
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Ha GC, Yoon JR, Yoo CG, Kang SJ, Ko KJ. Effects of 12-week aquatic exercise on cardiorespiratory fitness, knee isokinetic function, and Western Ontario and McMaster University osteoarthritis index in patients with knee osteoarthritis women. J Exerc Rehabil 2018; 14:870-876. [PMID: 30443535 PMCID: PMC6222165 DOI: 10.12965/jer.1836308.154] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 08/14/2018] [Indexed: 01/08/2023] Open
Abstract
The purpose of this study is to investigate the risk factors of metabolic syndrome, cardiorespiratory fitness, knee isokinetic function, and osteoarthritis index inpatients with knee osteoarthritis women. Subjects were divided into the exercise group (n=9, aged 60.89±5.06), and the control groups (n=8, aged 61.25±1.91). Aquatic exercise was performed for 12 weeks, 3 times a week, 60 min a day. The changes of metabolic syndrome risk factors, cardiorespiratory fitness, knee isokinetic function, and WOMAC index (Western Ontario and McMaster University osteoarthritis index) were measured and analyzed at pre- and postexercise program for verifying exercise effectiveness. As a result, fasting blood glucose (P<0.05), glycosylated hemoglobin (P<0.01), and triglyceride (P<0.05) were significantly decreased in the risk factors of metabolic syndrome. The maximum oxygen uptake in cardiorespiratory fitness was not significantly different. The left and right extensor muscles of knee isokinetic function increased significantly (P<0.01, P<0.01, respectively). There was no significant difference in flexor muscles. Osteoarthritis index was significantly improved in stiffness (P<0.01) and physical function (P<0.05). In conclusion, aquatic exercise can be regarded as an effective exercise program for managing metabolic syndrome risk factors, increasing muscle function, and improving osteoarthritis index in patients with osteoarthritis of the knee.
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Affiliation(s)
- Gi-Chul Ha
- Department of Physical Education, Korea National Sport University, Seoul, Korea
| | - Jae-Ryang Yoon
- Department of Physical Education, Korea National Sport University, Seoul, Korea
| | - Cheol-Gyu Yoo
- Department of Physical Education, Korea National Sport University, Seoul, Korea
| | - Seol-Jung Kang
- Department of Physical Education, Changwon National University, Changwon, Korea
| | - Kwang-Jun Ko
- Department of Sports Medicine, National Fitness Center, Seoul, Korea
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