Validation of the Western Ontario and McMaster Universities Arthritis Index Short Form (WOMAC-SF) and Its Relevance to Disability and Frailty

박수현,강병훈,김미지,김보경,이경예,서영미,유준일,박기수 연세대학교의과대학 2020 Yonsei medical journal Vol.61 No.3

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 WorldHealth Organization Disability Assessment Schedule 12 (WHODAS-12) and Kaigo-Yobo questionnaires for assessing health-outcomesin 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-confirmedknee osteoarthritis (RKOA), sarcopenia, and osteoporosis. The relationships among WOMAC-SF, WHODAS-12, and Kaigo-Yoboscores were analyzed by stepwise multiple regression analysis. Results: WOMAC-SF was associated with the WOMAC questionnaire. The results of confirmatory factor analysis for the hypothesizedmodel with two latent factors, pain and function, provided satisfactory fit indices. WOMAC-SF pain and function were associatedwith 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 qualityof life in a community-based population. Furthermore, we confirmed that WOMAC-SF were reflective of disability and frailty, whichaffect health outcomes.

도시와 농촌지역 노인의 K-WOMAC index를 이용한 무릎관절의 통증과 일상생활동작 비교

백용익(Beak Yong Ik),윤지연(Yun Jee Yeon),정수인(Jeong Su in),김수민(Kim Soo Min) 한독심리운동학회 2016 심리운동연구 Vol.2 No.2

본 연구의 목적은 도시와 농촌에 독립적으로 거주하고 있는 65세 이상의 노인을 대상으로 농촌 노인과 도시 노인의 일상생활동작, 무릎관절의 기능 상태, 무릎관절에 대한 주관적인 건강상태를 비교하고 농촌과 도시의 의료 복지 면에서의 차이점을 알아보는데 있었다. 연구의 목적을 달성하기 위한 대상자는 울산광역시 내 농촌 및 도시에 거주하는 65세 이상의 노인으로 노인 회관 및 노인정 노인들 중 연구의 목적을 이해하고 참여를 수락한 도시노인 100명, 농촌노인 100명으로 총 200명이었다. 통증 척도는 VAS(Visual analog scale)를 사용하였다. 주관적 건강상태는 훌륭하다, 매우 좋다, 좋다, 그럭저럭, 나쁘다로 이루어져 있는 5점 척도 측정 항목과 넘어진 경험, 낙상 두려움 항목으로 설문지에 응답하도록 하였다. 무릎 기능은 환자의 전반적인 기능상태를 평가하기 위하여 환자의 임상적 치료 결과와 기능적 장애 정도를 측정할 수 있는 한국형으로 번역한 한국형 WOMAC을 사용하였다. 최근 1~2년 사이에 넘어진 적이 있는지에 대해서 도시노인의 경우 경험이 있는 노인은 30명, 없는 노인은 63명으로 나타났고, 농촌노인의 경우 경험이 있는 노인은 26명, 없는 노인은 72명으로 나타났다. 주관적 건강상태의 경우 농촌노인의 경우 3.540±0.925 도시노인의 경우 3.802±0.815로 나타났다. 통증은 VAS(Visual analog scale)로 측정하여 도시노인의 경우 5.203±2.531, 농촌노인의 경우 4.505±1.918로 유의함을(p=0.012) 확인할 수 있었다. 한국형 WOMAC을 사용하여 측정한 결과 통증, 뻣뻣함, 신체적 기능 3가지 항목 전부 도시에 비해 농촌이 점수가 높은 것을 확인할 수 있었다. 결론적으로 65세 이상 울산광역시 노인들의 무릎상태 및 건강수준은 이들의 거주 지역에 따라 유의한 차이가 있음을 알 수 있었다. 노인들의 무릎관절기능의 상태와 건강수준의 향상을 위해서는 지역 여건에 맞는 프로그램 개발이 필요한 것으로 나타났다. Purpose: The purpose of the study is to compare the WOMAC Index and the physical condition of old people living in the city and country. Method: A survey was performed to check the subjective physical condition and WOMAC Index of 200 people over the age of 65 years old. Result Physical condition: Urbanites reported better physical condition than country dwellers. Ache measure: Urbanites felt more pain than country dwellers. WOMAC index: The score of country dwellers was higher than that of urbanites. We found that country dwellers felt more discomfort in the function of their knees. Consideration: We found there is a difference in the level of health and the condition of the knees of people depending on where they reside. To improve the condition of their knees and health level, we need to develop programs keeping their place of residence in consideration.

적외선 체열촬영의 퇴행성 슬관절염 평가도구와의 상관관계 연구

김영진,이소영,이민호,유승연,이승훈,남상수,이재동,최도영 대한침구의학회 2009 대한침구의학회지 Vol.26 No.6

Objectives : To investigate the correlation between DITI and assessment instruments of knee OA. Methods : Data were obtained from 127 subjects with OA of the knee. They were asked to answer VAS pain scale, LFI, WOMAC and KHAQ. Correlation was assessed by examing the pearson’s correlation and spearman’s rank correlation coefficients. Results : The thermal difference between the patella of knee was correlated with VAS, LFI and WOMAC. Age, duration, BMI and sex were not correlated with the thermal differences of each region. Conclusions : DITI value was useful for evaluating the severity of OA. And we should find out the standardization of analysis of DITI value for diagnosis of OA.

WOMAC-VA3.0의 타당도 및 신뢰도 -일부 슬관절 및 고관절 골관절염환자를 대상으로-

이승주 ( Seung Ju Yi ),이현주 ( Hyun Ju Lee ),우영근 ( Young Keun Woo ) 한국전문물리치료학회 2008 한국전문물리치료학회지 Vol.15 No.2

요추의 병변이 슬관절 전치환술의 결과에 미치는 영향

조우신(Woo-Shin Cho),변성은(Seong-Eun Byun),윤영선(Young-Sun Yoon),선지호(Ji-Ho Sun) 대한정형외과학회 2013 대한정형외과학회지 Vol.48 No.1

목적: 요추의 병변이 슬관절 전치환술의 결과에 미치는 영향을 알아보고자 하였다. 대상 및 방법: 2009년 8월부터 2010년 5월까지 퇴행성 슬관절염으로 단일 집도의에 의해 슬관절 전치환술을 시행받은 환자 중 87명 149예를 대상으로 수술 후 1년 및 2년에 Hospital for Special Surgery scale (HSS 점수)과 슬관절 점수, Western Ontario & McMaster Osteoarthritis Index Score (WOMAC 점수)및 Swiss Spinal Stenosis score (SSS 점수)를 측정하여 전향적 방법을 통해 조사하였다. 결과: 수술 전에 비해 슬관절 점수와 HSS 점수 및 WOMAC score는 수술 후에 월등히 향상되었고, 수술 후 1년보다 2년 추시 시 더 많이 향상되었다. 수술 후 SSS 점수와 슬관절 점수의 상관관계는 통계적으로 유의하지 않은 결과를 보인 반면, HSS 점수와 WOMAC 점수 및 슬관절 점수와 HSS 점수의 차이값은 SSS 점수와 뚜렷한 상관관계를 보였다. 결론: 요추의 병변이 슬관절 전치환술 전, 후의 평가에 영향을 주기 때문에 술 후 평가 시 요추의 병변을 반영하는 평가법과 병행하는 것이 바람직하며, 이 중 SSS 점수가 좋은 평가법이라고 생각된다. Purpose: Patients with osteoarthritis of knee joint often concomitantly suffer from degenerative disease of the spine. Furthermore, resulting spinal problems could influence function and pain after total knee arthroplasty (TKA), and hence, cause the results of TKA to be misinterpreted. The purpose of this prospective study was to evaluate the effect of spinal disorders, as assessed by Swiss Spinal Stenosis score (SSS scores), on knee function as assessed by knee scores, the Hospital for Special Surgery scale (HSS scale) and Western Ontario & McMaster Osteoarthritis Index scores (WOMAC scores) in patients that after TKA. Materials and Methods: One hundred and forty nine osteoarthritic knees of 87 patients were enrolled in this study. All patients received TKA by single surgeon (W-S Cho) from August 2009 to May 2010. Preoperative and postoperative 1- and 2-years HSS scale, Knee, WOMAC, and SSS scores were recorded and analyzed. Results: Postoperative HSS scale, Knee, and WOMAC scores showed marked improvements versus preoperative scores, and scores at 2 years postoperatively were better than at 1 year postoperatively. No significant correlation was found between postoperative Knee scores and SSS scores. On the other hand, statistically significant correlations were found between HSS and SSS scores and between WOMAC and SSS scores. Interestingly, differences between Knee scores and HSS scores were found to be significantly correlated with SSS scores. Conclusion: When evaluating outcome after TKA, spinal problems should be investigated concomitantly. SSS scores appear to provide a suitable means of assessing spinal problems.

모션테이핑을 적용한 재활운동 프로그램이 무릎 골관절염을 가진 50대 중년여성의 통증, 근력, WOMAC index에 미치는 영향

김민규 ( Min-Kyu Kim ),조용호 ( Yong-Ho Cho ) 대한물리의학회 2022 대한물리의학회지 Vol.17 No.4

PURPOSE: This study examined the effects of motion taping during combined lower extremity exercise application on pain, ROM, muscle strength, and WOMAC index in middle-aged women with osteoarthritis of the knee joint METHODS: The subjects were 26 middle-aged women with osteoarthritis in the knee joint. Twenty-six subjects were divided into two groups. Each group contained 13 subjects. Three subjects dropped out in the middle of the experiment. The intervention was six weeks, three times a week. The control group performed traditional physical therapy and lower extremity exercise. The experimental group was motion taping applied to the lower extremity exercise. The measurement factors were knee joint pain, quadriceps muscle strength, and WOMAC index. The pain was measured using the numeric pain scale instrument (NPSI). The quadriceps strength was measured using the 1RM method. RESULTS: In both groups, pain, muscle strength, and WOMAC index showed significant improvement according to the intervention (p < .05). In comparison between groups of the change values pre-post intervention, pain and WOMAC index showed statistically significant differences between the two groups. On the other hand, there was no difference in strength between the two groups. CONCLUSION: When performing a rehabilitation exercise program for middle-aged women with osteoarthritis of the knee, motion taping has a positive effect on pain and the WOMAC index.

지상걷기와 수중걷기 운동이 퇴행성관절염 노인여성의 WOMAC 및 활동체력에 미치는 효과

정채원(Jeong, Tchae-Won),최영철(Choi, Young-Chyul),이준우(Lee, Jun-Woo) 한국체육과학회 2016 한국체육과학회지 Vol.25 No.3

In this research, based on the hypothesis that diverse types of walking exercises should be chosen according to the ability of the elderly, the effects of walking exercise on the ground and walking exercise in the water on WOMAC and activity fitness of the elderly women with degenerative arthritis were analyzed. To do this, 30 elderly women with degenerative arthritis were divided into 3 groups according to the types of exercises: the group of walking exercise on the ground, the group of walking exercise in the water, and the control group, and 10 of those elderly women were randomly assigned to each group, and then WOMAC and activity fitness were measured and analyzed in line with the research purpose through pre-and post-test control group design. The conclusions of the analysis are as follows. Walking exercise on the ground and walking exercise in the water were proved to have positive effects on WOMAC and activity fitness of the elderly women with degenerative arthritis. It was found that walking exercise on the ground had positive effects on upper body strength, upper body flexibility, and quickness/dynamic balance of the elderly women with degenerative arthritis, and walking exercise in the water had positive effects on WOMAC and lower body flexibility. Accordingly, the conclusion that walking exercise in the water and walking exercise on the ground are positive exercises that can promote health for the elderly women with degenerative arthritis and the conclusion that, since walking exercises contribute to active fitness differently, walking exercises suitable to the characteristics required of the individuals should be chosen were derived.

무릎관절 전치환술 환자에 대한 WOMAC 지수의 신뢰도와 타당성에 관한 연구

조훈 ( Hoon Jo ),김경 ( Kyoung Kim ),임상철 ( Sang-cheol Im ) 대한물리의학회 2023 대한물리의학회지 Vol.18 No.2

PURPOSE: The Western Ontario and McMaster Universities Arthritis (WOMAC) index has been used to measure the outcome of total knee replacement (TKR), but studies on its reliability and validity are limited. The present study examined the reliability and validity of this index for patients with knee osteoarthritis who underwent TKR. METHODS: Seventy-one inpatients and outpatients who underwent bilateral TKR for knee osteoarthritis were included in this study. The pain assessment scale and WOMAC index were used to evaluate the participants every two weeks to examine the test-retest reliability, internal consistency, and construct validity. RESULTS: The test-retest reliability scores for pain, stiffness, and physical function were .75-.92, .85-.90, and .75 -.95, respectively. The corresponding intraclass correlation coefficients were .75-.88, .76-.88, and .71-.95, respectively. The internal consistency score in the first and second examinations was .92. Furthermore, the construct validity scores for pain, stiffness, and physical function were .83, .41, and .58, respectively. CONCLUSION: The application of the WOMAC index in patients who underwent TKR showed high test-retest reliability and internal consistency with the use of the WOMAC index and good validity with the use of the pain assessment scale.

퇴행성 슬관절염 환자에서 찜질방 치료와 적외선 치료의 효과 비교

김영진(Young-Gene Kim),김재덕(Jae-Deok Kim),김태곤(Tai-Kon Kim),이규훈(Kyu-Hoon Lee),한승훈(Seung-Hoon Han),최정화(Jeong-Wha Choi),김미정(Mi Jung Kim) 대한임상노인의학회 2006 대한임상노인의학회지 Vol.7 No.4

연구배경: 최근 우리나라에 널리 보급되고 있는 찜질방 시설의 온도는 거의 대부분 체온보다 매우 높은 고온으로 설정되어 있으나, 적정 온도 및 그에 따른 이용 시간에 대한 과학적인 연구가 없이 경험적으로만 사용되고 있는 형편으로 그동안 적지 않은 부작용의 발생 예가 있었다. 이에 본 연구에서는 찜질방이 활력 징후 및 혈액 검사 소견에 미치는 영향을 알아보고, 대표적인 만성 근골격계질환 중 하나라고 할 수 있는 퇴행성 슬관절염 환자들을 대상으로 찜질방과 기존의 국소 온열 치료 중 하나인 적외선 치료를 시행하여 그 효과를 비교하고자 하였다. 방법: 퇴행성 슬관절염으로 진단 받은 여자 환자 14명을 무작위로 7명씩 가, 나군으로 나누어 가군은 찜질방 치료를 5일간 시행한 후 2주간의 휴식기를 갖고 역시 5일간 적외선 치료를 하였고, 나군은 순서를 바꾸어 먼저 적외선 치료를 시행한 후 2주간의 휴식기를 갖고 찜질방 치료를 하였다. 찜질방 치료는 온도가 72±2℃로, 습도가 45±2%로 유지되는 찜질방에 10분간 입실 후, 상온(25±1℃)에서 10분간 휴식하는 것을 연속으로 3회 반복 시행하였다. 치료 전후의 슬관절 표면 온도를 매일 측정하였고, 5일간의 치료가 끝난 후에는 통증시각상사척도와 WOMAC (Western Ontario and MacMaster Universities Osteoarthritis) 점수 및 Lequesne 점수를 측정, 비교하였다. 또한 5일간의 찜질방 치료기간동안 매일 찜질방 출입 전후의 활력 징후, 혈당, 말초혈액 산소 포화도를 측정하였고, 5일간의 찜질방 치료가 끝난 후에는 전혈 및 전해질 검사를 시행하여 비교하였다. 결과: 슬관절 표면 온도는 찜질방과 적외선 치료 후 모두 유의하게 증가하였고, VAS, WOMAC 점수 및 Lequesne 점수는 찜질방과 적외선에 5일간 노출된 후 모두 유의하게 감소하였으며 두 가지 치료방법에 따른 VAS, WOMAC 점수 및 Lequesne 점수 감소의 차이는 없었다. 찜질방 치료 기간 중에 매일 측정한 활력 징후, 산소포화도 및 혈당은 모두 정상 범위로 유지되었으며, 5일후 측정한 전혈 및 전해질 검사 역시 치료 전과 비교하여 유의한 차이를 나타내지 않았다. 결론: 퇴행성 슬관절염 환자를 대상으로 찜질방 치료와 적외선 치료의 효과를 비교한 결과 두 치료방법 모두에서 유의한 통증 감소와 기능 개선이 있었다. 따라서 찜질방 치료는 퇴행성 슬관절염 환자의 통증 완화에 유용한 부가적인 방법으로 사용될 수 있을 것으로 생각한다. Background: To compare the short-term effects of Jjimjilbang (dry sauna) therapy and infrared therapy on pain scale of patients with knee osteoarthritis. Methods: 14 women older than 40 years were included in the study. All had knee osteoarthritis, and none had contraindications to Jjimjilbang therapy. They were all℃ated into two groups of 7 patients each. The first group underwent a Jjimjilbang therapy for 5 days, and after 2 weeks' wash-out period, they received infrared therapy for 5 days. The second group first underwent infrared therapy, and after wash-out period, received Jjimjilbang therapy. The results were evaluated with visual analogue scale, WOMAC (Western Ontario and MacMaster Universities Osteoarthritis) index and Lequesne's index. Results: Visual analogue scale, WOMAC and Lequesne's index showed that pain was significantly reduced by Jjimjilbang therapy and infrared therapy (P<0.05). And there was no significant difference between two therapies. Conclusion: Jjimjilbang therapy can reduce the pain of patients suffering from knee osteoarthritis.

퇴행성 슬관절염 환자의 증상 중증도 지표와 DITI의 상관성 연구

서병관,류성룡,강중원,안경애,이재동,최도영,김건식,이두익,이윤호,이상훈 대한침구의학회 2005 대한침구의학회지 Vol.25 No.6

Objectives: To investigate the applicability of thermography as severity measurement in the patients with osteoarthritis (OA) of the knee Methods: Data were obtained from 80 patiens with OA of the knee. They were asked to answer two disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index, Lequesne's Functional Index (LFI)), one generic instrument (Korean Health Assessment Questionnaire (KHAQ)), VAS in order to assess the severity of disease, quality of life, and degree of pain and taken thermography in standardized environment. Results: The thermal difference between ipsilateral side and contralaterla side of lateral aspect of knee was correlated with that of medial aspect of knee, and the thermal difference of anterior thigh was correlated with that of lateral, medial aspect of knee and patella region. Age, duration of disease, duration of morning stiffness, sex, crepitus, and painful side of knee were not correlated with the thermal differences of each region. LFI, WOMAC, WOMAC pain subscale, WOMAC stiffness subscale, WOMAC physical function, KHAQ, VAS were not correlated with the thermal differences of each region. Conclusions: Futher study on the thermography on OA of the knee in population with appropriate severity grade and the standardization of analysis of thermographic data were recommended.