Relaxation exercise therapy improves pain, muscle strength, and kinesiophobia following total knee arthroplasty in the short term: a randomized controlled trial

Abstract

Purpose This study aimed to compare progressive muscle relaxation (PMR) + standard physiotherapy (PT) to standard PT during inpatient rehabilitation of total knee arthroplasty (TKA) patients in terms of post-operative outcomes. The hypothesis was that PMR + standard PT would lead to better pain, function, and neuromuscular outcomes than standard PT. Methods A total of 106 patients were randomly allocated into PMR or standard rehabilitation (SR) groups. Both groups received standard PT during their hospital stay. PMR group additionally performed PMR exercise on post-operative days 1, 2, and 3. Patients were evaluated regarding pain intensity, functional outcomes, muscle strength, active range of motion, knee edema, anxiety, depression, and kinesiophobia. Results There were no diferences between groups at baseline (n.s.). During the inpatient period and at discharge, the PMR group had better results in terms of pain relief (p < 0.05), quadriceps strength (p = 0.001), kinesiophobia level (p = 0.011) compared to the SR group. No diference was detected between groups regarding other evaluation parameters during the inpatient period, at discharge, and third post-operative month (n.s.). The within-group analysis showed statistically signiicant diferences over time in both groups in each variable (p < 0.05). Conclusion Our indings support that PMR therapy ofers beneicial results in subjective and objective measures of TKA patients during the inpatient period. Therefore, PMR therapy could be implemented into the rehabilitation program of TKA patients to enhance their early recovery from various symptoms following TKA. Level of evidence II.

The patients‘ perspective - a qualitative analysis of experiencing a fracture-related infection

“…Positive effects of mind–body interventions, and especially mindfulness meditations are widely reported for a range of diseases ( Sampaio et al, 2017 ). While the effect of such an adjunct therapy approach has still to be evidenced in FRI patients ( Walter et al, 2022a ), improvements in functional outcomes were reported in patients undergoing primary arthroplasty procedures after relaxation exercise ( Lim et al, 2014 ; Eymir et al, 2022 ).…”

Long‐lasting decreased pain threshold negatively affects functional recovery after arthroscopic rotator cuff repair

“…In the current study, patients with a decreased PPT received signal inputs by stimulations that would be barely noticeable under normal conditions, and a mechanism that restricts movement was activated at the level above the spine, leading to decreased motor functions. Another possible explanation for the relationship between pain and the motor system is that pain reduction may lead to decreased motor phobia, resulting in an increased ROM [11]. Therefore, it is important to control pain preoperatively and postoperatively, and appropriate postoperative analgesics should be provided to prevent any prolonged decrease in pain thresholds and to achieve favorable postoperative recovery.…”

Increased kinesiophobia leads to lower return to sport rate and clinical outcomes following osteochondral allograft transplantation of the knee

“…Growing evidence suggests psychosocial factors such as kinesiophobia (fear of movement/reinjury), preoperative mental health and pain catastrophizing may influence return to sport [9,10]. While kinesiophobia has been predominantly recognized as affecting outcomes following anterior cruciate ligament reconstruction (ACLR) [11][12][13], shoulder arthroscopy [14][15][16], hip [17] and total knee arthroplasty (TKA) [18,19], there is still limited evidence describing it's effects on RTS and clinical outcomes after OCA transplantation of the knee [20].…”