The Effects of a Patient-Specific Integrated Education Program on Pain, Perioperative Anxiety, and Functional Recovery following Total Knee Replacement

Ho, C.-T.; Chen, Yen-Ti; Wu, Hung-Lan; Huang, Hsuan-Ti; Lin, Sung‐Yen

doi:10.3390/jpm12050719

Cited by 10 publications

(12 citation statements)

References 31 publications

(34 reference statements)

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“…One trial did not report separate outcomes for hip and knee arthroplasty, 47 and in another study the reviewers were unable to obtain the raw data sets. 48 Therefore, 20 trials were included in the meta-analysis ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…the reviewers were unable to obtain the raw data sets. 48 Therefore, 20 trials were included in the meta-analysis (Figure 1). Study characteristics.…”

Section: Resultsmentioning

confidence: 99%

“…Intervention designs are described in Table I. A total of 19 trials compared prehabilitation interventions with usual care, [47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65] while three trials compared two intervention methods to usual care. [66][67][68] For participants awaiting TKA, 14 trials studied prehabilitation interventions compared to usual care.…”

Section: Resultsmentioning

confidence: 99%

“…[66][67][68] For participants awaiting TKA, 14 trials studied prehabilitation interventions compared to usual care. [48][49][50]54,55,57,59,[61][62][63][64][65][66][67] The exercise interventions included a combination of physiotherapy-led supervised sessions followed by remote unsupervised home-based exercises, 49,50,55,57,59,61,62,65 as well as fully home-based programmes. 63,66 Other interventions in addition to homebased exercise included telerehabilitation, 66 home-based resistance training and neuromuscular electrical stimulation, 64,67 an integrated education programme, 48,54,59 selfmanagement plans, 47 and telephone monitoring.…”

Section: Resultsmentioning

confidence: 99%

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Effects of home-based prehabilitation on pre- and postoperative outcomes following total hip and knee arthroplasty

et al. 2023

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AimsThe aim of this study was to determine the effectiveness of home-based prehabilitation on pre- and postoperative outcomes in participants awaiting total knee (TKA) and hip arthroplasty (THA).MethodsA systematic review with meta-analysis of randomized controlled trials (RCTs) of prehabilitation interventions for TKA and THA. MEDLINE, CINAHL, ProQuest, PubMed, Cochrane Library, and Google Scholar databases were searched from inception to October 2022. Evidence was assessed by the PEDro scale and the Cochrane risk-of-bias (ROB2) tool.ResultsA total of 22 RCTs (1,601 patients) were identified with good overall quality and low risk of bias. Prehabilitation significantly improved pain prior to TKA (mean difference (MD) -1.02: p = 0.001), with non-significant improvements for function before (MD -0.48; p = 0.06) and after TKA (MD -0.69; p = 0.25). Small preoperative improvements were observed for pain (MD -0.02; p = 0.87) and function (MD -0.18; p = 0.16) prior to THA, but no post THA effect was found for pain (MD 0.19; p = 0.44) and function (MD 0.14; p = 0.68). A trend favouring usual care for improving quality of life (QoL) prior to TKA (MD 0.61; p = 0.34), but no effect on QoL prior (MD 0.03; p = 0.87) or post THA (MD -0.05; p = 0.83) was found. Prehabilitation significantly reduced hospital length of stay (LOS) for TKA (MD -0.43 days; p < 0.001) but not for THA (MD, -0.24; p = 0.12). Compliance was only reported in 11 studies and was excellent with a mean value of 90.5% (SD 6.82).ConclusionPrehabilitation interventions improve pain and function prior to TKA and THA and reduce hospital LOS, though it is unclear if these effects enhance outcomes postoperatively.Cite this article: Bone Jt Open 2023;4(5):315–328.

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Section: Resultsmentioning

confidence: 99%

“…the reviewers were unable to obtain the raw data sets. 48 Therefore, 20 trials were included in the meta-analysis (Figure 1). Study characteristics.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Effects of home-based prehabilitation on pre- and postoperative outcomes following total hip and knee arthroplasty

et al. 2023

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“…Medina-Garzon [19] evaluated the effectiveness of a nursing intervention with three sessions of motivational interviewing to reduce preoperative anxiety in patients who underwent TKA and reported that anxiety levels improved after the intervention. Ho et al [20] introduced a patient-speci c integrated education program into the TKA clinical pathway and reported that anxiety status improved after the intervention regarding STAI scores during hospitalization. This study evaluated anxiety levels before and after intervention in the same patients and indicated that anxiety levels signi cantly decreased after intervention compared with those before intervention.…”

Section: Effectiveness Of Preoperative Interventionmentioning

confidence: 99%

Preoperative severe pain, decreased function, and high anxiety levels increase preoperative anxiety in patients who underwent primary total knee arthroplasty

Park,

Jeon,

Kim

et al. 2024

Preprint

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Patients experience clinically significant anxiety from the time they are recommended to undergo total knee arthroplasty (TKA). This study aimed to evaluate the efficacy of a preoperative intervention regarding anxiety levels in patients undergoing TKA for knee osteoarthritis (OA) and to evaluate whether patient characteristics affect the effectiveness of the intervention according to anxiety level. This retrospective observational study recruited 89 patients who underwent TKA under general anesthesia for knee OA. The preoperative intervention comprised rehabilitation education and an interview with an orthopedic surgeon regarding surgical preparation status. The State-Trait Anxiety Inventory (STAI) was administered before and after the preoperative intervention. The mean STAI score significantly improved after the intervention. The proportion of patients with clinically meaningful state anxiety (CMSA) also significantly decreased after the intervention. There were no significant differences in demographic and social factors between the two groups. However, the patients whose CMSA status did not improve experienced severe pain, poor functional scores, and high anxiety scores. For patients undergoing TKA, the implementation of a patient-specific intervention, which consists of preoperative rehabilitation education and a surgeon interview, helps reduce preoperative anxiety. However, these interventions may not be effective in patients who present with severe pain, poor functional status, or high anxiety levels before surgery. Thus, higher levels of intervention for anxiety may be necessary.

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Spasmodic Dysphonia Patients' Perception of Pain with Botulinum Toxin Injections

Heffernan

2023

The Laryngoscope

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ObjectivesTo evaluate spasmodic dysphonia patients' perception of pain associated with laryngeal botulinum toxin (BTX) injections and to determine factors associated with higher pain scores relative to other included patients.MethodsProspective cohort study. Adult patients with adductor spasmodic dysphonia that presented to a tertiary laryngology practice for BTX injections were recruited from March to July 2022. Patients completed the visual analog scale (VAS) pre‐procedure to quantify predicted pain. Ten minutes post‐procedure they completed VAS and the short form McGill Pain Questionnaire (SF‐MPQ). Factors that may affect pain were extracted from charts. Descriptive statistics, univariate, and multivariate analyses were conducted (alpha = 0.05).ResultsOne hundred and nineteen patients were included (63 ± 14 yo, 26% Male). SF‐MPQ reported mild pain (4.12 ± 4.05 out of 45) with a pain intensity of none to mild (0.70 ± 0.89 out of 5). Bilateral injections yielded significantly higher SF‐MPQ scores (5.19 ± 4.66) than unilateral injections (3.30 ± 3.30) (p = 0.012). There was a significant VAS reduction from pre 28.9 ± 24.6 mm (out of 10 mm) to post 24.5 ± 22.3 (p < 0.001). On multiple regression analyses, receiving a bilateral injection significantly (p < 0.05) contributed to a model that predicted higher pre‐VAS (p = 0.013). Bilateral injections (p < 0.05) and higher VHI‐10 (p < 0.05) contributed to a model that predicted higher total SF‐MPQ (p = 0.001) and affective SF‐MPQ (p = 0.001) scores. Not being a professional voice user (PVU) significantly (p < 0.05) contributed to a model that predicted higher post‐VAS (p = 0.008) scores.ConclusionsBTX injections were well tolerated with low pain scores. Factors associated with higher relative predicted or experienced pain included bilateral versus unilateral injection, PVU status, and higher VHI‐10.Level of EvidenceLevel 4 Laryngoscope, 2023

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The Effects of a Patient-Specific Integrated Education Program on Pain, Perioperative Anxiety, and Functional Recovery following Total Knee Replacement

Cited by 10 publications

References 31 publications

Effects of home-based prehabilitation on pre- and postoperative outcomes following total hip and knee arthroplasty

Effects of home-based prehabilitation on pre- and postoperative outcomes following total hip and knee arthroplasty

Preoperative severe pain, decreased function, and high anxiety levels increase preoperative anxiety in patients who underwent primary total knee arthroplasty

Spasmodic Dysphonia Patients' Perception of Pain with Botulinum Toxin Injections

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