KJC Korea
Journal Central

Objectives This review aims to analyze the current research trend in the usage of bee venom (BV) acupuncture for spinal diseases. Methods We collected 80 articles on BV acupuncture clinical study for spinal diseases by searching Korean web databases ‘Journal of Korean Medicine Rehabilitation’, ‘Oriental Medicine Advanced Searching Integrated System’, ‘Korean Traditional Knowledge Portal’ from 1999 to 2018. Results We summarized the most frequent clinical treatment methods of BV acupuncture. 1. Herniated intervertebral disc was treated for 40% and the treated spinal diseases were various. 2. ‘1:10,000’ in the type of BV was chosen for 21%. 3. 29% of studies used 6-7 acupoints per session and 23% of studies used ‘BL’ as the injection site. 3. The highest volume of injected BV into each acupoint was 0.1 cc for 34% and the highest total volume of injected BV was 1.0 cc for 39%. Conclusions We found the limited evidence on the lack of consensus and detailed description in the reported experimental design. The results in this review suggest that future works should focus on more consistent and systematic study for the reproducible and standardized treatment methods. (J Korean Med Rehabil 2019;29(3):1-13)

Objectives The objective of this study is to provide the evidence of the effectivness of herbal medicine for frozen shoulder. Methods 2 Korean medical on-line databases (Oriental Medicine Advanced Searching Integrated System, Korean Traditional Knowledge), and 3 foreign databases (Pubmed, Cochrane library, China National Knowledge Infrastructure) were searched to find articles concerning herbal medicine for frozen shoulder. We selected randomized controlled trials (RCTs). Several repeated articles and those not relevant to the topic were excluded, as well as review articles and commentaries. The methodological quality of RCTs were evaluated using the Cochrane risk of bias tool and meta-analyes were perfomed. Results Total 474 studies were founded and 22 RCTs were selected for systematic review. Efficiency rate was used as the primary evaluation method. Almost studies reported that herbal medicine has significant effect on pain reduction, increasing shoulder function on frozen shoulder. 3 studies comparing herbal medicine and chuna with chuna and 3 studies comparing herbal medicine with ibuprofen were included in the meta-analysis. At herbal medicine and chuna with chuna meta-analysis, it showed positive results of herbal medicine for efficiency rate (risk ratio: 1.18, 95% confidence interval: 1.09-1.27, p<0.0001). At herbal medicine with ibuprofen medta-analysis, it showed positive results of herbal medicine for efficiency rate (risk ratio: 1.15, 95% confidence interval: 1.05-1.27, p=0.003). Conclusions The studies showed that herbal medicine can significantly effective on frozen shoulder. However, the risk of bias in RCTs were evaluated as uncertain. In the future, further well-designed RCTs are needed to prove the effectiveness of herbal medicine for frozen shoulder and reduce the risk of bias. (J Korean Med Rehabil 2019;29(3):15-33)

Objectives The purpose of this research is to evaluate the effectiveness of moxibustion theraphy for frozen shoulder through systematic review and meta-analysis. Methods The effect of moxibustion for frozen shoulder was constructed as a key question to search randomized controlled trials (RCTs) in 16 databases without type of publication restriction. Results A total of 790 studies were searched and 22 RCTs were finally selected through primary and secondary selection/exclusion process. In most of the evaluation indexes used in each study, moxibustion treatment for shoulder pain was statistically significant compared with other treatments. A meta-analysis of effective rate in 10 studies comparing moxibustion with acupuncture and acupuncture showed a statistically significant effect of moxibustion treatment. And there was a significant effect on the improvement of the shoulder mobility, but the effect size of shoulder pain was no significant effect for shoulder pain reduction. In addition in the result of meta-analysis of 4 studies' effective rate comparing moxibustion with electronic acupuncture, the effect of moxibustion was significantly higher than that of electronic acupuncture in frozen shoulder. Conclusions Moxibustion therapy was effective in symptoms in patients with frozen shoulder. However because of the high risk of bias in the quality of the included studies, the applicability of this study seems to be limited. It is thought that future randomized controlled trials will need to be designed and performed by reviewing ways to minimize bias. (J Korean Med Rehabil 2019;29(3):35-49)

Objectives Osteoarthritis is hard to manage with both conventional and Korean medicine treatment. The core outcome set (COS) to demonstrate the effectiveness of Korean medicine treatment has not been established yet. We aimed to present preliminary data of COS by performing a literature review on the evaluation indices used in existing clinical research. Methods We examined the literature from 2000 to 2017 in two Korean electronic databases (Korea citation index and oriental medicine advanced searching integrated system) by searching for the following 3 terms ‘total knee replacement (Korean)’, ‘total knee replacement,’ and ‘knee surgery.’ We found 333 articles; among them, 50 duplicates were removed. Finally, we selected 160 articles after complete screening. We then extracted measured indices and clinical outcomes from the selected articles and categorized the relevant criteria. Results According to this study, the hospital for special surgery and knee society, range of movement angle, cross leg, Berg balance scale and balance ability, muscle strength, 6 minutes walking test, visual analogue scale, self-efficacy, the 12-item and 36-item short form survey and self-rated health status are the most commonly used outcomes of knee. Conclusions This study found that the several categories after total knee replacement (TKR) are being evaluated in the literature, and we were able to verify the most frequently used evaluation indices in these categories. The results of this study will be used to establish evaluation indices for the treatment of TKR in the future using Korean medicine. (J Korean Med Rehabil 2019;29(3):51-60)

Objectives This study aimed to review clinical studies about Korean medicine used in peroneal nerve palsy. Methods In 11 online databases (Earticle, Research Information Sharing Service, Oriental Medicine Advanced Searching Integrated System, KMbase, Korean Traditional Knowledge Portal, National Digital Science Library, MEDLINE/Pubmed, Ebscohost, Cochrane CENTRAL, EMBASE, China National Knowledge Infrastructure), we searched clinical studies about Korean medicine. Among the studies that we've searched, we excluded the studies that are not related to Korean medicine, case reports, randomized controlled trials and retrospective studies. As a result, 16 case studies and 1 randomized controlled trial are included. Results Total number of patients was 123. In these studies, acupuncture (100%), herbal medicine (58.8%), pharmacopuncture (58.8%), Korean physical therapy (58.8%), moxibustion (41.1%), cupping (41.1%) etc. were used. In acupuncture, GB34 and ST36 were most frequently used. Most of the herbal medicines used in these studies were different. Range of movement were most frequently used in outcome measure. Conclusions In this study, we reviewed studies about Korean medicine used in peroneal nerve palsy. It was difficult to clearly determine which intervention has improved the symptom. In the future, Further clinical studies will be needed to retain the evidence for the treatment of peroneal nerve palsy. And also more randomized controlled clinical trials to prove the efficacy of Korean medicine will be needed. (J Korean Med Rehabil 2019;29(3):61-74)

Objectives This study was perfomed to assess the adherance to CARE (CAse REport) guideline of case reports in the Journal of Korean Medicine Rehabilitation Methods We searched the case reports published in the Journal of Korean Medicine Rehabilitation from January 2016 to April 2019 in the database of oriental medicine advanced searching integrated system (OASIS). Then we evaluated the quality of the searched case reports based on the CARE guideline. Results Totally 31 papers were selected after the screening the case reports by the inclusion and exclusion criteria. The report rate of the sub-items of the CARE guideline was 78.26% at the maximum, 60.87% at the maximum, and 70.97% on the average. The following items were reported only in less than 50% of them; ‘Timeline', 'Diagnostic challenges', 'Diagnostic reasoning including other diagnoses considered' 'Prognostic characteristics', 'Follow-up and Outcomes', 'Patient Perspective', 'Informed Consent' Conclusions This study is expected to contribute to the overall improvement of the level of case reports in the Journal of Korean Medicine Rehabilitation. (J Korean Med Rehabil 2019;29(3):75-85)

Objectives The purpose of this study is to investigate characteristics of low back pain patients and trends of Korean medicine conservative treatment effects of low back pain patients by registry data. Methods A total of 78 patients were analyzed, statistical analysis was performed using a generalized linear model. The comparison between groups was performed using independent two samples t-test or Wilcoxon rank sum test according to the distribution of normality. Before and after the treatment effects, ANOVA and Kruskal-Wallis method were used for the comparison, Sheffe method was used for the post test. Results The average age of hospitalized patients was 31.8 years old and out-patient department (OPD) patients was 44.9 years old. Lots of OPD patients and hospitalized patients were classified to ‘Lumbago due to Coexist Qu Stagnation and Bloos Stasis’. Both OPD patients and hospitalized patients classified to ‘Lumbago due to Coexist Qu Stagnation and Bloos Stasis’ showed statistically significant decrease in RMDQ (Roland-Morris disability questionnaire) and NRS (numeric rating scale) on 1 month and 3 month after clinical research start date. Comparing the treatment effects of Chuna manual therapy, both Chuna group and non-Chuna group showed statistically significant decrease in RMDQ and NRS on discharge date, 1 month and 3 month after clinical research start date. Conclusions We expect that a larger scale registry study will be carried out to provide a higher level of basis for the Korean medical treatment of low back pain. (J Korean Med Rehabil 2019;29(3):87-101)

Objectives The purpose of this study is to investigate pain reduction and treatment satisfaction of patients with rib fracrture treated with Soyeom pharmacopuncture therapy under ultrasonic guided - thoracic paravertebral space (TPVS), and also compare to the patients with non-guided pharmacoacupuncture. Methods We studied medical records of 6 patients hospitalized with rib fractures were analyzed retrospectively at department of Korean Medicine Rehabilitation from March 1, 2019 to May 31, 2019, The 3 patients had performed the treatment of Soyeom pharmacopuncture therapy on TPVS under ultrasonic guidance with Korean Medicine treatment (such as herbal medicine, acupuncture, moxabustion, etc) and the other 3 patients had performed the treatment of Soyeom pharmacopuncture therapy on TPVS through non-guided. We used numeric rating scale to assess improvements in pain and the five-point likert scale was used to assess treatment satisfaction. Statistical analysis was carried out using the IBM SPSS Statistics 24 program. Results The purpose of this study is to investigate pain reduction and treatment satisfaction of patients with rib fracrture treated with Soyeom pharmacopuncture therapy under ultrasonic guided - TPVS, and also compare to the patients with non-guided pharmacoacupuncture. Conclusions After analyzing 6 studies, we could imply that the treatment of Soyeom pharmacopuncture therapy on TPVS under ultrasonic guidance could be more effective on pain reduction and improvement of treatment satisfaction with rib fracture compared to those who were treated with non-guided pharmacoacupuncture. (J Korean Med Rehabil 2019;29(3):103-112)

Objectives To evaluate the pattern identification tool for knee osteoarthritis and to investigate the relationship between pattern identification tool and knee ROM (range of motion), VAS (visual analog scale) and WOMAC (Western Ontario & McMaster Universities osteoarthritis index). Methods We studied 50 patients who are diagnosed as degenerative osteoarthritis . With one patient dropping out, total of 49 patient went through pattern identification tool. Re-test of the pattern identification tool was implemented after about a week. The reliability was analyzed by calculating ICC (intraclass correlation coefficient). Also, reliability of each pattern identification score was calculated along with influence factor and correlation between knee ROM, VAS and WOMAC. Results Reliability of the pattern identification tool was evaluated as ‘poor agreement beyond chance’ with ICC value of 0.396. Reliablility of each pattern identification score was calculated and four out of five were measured ‘good’ with one ‘moderate’ reliability. Two of inter-item consistency were ‘good’, two were ‘acceptable’ and one was ‘questionable’. Correlation between each pattern identification and knee ROM showed ‘clear negative linear relationship’ with two patterns. VAS showed ‘clear positivie linear relationship’ with all five patterns. WOMAC showed ‘positivie linear relationship’ with all five patterns. Conclusions According to the results, pattern identification tool for knee osteoarthritis seems to have meaningful relationship with other agnedas. Also, further research is needed to develop the tool. (J Korean Med Rehabil 2019;29(3):113-128)

Objectives The purpose of this study is to investigate present status of cooperation through Korean medicine and Western medicine collaboration process. Methods We have established Korean medicine and Western medicine collaboration process to examine the status of cooperation. The medical records were investigated retrospectively, the general characteristics of gender, age of cooperative patients, classification of disease, frequency of medical treatment and type of insurance were analyzed. Results The Korean medicine and Western medicine collaboration process conducted in 4 stages, the convenience of patient movements is considered. A total of 245 people received cooperative medical treatment, 156 were out-patient department (OPD) patients and 89 were hospitalized patients, both group have more women than men. When classified as disease, OPD patients were most diagnosed with Sprain and strain of lumbar spine, while hospitalized patients were most diagnosed with lumbar and other intervertebral disc disorders with radiculopathy. A total of 72.7% patients were received cooperative medical treatment at once. In a survey of cooperative satisfaction, 68.5% of all medical staff responded positively to the treatment effect, and 68.6% said the need for cooperation was necessary. Conclusions As a result of this study, we were able to see the present status of cooperation, and through this, we found an improvement in the continuation of the cooperation. Based on the present study, It is hoped that a cooperative process will emerge that can improve the problems shown in this study. (J Korean Med Rehabil 2019;29(3):129-139)

Cervical spondylotic myelopathy (CSM) is a severe disease that usually needs surgical treatment. We have treated two CSM patients with Korean traditonal medicine, which includes acupuncture, pharmacopuncture, herbal medicine and manual treatment (Chuna). For objective evaluation, we used Nurick’s classification, JOA (Japanses Orthopedic Association) score, grip and release test and hand grasping power measurement. Post-treatment analysis has shown that grip and release test score and grasping power of two patients were both remarkably improved, along with the improvements on both Nurick's classification and JOA score. This study showed that Korean traditional medicine could be effective conservative treatment for CSM. (J Korean Med Rehabil 2019;29(3):141-148)

This study was performed to evaluate the effectiveness of pharmacoacupuncture treatment of coccygodynia caused by perforating cutaneous nerve entrapment syndrome. Two patients were diagnosed as coccygodynia caused by perforating cutaneous nerve entrapment syndrome which pain was within the anatomical field of the nerve, worsened by pressure-inducing posture, no objective sensory loss and in presence of pin-point tenderness. They were treated by pharmacoacupuncture at perforating cutaneous nerve region penertrating the sacrotuberous ligament and local tenderness point of coccyx. The evaluation of clinical outcome was done by pain intensity numerical rating scale (PI-NRS), pressure pain threshold (PPT) and EuroQol five dimensions questionnaire (EQ-5D) index. After treatment, their PI-NRS was decreased, PPT and EQ-5D index were increased. The pharmacoacupuncture therapy at entrapment point of perforating cutaneous nerve could be an effective way to treat coccygodynia caused by perforating cutaneous nerve entrapment syndrome. (J Korean Med Rehabil 2019;29(3):149-156)

This study is to report the usefulness of ultrasound in diagnosing rib fracture and the effectiveness of ultrasound-guided essential bee venom pharmacopuncture as a treatment of it. A 46-year-old unable to find a fracture by chest radiography was diagnosed it on ultrasound. The patient was applied integrative Korean medical treatments and ultrasound-guided essential bee venom pharmacopuncture at the fracture site for 4 weeks, 18 times total. Numeral rating scale (NRS) was used to evaluate the amount of pain. The chest pain when turning over the body was reduced from NRS 8 to 2 for 4 weeks. The remarkable aspect is that the pain was immediately relieved after phamacopuncture and its effect lasted for 3 hours. This report suggests ultrasound can be useful for diagnosing rib fracture and also helpful for safety and accuracy of pharmacopuncture. Additionally, essential bee venom can be considered one of the methods of treating rib fracture. (J Korean Med Rehabil 2019;29(3):157-163)

The objective of this study is to propose postoperative rehabilitation for foot fracture in Korean Medicine and to report its effectiveness. There were three patients who were got foot fracture surgery received korean medicine with acupuncture, herbal medicine, cupping and exercise treatment. Patients were evaluated numeric rating scale (NRS), range of motion (ROM), American Orthopaedic Foot and Ankle Society (AOFAS) ankle hindfoot score, foot function index (FFI) and EuroQol-5 dimension (EQ-5D) index. Case 1 and 2 were improved NRS from 6 to 3. Case 3 was improved NRS from 5 to 2. These cases were improved ROM in all directions, AOFAS score, FFI, EQ-5D and walking status. This study suggest that Korean medicine rehabilitation could be effective for patients who have received foot fracture operation. (J Korean Med Rehabil 2019;29(3):165-172)

This study is to report the effectivenes of Meridian-Test (M-test) in 2 cases on shoulder diseases. The M-test was applied to one patient diagnosed with as impingement syndrome and one patient diagnosed with tear of supraspinatus tendon. The changes in numeral rating scale and range of motion were identified to assess the progress of the treatment. After three times treatments, In example 1, the pain decreased from 6 to 0.5 and the range of flexion and abduction increased from 150° to 180°. In example 2, the pain decreased from 6.5 to 1, and the range of shoulder flexion increased from 120° to 170°, while the range of abduction increased from 90° to 170°. Based on the above results, it would be effective to apply M-test to treat shoulder diseases in these two cases. (J Korean Med Rehabil 2019;29(3):173-182)