Volume 25, Issue 3 (Autumn 2024)
jrehab 2024, 25(3): 500-519 |
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Telicani F, Khademi Kalantari K, Rahimi A, Akbarzadeh Baghban A, Omidian M M, Daryabor A. Relationship Between Psychological and Clinical Outcomes of 12-Week Therapeutic Exercises Following Total Knee Arthroplasty. jrehab 2024; 25 (3) :500-519
URL: http://rehabilitationj.uswr.ac.ir/article-1-3366-en.html
URL: http://rehabilitationj.uswr.ac.ir/article-1-3366-en.html
Fariba Telicani1 
, Khosro Khademi Kalantari * 2, Abbas Rahimi1 , Alireza Akbarzadeh Baghban3 , Mohammad Mahdi Omidian4 , Aliyeh Daryabor5
, Khosro Khademi Kalantari * 2, Abbas Rahimi1 , Alireza Akbarzadeh Baghban3 , Mohammad Mahdi Omidian4 , Aliyeh Daryabor5
1- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. ,khosro_khademi@yahoo.co.uk
3- Department of Biostatistics, Proteomics Research Center, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4- Department of Orthopedics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
5- Department of Orthotics and Prosthetics, Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. ,
3- Department of Biostatistics, Proteomics Research Center, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4- Department of Orthopedics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
5- Department of Orthotics and Prosthetics, Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract: (3801 Views)
Objective This study aimed to investigate the relationship between psychological factors and clinical outcomes of therapeutic exercise after 3 months in individuals undergoing total knee arthroplasty (TKA). Another aim of this study was to evaluate the effect of 3 months of therapeutic exercise on the psychological factors of these patients.
Materials & Methods This quasi-experimental study involved 29 patients with an average age of 62.76 years who had undergone TKA for their first knees. These patients performed therapeutic exercises for three months. Pain intensity and range of motion (ROM) of flexion and extension were assessed 3 times: before surgery, at the beginning of physiotherapy and 12 weeks after therapeutic exercises. Patients’ functional ability and psychological indicators were evaluated in two phases: Before surgery and at the end of the 12th week. Clinical outcomes, including pain, knee ROM, and functional ability, were assessed using the visual analog scale, goniometer and Oxford knee score, respectively. The depression index was assessed with the Beck depression inventory (BDI) second version, anxiety with the state-trait anxiety index, fear of movement with the tampa scale of kinesiophobia (TSK) questionnaire and pain catastrophizing with the pain catastrophizing scale questionnaire.
Results The results showed that two psychological indices, including trait anxiety and pain catastrophizing, had a significant negative correlation with the clinical outcomes of physiotherapy after TKA. The higher the trait anxiety before surgery was, the lower the pain reduction during the activity (r=-0.574, P=0.002) and the lower the improvement in functional abilities (r=-0.402, P=0.038). Also, the higher the index of preoperative pain catastrophizing, the lower the pain reduction during activity (r=-470, P=0.013) and the lower the improvement in functional abilities (r=-0.436, P=0.023). No significant correlation was found between other psychological indicators before surgery and the clinical outcomes of physiotherapy. On the other hand, among the psychological factors, trait anxiety (P=0.01) and fear of movement (P=0.01) were significantly improved after 3-month therapeutic exercise.
Conclusion Psychological factors can play an essential role in predicting the clinical outcomes of physiotherapy after TKA. In addition, the improvement of psychological factors after therapeutic exercises may indicate that these psychological problems can be improved by reducing pain and achieving better ROM during treatment, so psychological factors are not considered an obstacle to surgery.
Materials & Methods This quasi-experimental study involved 29 patients with an average age of 62.76 years who had undergone TKA for their first knees. These patients performed therapeutic exercises for three months. Pain intensity and range of motion (ROM) of flexion and extension were assessed 3 times: before surgery, at the beginning of physiotherapy and 12 weeks after therapeutic exercises. Patients’ functional ability and psychological indicators were evaluated in two phases: Before surgery and at the end of the 12th week. Clinical outcomes, including pain, knee ROM, and functional ability, were assessed using the visual analog scale, goniometer and Oxford knee score, respectively. The depression index was assessed with the Beck depression inventory (BDI) second version, anxiety with the state-trait anxiety index, fear of movement with the tampa scale of kinesiophobia (TSK) questionnaire and pain catastrophizing with the pain catastrophizing scale questionnaire.
Results The results showed that two psychological indices, including trait anxiety and pain catastrophizing, had a significant negative correlation with the clinical outcomes of physiotherapy after TKA. The higher the trait anxiety before surgery was, the lower the pain reduction during the activity (r=-0.574, P=0.002) and the lower the improvement in functional abilities (r=-0.402, P=0.038). Also, the higher the index of preoperative pain catastrophizing, the lower the pain reduction during activity (r=-470, P=0.013) and the lower the improvement in functional abilities (r=-0.436, P=0.023). No significant correlation was found between other psychological indicators before surgery and the clinical outcomes of physiotherapy. On the other hand, among the psychological factors, trait anxiety (P=0.01) and fear of movement (P=0.01) were significantly improved after 3-month therapeutic exercise.
Conclusion Psychological factors can play an essential role in predicting the clinical outcomes of physiotherapy after TKA. In addition, the improvement of psychological factors after therapeutic exercises may indicate that these psychological problems can be improved by reducing pain and achieving better ROM during treatment, so psychological factors are not considered an obstacle to surgery.
Keywords: Physiotherapy, Psychological factors, Total knee arthroplasty (TKA), Pain, Range of motion (ROM), Functional ability
Type of Study: Original |
Subject:
Physical Therapy
Received: 21/09/2023 | Accepted: 6/04/2024 | Published: 1/10/2024
Received: 21/09/2023 | Accepted: 6/04/2024 | Published: 1/10/2024
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This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-By-NC), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
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