Effect of Emulgel containing Langkasuka Oil versus Diclofenac Gel for Improving Physical Function in Patients with Knee Osteoarthritis: A randomized controlled trial
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Abstract
Knee osteoarthritis (KOA) is characterized by a progressive decline in physical functioning. Emulgel containing Langkasuka oil (ELO) represents a newly developed formulation incorporating Langkasuka oil as an active constituent. This study aimed to evaluate the impact of ELO on lower limb function and mobility, as assessed by the Timed Up and Go (TUG) test and 30-Second Chair Stand (30-CST) test. Participants were allocated into two groups: an experimental group receiving topical ELO and a control group receiving topical diclofenac gel (DG). Both groups were instructed to apply the assigned substance to the knee area three times daily for a period of four weeks. Outcome measures were assessed at baseline, day 14, and day 28. Statistical analysis was performed using repeated measures ANOVA to assess within-group changes over time, and one-way ANOVA to examine between-group differences. In the ELO group, mean scores progressively declined from 11.29±1.42 at baseline to 8.10±0.94 at Day 28, indicating a clinically significant transition from moderate fall risk to normal functional status. A comparable reduction was observed in the DG group, with mean scores decreasing from 11.26±1.55 at baseline to 8.06±1.12 at Day 28. Both the ELO and DG groups demonstrated statistically significant improvements in 30-CST performance over the 28-day intervention period (p<0.001), with mean scores increasing from 8.61±1.05 to 10.26±1.29 and from 8.65±0.98 to 10.13±1.26, respectively. In conclusion, the newly developed ELO demonstrated effectiveness in improving physical function in the management of knee osteoarthritis, with outcomes comparable to those achieved with conventional pharmacological treatment.
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References
R. Vina, K. Kwoh, Epidemiology of osteoarthritis: literature update, Current opinion in rheumatology 30(2) (2018) 160-167.
]2] M. Jordan, G. Helmick, B. Renner, G. Luta, D. Dragomir, J. Woodard, C. Hochberg, Prevalence of knee symptoms and radiographic and symptomatic knee osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project, The Journal of rheumatology 34(1) (2007) 172-180.
D. Li, S. Li, Q. Chen, X. Xie, The prevalence of symptomatic knee osteoarthritis in relation to age, sex, area, region, and body mass index in China: a systematic review and meta-analysis, Frontiers in medicine 7 (2020) 304.
S. Paitoonpong, Promotion of active aging and quality of life in old age and preparation for a complete aged society in Thailand, TDRI Quarterly Review 38(3) (2023) 3-13.
S. Pengpid, K. Peltzer, Prevalence and associated factors of cross-sectional and incident self-reported arthritis or rheumatism among a national community sample of middle-aged and older adults in Thailand, Front Public Health 11 (2023) 1064751.
C. Sangdee, S. Teekachunhatean, K. Sananpanich, et al., Electroacupuncture versus diclofenac in symptomatic treatment of osteoarthritis of the knee: a randomized controlled trial, BMC Complement Altern Med 2(3) (2002).
ST. Sutbeyaz. N. Sezer, BF. Koseoglu, F. Ibrahimoglu, D. Tekin, Influence of knee osteoarthritis on exercise capacity and quality of life in obese adults, Obesity 15 (2007) 2071‑6.
C. Patrono, P. Patrignani, LA. Garcia Rodriguez, Cyclooxygenase-selective inhibition of prostanoid formation: transducing biochemical selectivity into clinical read-outs, Journal of Clinical Investigation 108(1) (2001) 7–13.
E. Ricciotti, GA. FitzGerald, Prostaglandins and inflammation, Arteriosclerosis, Thrombosis, and Vascular Biology 31(5) (2011) 986–1000.
L. Gallell, O. Galasso, D. Falcone, S. Southworth, M. Greco, V. Ventura. et al, The effects of nonsteroidal anti-inflammatory drugs on clinical outcomes, synovial fluid cytokine concentration and signal transduction pathways in knee osteoarthritis: A randomized open label trial, Osteoarthritis and Cartilage 21(9) (2013) 1400–8.
C. Nasruddin, Langkasuka oil massage, Narathiwat, 2019.
Department of Thai Traditional and Alternative Medicine, Thai identity massage: Langkasuka oil massage, Magnet Store, 2020.
P. Kabkrathok, S. Jarussophon, O. Unger, P. Lomarat, V. Reutrakul, P. Pittayanurak, B. Bongcheewin, N. Anantachoke, Mass spectral analysis of secondary metabolites from Zingiber montanum rhizome extract using UHPLC-HR-ESI-QTOF-MS/MS, Phytochemical Analysis 33(1) (2022) 57-71.
A. Singharach, S. Thongpraditchote, N. Anantachoke, R. Temsiririrkkul, Anti-inflammatory activity of Zingiber montanum (J. König) Link ex Dietr. extracts prepared by deep frying in coconut oil, Pharm Sci Asia 47 (2020) 51-7.
B. Kocaadam, N. Şanlier, Curcumin, an active component of turmeric (Curcuma longa), and its effects on health, Critical reviews in food science and nutrition 57(13) (2017) 2889-2895.
H. Weahalimah, T. Hathaithip, Effectiveness of Self-massage with Langkasuka Oil for Treating Neck and Shoulder Pain in Patients with Office Syndrome, Journal of Thai Traditional and Alternative Medicine Volume 22 (2) (2024) 265-277.
F. Dobson, RS. Hinman, M. Hall, CB. Terwee, EM. Roos, KL. Bennell, Measurement properties of performance-based measures to assess physical function in hip and knee osteoarthritis: a systematic review, Osteoarthritis Cartilage 20(12) (2012) 1548–62.
D. Nidup, S. Kietinun, S. Niempoog, K. Sriyakul, Efficacy of rtsa-byugs vs diclofenac gel in relieving knee pain of patients with osteoarthritis of the knee, Journal of Health Research 35(5) (2021) 424-433.
D. Podsiadlo, S. Richardson, The timed “up and go”: a test of basic functional mobility for frail elderly persons, Journal of the American Geriatrics Society 39(2) (1991) 142–148.
CJ. Jones, RE. Rikli, WC. Beam. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults, Research Quarterly for Exercise and Sport 70(2) (1990) 113.
S. Maenpuen, O. Duangmala, K. Kednai, W. Hemtong, P. Sirited, P. Tunit, Effect of Thai Yoga exercise for reducing pain and improve functional disability in patients with text neck syndrome: A randomized controlled trial, Journal of Current Science and Technology 15(1) (2025) 79-79.
L. Khuna, T. Plukwongchuen, W. Yaemrattanakul, Y. Lee, Discriminative ability of functional performance tests on risk of falling among older adults with knee osteoarthritis: A cross-sectional study, Medicine 104(21) (2025) e42578.
CM. Arnold, RA. Faulkner, The history of falls and the association of the timed up and go test to falls and near-falls in older adults with hip osteoarthritis, BMC Geriatrics 7(17) (2007) 1-9.
E. Barry, R. Galvin, C. Keogh, F. Horgan, T. Fahey, Is the timed up and go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis, BMC Geriatrics 1(14) (2014) 14.
Uengpanichpong, W, Rehabilitation manual for elderly patients following total knee replacement surgery, Physical Therapy Association of Thailand (2015).
C. Saereewat, K. Sriyakul, P. Tungsukruthai, S. Niempoog, S. Tungsukruthai, C. Kamalashiran, Efficacy and Safety of Traditional Transdermal Patch (Ya-Pok- Dud-Pid) in Primary Knee Osteoarthritis Patients: A Randomized Controlled Trial, Pharmacognosy Journal 16(3) (2024) 570-575.
E. Zasadzka, A. Borowicz, M. Roszak, M. Pawlaczyk, (2015). Assessment of the risk of falling with the use of timed up and go test in the elderly with lower extremity osteoarthritis, Clinical interventions in aging 10 (2015) 1289-1298.
M. Roghani, T. Baluchnejadmojarad, M. Sajadi, E. Kavandi, F. Kargar-sharif, Effect of Chronic Oral Administration of Nigella Sativa Seeds in Diabetic Rats, Journal of Social Sciences Naresuan University 14(2) (2006) 44-50.
F. Azizi, F. Ghorat, M. Hassan Rakhshani, M. Rad, Comparison of the effect of topical use of Nigella Sativa oil and diclofenac gel on osteoarthritis pain in older people: A randomized, double-blind clinical trial, Journal of Herbal Medicine 16 (2019) 100259.
P. Tunit, N.Mahama, N. Mina, N. Chi, S. Maenpuen, P. Sawangwong, P, C. Chittasupho, Efficacy of Phlai (Zingiber montanum) Spray Cool Formula in Managing Upper Trapezius Myofascial Pain Syndrome: A Randomized Controlled Trial, Life 15(3) (2025) 360.
M. Vitaloni, A. Botto-van Bemden, M. Sciortino Contreras, D. Scotton, Bibas, M. Quintero, J. Verges, Global management of patients with knee osteoarthritis begins with quality of life assessment: a systematic review, BMC musculoskeletal disorders 20(1) (2019) 493.
B. Aglamis, NF. Toraman, H. Yaman, Change of quality of life due to exercise training in knee osteoarthritis: SF-36 and WOMAC, Journal of Back and Musculoskeletal Rehabilitation 22 (2009) 43–48.
T. Kumar, V. Pandey, A. Kumar, A. Elhence, V. Choudhary, Quality of life and self-reported disability in patients with osteoarthritis: Cross-sectional descriptive study, Journal of education and health promotion 12 (2023) 81.
A. Montero, F. Mulero, C. Tornero, J. Guitart, M. Serrano, Pain, disability and health-related quality of life in osteoarthritis joint matters: an observational, multi-specialty trans-national follow-up study, Clinical rheumatology 35(9) (2016) 2293-2305.
