Background
Whether land- or aquatic-based rehabilitation is more effective in improving knee osteoarthritis (OA) is still unclear. This study assessed the effectiveness of aquatic-based treatments in patients with knee OA.
Methods
The participants were divided into a land-based exercise group (G1, n=30) and a water-based exercise group (G2, n=30). The exercises were performed for 8 weeks. The primary endpoint was a response to physical therapy, defined as a 20% decrease in the summed score for the Western Ontario and McMaster Universities-Osteoarthritis Index (WOMAC) pain subscale from T1 (before the start of the rehabilitation program) to T2 (8 weeks later). The secondary endpoints included the Visual Analog Scale (VAS) for pain, WOMAC functional and stiffness subscales, Lequesne Index, and Medical Outcome Study Short Form (SF-12) for physical and mental health.
Results
A 20% decrease in the summed WOMAC pain subscale score was noted in 33% of patients in G1 (n=10) and 93% in G2 (n=28) (P<0.001). VAS scores at walking decreased by 14% in G1 vs. 37% in G2 (P<0.001), WOMAC stiffness subscale decreased by 18% in G1 vs. 53% in G2 (P<0.001), and the Lequesne index decreased by 10% in G1 vs. 33% in G2 (P<0.001). Quality of life improvement was greater in G2 than in G1; SF-12 (physical) increased by 2.3 in G1 vs. 5.4 in G2 (P=0.023), and SF-12 (mental) increased by 6.3 in G1 vs. 10.9 in G2 (P=0.022).
Conclusion
Both aquatic and land-based exercises improved pain intensity, functional impairment, degree of handicap, and quality of life impairment caused by OA. However, the improvement was more significant in the aquatic-based exercises group.

Citations

• Effects of Eight Weeks of Aquatic Therapy on Knee Proprioception and Gait Speed Among Female Older Adults with Knee Osteoarthritis: A Randomized Clinical Trial
  Zahra Bagherpoor Kalkhoran, Razieh Khanmohammadi
  Middle East Journal of Rehabilitation and Health Studies.2024;[Epub]     CrossRef

Background
Evidence on the association between obesity parameters, including body mass index (BMI) and waist circumference (WC), and osteoarthritis is limited. This study aimed to investigate these associations in Korean adults.
Methods
This nationwide cross-sectional study used data from 24,101 adults aged ≥19 years who participated in the Korea National Health and Nutrition Examination Survey 2016–2020. Odds ratios (ORs) and 95% confidence intervals (CIs) for osteoarthritis according to BMI and WC were analyzed using multivariable logistic regression analyses.
Results
The prevalence of osteoarthritis was higher in individuals with general (10.0%) and abdominal obesity (12.8%) compared with those without. Greater BMI and WC were associated with a higher prevalence (P<0.001) and risk of osteoarthritis (Model 3, P for trend <0.001). Individuals with general and abdominal obesity were associated with a 1.50-fold (OR, 1.50; 95% CI, 1.35–1.67) and 1.64-fold (OR, 1.64; 95% CI, 1.47–1.84) increased risk of osteoarthritis, compared with those without. Similar associations were observed in subgroups according to age, sex, smoking status, and presence of diabetes mellitus. The odds of osteoarthritis 1.73-fold increased (OR, 1.73; 95% CI, 1.53–1.95) in individuals with both general and abdominal obesity compared with those without any of them.
Conclusion
Greater BMI, WC, and general and abdominal obesity were associated with an increased risk of osteoarthritis in Korean adults. Appropriate management of abdominal and general obesity may be important to reduce the risk of osteoarthritis.

Citations

• Association between waist circumference or weight change after smoking cessation and incidence of cardiovascular disease or all-cause death in Korean adults with type 2 diabetes
  Heajung Lee, Jaeyong Shin, Jae Woo Choi
  Frontiers in Endocrinology.2024;[Epub]     CrossRef

Primary care physicians should encourage their patients to engage in adequate physical activity. Current recommendations for physical activity in adults are as follows: at least 150–300 minutes per week of moderate-intensity, 75–150 minutes per week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Adults should also perform muscle-strengthening activities of moderate intensity or higher that involve all major muscle groups for 2 or more days per week. The elderly should perform additional balance training and fall prevention exercises more than 3 times a week. Children and adolescents should perform at least 1 hour of moderate-to-vigorous physical activity daily, which includes vigorous aerobic activity at least 3 days per week. As part of their 60 minutes or more of daily physical activity, resistance training and bone strengthening exercise should be done at least 3 days per week. According to new evidence, one bout of any exercises can be shorter than 10 minutes. Previously, physical activities were recommended for more than 10 minutes. For patients with diabetes, it is advisable to perform resistance exercise or short-distance running before aerobic exercise to prevent hypoglycemia. New evidence shows that dynamic resistance training is safe and effective in patients with hypertension provided the load is not too heavy. Exercise reduces pain and improves quality of life and physical function in patients with osteoarthritis,. Therefore, the treatment guidelines for osteoarthritis have been changed recently from not recommending exercise to highly recommending it.

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• Overview of Physical Activity Counseling in Primary Care
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Background
Knee osteoarthritis is highly prevalent, especially among the elderly. However, its risk factors have not been well identified, especially in the Korean population. This study aimed to assess the epidemiologic characteristics and risk factors of knee osteoarthritis in the Korean population.
Methods
Data of 2,280 (1,295 women) participants of the 2013 Korea National Health and Nutrition Examination Survey aged ≥50 years who underwent knee radiography were analyzed. According to the American College of Rheumatology clinical/radiographic classification criteria, knee osteoarthritis was defined as knee pain and radiographic knee osteoarthritis. The association between risk factors and knee osteoarthritis was analyzed using the chi-square test and binominal logistic regression.
Results
The participants had an average age of 62.6 years; 56.8% of them were women. The average body mass index was 24.2 kg/m2 , and 296 (13%) participants were diagnosed with knee osteoarthritis. After adjustment for multiple risk factors, age of ≥65 years (adjusted odds ratio [OR], 2.552; 95% confidence interval [CI], 1.868–3.486), female sex (OR, 2.050; 95% CI, 1.275–3.295), obesity (body mass index, ≥25.0 kg/m2 ; OR, 1.563; 95% CI, 1.191–2.051), hypertension (OR, 1.394; 95% CI, 1.052–1.846), low educational level (lower than or equal to elementary school: OR, 4.761; 95% CI, 2.131–10.635; middle school: OR, 3.184; 95% CI, 1.375–7.369), and low strength exercise frequency (<2 times/wk; OR, 1.829; 95% CI, 1.202–2.784) increased the risk of knee osteoarthritis.
Conclusion
Old age, sex, obesity, hypertension, low educational level, and low strength exercise frequency were found to be risk factors for knee osteoarthritis.

Citations

• Effect of knee pain on muscles imbalance and physical limitation in individuals with bilateral knee osteoarthritis: A comparative cross-sectional study
  Shabana Khan, Huma Waseem, Uzair Ahmad
  Journal of Musculoskeletal Surgery and Research.2024; 8: 119.     CrossRef
• Prevalence and Risk Factors of Osteoarthritis in Korea: A Cross-Sectional Study
  Do-Youn Lee
  Medicina.2024; 60(4): 665.     CrossRef
• The association between ADAMTS14/rs4747096 gene polymorphism and some risk factors and knee osteoarthritis
  Ghada A. Elshaarawy, Iman I. Salama, Somaia I. Salama, Amany H. Abdelrahman, Mirhane Hassan, Eman Eissa, Sherif Ismail, Sherif E. Eldeeb, Doaa E. Ahmed, Hazem Elhariri, Rasmia Elgohary, Aida M. Abdelmohsen, Walaa A. Fouad, Hala M. Raslan
  BMC Musculoskeletal Disorders.2024;[Epub]     CrossRef
• The relationship between experience of knee pain and physical activity participation: A scoping review of quantitative studies
  Lu Yang, Peipei Wang, Bronwyn McGill
  International Journal of Nursing Sciences.2023; 10(2): 258.     CrossRef
• Assessment of the quality of life in patients with knee osteoarthritis
  Natasa Milenovic, Marijana Hornjak, Sonja Lukac, Ana Simundja, Milan Veselinovic, Gordan Bajic
  Medicinski pregled.2022; 75(3-4): 103.     CrossRef
• Metabolic syndrome, hypertension, and hyperglycemia were positively associated with knee osteoarthritis, while dyslipidemia showed no association with knee osteoarthritis
  Yinhao Xie, Wei Zhou, Zhihong Zhong, Ziping Zhao, Haotao Yu, Yaxiang Huang, Ping Zhang
  Clinical Rheumatology.2021; 40(2): 711.     CrossRef
• Association of the Risk of Osteoarthritis and Hypertension in the Korean Adult Population Aged 40–59 in Pre- and Postmenopausal Women: Using Korea National Health and Nutrition Examination Survey 2012–2016 Data
  Mikyung Ryu, Ji Sun Ha, Sol Lee, Weon-Chil Baek, Heejin Kimm, Ho Gym, Massimo Salvetti
  International Journal of Hypertension.2021; 2021: 1.     CrossRef
• Healthcare Utilization and Knee Osteoarthritis Symptoms among Urban Older Malaysian
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• A nationwide study of patients with monoclonal gammopathy of undetermined significance with a 10-year follow-up in South Korea
  Ka-Won Kang, Ji Eun Song, Byung-Hyun Lee, Min Ji Jeon, Eun Sang Yu, Dae Sik Kim, Se Ryeon Lee, Hwa Jung Sung, Chul Won Choi, Yong Park, Byung Soo Kim
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• Barriers to and Facilitators of Physical Activity among Korean Female Adults with Knee Osteoarthritis and Comorbidity: A Qualitative Study
  Eunyoung Park, Hyung-Ran Park, Eui-Sung Choi
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• Prevalence of sarcopenia in community-dwelling older adults using the definition of the European Working Group on Sarcopenia in Older People 2: findings from the Korean Frailty and Aging Cohort Study
  Miji Kim, Chang Won Won
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  Dragana Lončar-Stojiljković
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• Comparison of Knee Muscle Strength and Endurance of Affected Legs of Korean Women Diagnosed with Kellgren-Lawrence grade (K-L II) by Age
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Citations

• Arthrose et incidence des accidents vasculaires cérébraux et des accidents ischémiques transitoires chez 320 136 adultes suivis dans des cabinets généralistes au Royaume-Uni
  Louis Jacob, Christian Tanislav, Karel Kostev
  Revue du Rhumatisme.2022; 89(1): 72.     CrossRef
• Long-term intake of Lilium lancifolium mitigated osteoarthritic effects by suppressing inflammatory cytokines in a dog model
  Jeong-Hwi Cho, Yang-Gyu Park, Jinyoung Choi, Gareeballah Osman Adam, Eun-Myeong Ju, Ho Park, Hong-Geun Oh
  Veterinary World.2022; : 2012.     CrossRef
• Osteoarthritis and incidence of stroke and transient ischemic attack in 320,136 adults followed in general practices in the United Kingdom
  Louis Jacob, Christian Tanislav, Karel Kostev
  Joint Bone Spine.2021; 88(2): 105104.     CrossRef
• Effect of Aerobic Physical Activity on Health-Related Quality of Life in Middle Aged Women with Osteoarthritis: Korea National Health and Nutrition Examination Survey (2016–2017)
  Mikyung Ryu, Sol Lee, Ho Kim, Weon-Chil Baek, Heejin Kimm
  International Journal of Environmental Research and Public Health.2020; 17(2): 527.     CrossRef
• Quality of life of rural poor elderly in Anhui, China
  Jian Rong, Hong Ding, Guimei Chen, Yanhong Ge, Tingting Xie, Nana Meng
  Medicine.2020; 99(6): e19105.     CrossRef
• Managing the Early Risk of Posttraumatic Osteoarthritis Following Anterior Cruciate Ligament Injury
  Brian Pietrosimone
  Journal of Science in Sport and Exercise.2020; 2(3): 258.     CrossRef
• Up-regulated expression of E2F2 is necessary for p16INK4a-induced cartilage injury
  Xinnan Bao, Xinyu Hu
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Background
Previous study suggested that beef tallow extract including cis-9-cetylmyristoleate was a safe and effective treatment for patients with osteoarthritis. We used extract of vegetable oils containing cetyl myristoleate. This study assessed the effect of this supplementation on knee pain and function in patients with osteoarthritis. Methods: The 70 patients who manifested the symptoms and signs of osteoarthritis of knee were randomly assigned to placebo (36) and plant-fatty acids complex (FAC) group (34). Two capsules of placebo (corn starch 350 mg) and plant-FAC (12% cetyl myristoleate in 350 mg) were orally administered to placebo and plant-FAC group three times a day for 60 day, respectively. Visual analogue scale (VAS) and Korean version of Western Ontario and McMaster' Universities Osteoarthritis Index (KWOMAC) were assessed before and after the intervention and we monitored any adverse effects. Results: The 6 of 36 patients (16.7%) in the placebo and the 5 of 34 patients (14.7%) in the plant-FAC group were missed due to low compliance. In the plant-FAC group, the VAS score was improved by mean 0.76 (P = 0.03) but the improvement was lower than that of placebo group. The KWOMAC was improved by mean 8.90 and 8.13 in the plant-FAC and placebo group, respectively. But the independent t-test showed no statistical signifi cance (P = 0.47). Conclusion: We failed to show the superiority of plant-FAC to placebo on the pain and function of patients with osteoarthritis of the knee.

Citations

• The minimal effective dose of cis-9-cetylmyristoleate (CMO) in persons presenting with knee joint pain
  Sang Chul Lee, Hyun Seung Jin, Young Joo, Yong Chul Kim, Jee Youn Moon
  Medicine.2017; 96(9): e6149.     CrossRef

Background
: When research based evidence is not sufficient, clinical practice guidelines can be based on opinions. In such situations, formal consensus development methods, often based on the modified nominal group techniques are widely used. It can be used to evaluate consistency, generalizability, applicability of recommendation when evidence comes from other countries.

Methods : To develop evidence based guidelines for osterarthritis pharmacotherapy, a consensus expert panel consisting of internists, family physicians, methodologists, and orthopedic surgeons were convened. After an extensive structured literature searching and evaluation, evidence statements for key question were developed. Rating methods for consistency, generalizability, applicability of statement were adopted from those jointly developed by Rand and the University of California, Los Angeles.

Results : We developed 27 evidence statements in 17 question domains. Among 72 rating items, 62 items reached agreement. Among 15 recommendations, 10 recommendation grading were A, 2 were B, and 3 were C.

Conclusion : When research based evidence is not sufficient, clinical practice guidelines can be based on formal consensus of experts, especially modified nominal group techniques. It can be used to evaluate consistency, generalizability, applicability of recommendation when evidence comes from other countries.

Background
: Knee osteoarthritis (OA) is a major cause of disability, particularly in the elderly. The factors determining disability remain unclear and have not been defined in Korea. The aim of this study was to assess the various aspects of the quality of life, and to define the determinant factors of disability in patients with knee OA.

Methods : The Korean version of AIMS2 (K-AIMS2) and CMCHS (Catholic Medical Center Health Survey) were administered to a cohort of 239 outpatients with symptomatic OA of the knee who attended 7 participating University Hospitals in Seoul, Ilsan and Taejon. The scores of K-AIMS2 12 subscales by demographic variables and body mass index were compared using Student t-test. And the determinant factors of the lower extremity disability were analysed by stepwise multiple regression method.

Results : The study subjects (n=239) were 61.6±9.1 years old, comprised of 197 (82.4%) females and 42 (17.6%) males, had been sick with knee osteoarthritis for 6.2±6.5 years, and had 24.7±3.1 kg/m² BMI. Among K-AIMS2 12 subscales 'Walking and bending' (5.82±2.17), 'Arthritis pain' (5.19±1.98), 'Social activities' (3.97±2.04), and 'Mobility level' (3.61±1.74) showed high scores, while subscales related with upper extremities function showed low scores, reflecting the costruct validity of K-AIMS2 in patients with symptomatic knee OA. After adjustment for the presence of sociodemographic variables, we found bodily pain (P＜0.001), age (P＜0.001), emotional function (P=0.033), and education level (P=0.099) as determinant factors of K-AIMS2 lower limb function.

Conclusion : It is recommendable that the knee OA patients should be treated properly in the emotional aspect as well as the bodily pain aspect. In addition, it is suggested that education level be considered as an important factor when teaching the OA patients about coping with knee disabilities.

Background
: Osteoporosis is becoming major health problem in old age and menopausal women, and osteoarthritis is most common joint disease in both ages. The inverse relationship between osteoporosis and osteoarthritis was first noticed 20years ago. However the subject had not been studied in korea. Thus, our objectives is to examine the influence of osteoarthritis on bone density measurements.

Methods : The study group consisted of 120 women, aged over 40 years, who visited for health examination in Health Center of Poondang-Jesaeng general hospital from October 1998 to April 1999. Bone mineral density(BMD) of the lumar spine was measured, using dual energy X-ray absorptiometry(Lunar, Expert XL), and lateal lumbar spine radiograph was taken. Severity of osteoarthritis were scored on osteophytes, disk space narrowing and vertebral body sclerosis.

Results : Postmenopausal women had significantly lower BMD than premenopausal women(P<0.001). Age(r=-0.545,p<0.001), body mass index(r=0.264,p<0.01) and education(r=0.284, p<0.001) were significantly correlated with BMD, but smoking, exercise, radiogrphic OA variables not correlated. However, stepwise multiple regression analysis using osteoporosis related variables and OA variables is indicated that menopausal status, body mass index, age, osteophytes were significantly associated factor with BMD, and lumbar osteophytes explained 2.7% of variation in lumbar spine BMD.

Conclusion : We conclude that, among women, lumbar BMD is higher in those with osteophytosis of the lumbar spine. The effect is largely directed by osteophytes being included in the BMD measurement.

Background
: About 80 percent of Korean population over 55 years old show radiographic signs of osteoarthritis. Hence, osteoarthritis has become one of the most important public health problem among the old age. Despite the importance of this disease, proper methods for evaluation and diagnosis of osteo-arthritis have not been developed. Authors have investigated the sensitivity and specificity of thermography in diagnosing osteoarthritis.

Methods : Twenty patients who had visited the department of family medicine, Korean University Hospital, with non-traumatic knee pain during the period from April 1 to May 30, 1999, were included in the study. Patients had gone through series of careful history taking, physical examination and laboratory evaluations for clinical evaluation of osteoarthritis of the knee joints. Furthermore, the radiographic and thermographic examination of both knee joints were assessed.

Results : Among the twenty patients who have been examined, 15 patients were to have shown radiographic abnormality; on the other hand, 14 patients showed thermographic abnormality. Seventeen patients showed clinical manifestations of osteoarthritis. Twelve patients, among those who had clinical osteoarthritis, were shown to have osteoarthritis in both image studies, i,e. radiographic and thermographic abnormalities. All patients who had not shown clinical osteoarthritis, were normal on both image studies. The sensitivity and specificity of thermography in diagnosing osteoarthritis were 80% and 80%, respectively (P<0.05).

Conclusion : Hot spots or asymmetric distribution in the knee joint area of osteoarthritis patients were in thermographic examination. Thermography has shown efficacy in the evaluation of osteoarthritis.