Abstract

Psychological factors affect chronic pain and may lead to inactivity after total knee arthroplasty (TKA). This study aimed to determine whether using an activity diary for early postoperative rehabilitation after TKA reduced pain and improved physical functioning and psychological factors. In this non-randomized controlled trial (intervention group: n = 140; control group: n = 150), postoperative rehabilitation with physical and occupational therapy was performed for both groups, and self-monitoring using an activity diary one week postoperatively was implemented for the intervention group. The outcome variables were the numerical rating scale of pain, Timed Up & Go Test score, timed 10 m walk test score, the Pain Catastrophizing Scale (PCS), and the Pain Self-Efficacy Questionnaire (PSEQ). The data were analyzed using ANOVA with post hoc tests. Time-by-group interactions were obtained for PCS and PSEQ (p < .05), which were both more favorable in the intervention group. The intervention group showed greater improvement in PCS and PSEQ four weeks postoperatively, compared with the control group (p < .05). However, no significant results were observed for neither physical performance measures assessed. These results indicated that including an activity diary increased postoperative rehabilitation effectiveness, improved pain catastrophizing and pain self-efficacy. An activity diary is an effective and feasible addition to postoperative care for TKA patients.

摘要

心理因素会影响慢性疼痛，并可能导致全膝关节置换术 (TKA) 后不活动。本研究旨在确定使用活动日记进行 TKA 术后早期康复是否可以减轻疼痛并改善身体机能和心理因素。在这项非随机对照试验（干预组：n = 140；对照组：n = 150）中，两组均进行了术后康复与物理和职业治疗，并在术后一周使用活动日记进行自我监测干预组。结果变量是疼痛的数值评定量表、Timed Up & Go Test 分数、定时 10 m 步行测试分数、Pain Catastrophizing Scale (PCS) 和 Pain Self-Efficacy Questionnaire (PSEQ)。使用具有事后检验的方差分析分析数据。获得了 PCS 和 PSEQ (p < .05) 的逐组交互作用，这在干预组中都更有利。与对照组相比，干预组在术后 4 周的 PCS 和 PSEQ 有更大的改善（p < .05）。然而，在评估的两种物理性能测量中都没有观察到显着的结果。这些结果表明，包括活动日记可以提高术后康复效果，改善疼痛灾难性和疼痛自我效能。活动日记是 TKA 患者术后护理的有效且可行的补充。与对照组相比，干预组在术后 4 周的 PCS 和 PSEQ 有更大的改善（p < .05）。然而，在评估的两种物理性能测量中都没有观察到显着的结果。这些结果表明，包括活动日记可以提高术后康复效果，改善疼痛灾难性和疼痛自我效能。活动日记是 TKA 患者术后护理的有效且可行的补充。与对照组相比，干预组在术后 4 周的 PCS 和 PSEQ 有更大的改善（p < .05）。然而，在评估的两种物理性能测量中都没有观察到显着的结果。这些结果表明，包括活动日记可以提高术后康复效果，改善疼痛灾难性和疼痛自我效能。活动日记是 TKA 患者术后护理的有效且可行的补充。