Rehabilitation following surgery: Clinical and psychological predictors of activity limitations.

Abstract

Interventions to reduce preoperative anxiety and postoperative depression may lead to reduced 4-month activity limitations. However, the additional variance explained by psychological variables was low (ΔR² = 0.05). Our models, which included biomedical and surgical variables, accounted for less than 50% of the variance in activity limitations overall. Therefore, further investigation of psychological variables, particularly cognitions related specifically to activity behavior, would be merited.

Improving Patient Outcomes Following Total Knee Arthroplasty: Identifying Rehabilitation Pathways Based on Modifiable Psychological Risk and Resilience Factors

“…Because pain catastrophising increases a person's perception that their pain is an indicator of threat or harm, this may also trigger avoidance behavior (Sturgeon and Zautra, 2013), contributing to worse postoperative outcomes. By limiting an individual's exposure to pain and pain-related stimuli, avoidance can result in failure to extinguish pain-related fears (Leeuw et al, 2007;Powell et al, 2013), reduced efforts to develop more diverse and flexible pain-related coping resources (internal or external), and decreased likelihood of ceasing ineffective behavioral coping mechanisms in response to pain (Sturgeon and Zautra, 2013). Furthermore, when patients are unable to shift their attention away from pain and related experiences after surgery, they may experience difficulty attending to broader experiences, including more adaptive emotions, cognitions, or behaviors.…”

“…Following TKA, anxiety may predispose patients to avoid stimuli, activities, sensations or situations that they fear will exacerbate their condition ( Theunissen et al, 2012 ), such as musculoskeletal physiotherapy rehabilitation programs that may cause pain or re-injury ( Jack et al, 2010 ). This can result in longer-term adverse outcomes such as physical deconditioning, comorbidities, loss of function and muscle tone, and enduring chronic pain ( Bortz, 1984 ; Sullivan et al, 2009 ; Powell et al, 2013 ). Avoidance behaviors, therefore, can ultimately lead to augmentation of the outcome that an individual is seeking to diminish ( DeGaetano et al, 2016 ), such as worse pain intensity and longer-term disability ( Goubert and Trompetter, 2017 ), resulting in further avoidance and the perpetuation of a detrimental fear-avoidance behavioral cycle ( Theunissen et al, 2012 ).…”

The effect of peri-operative pain neuroscience education on post-operative pain and recovery in adult patients receiving laparoscopic inguinal hernia repair---A prospective randomized controlled trial

“…Patients who are inadequately informed about the surgical procedure, perioperative analgesia, and strategies for coping with stress and pain may engage in catastrophic thinking, exacerbating acute pain and prolonging its course [Liu 2020,Gil 2018]. Therefore, the genesis and perpetuation of peri-operative pain are multifactorial, in uenced not merely by physical determinants such as surgical trauma and comorbid conditions, but also signi cantly modulated by the psychological capacity to cope with such pain [Campbell 2009,Powell 2013]. Consequently, the re nement of perioperative multimodal analgesia should transcend pharmacological interventions and procedural analgesic techniques to encompass a more comprehensive, psychosomatic multimodal approach [Miller 2023].…”