Cognitive behavior therapy alleviates kinesiophobia after total knee arthroplasty

doi:10.3969/j.issn.2095-4344.2017.23.009

Abstract

Abstract:

BACKGROUND: Early rehabilitation after total knee arthroplasty (TKA) can help the rapid functional recovery of knee, but some patients are fear of moving and refuse to do exercising because of kinesiophobia, thereby delaying functional recovery. Foreign study has confirmed that patients with cognitive behavioral therapy (CBT) can effectively alleviate kinesiophobia, but no related studies have been reported in China.

OBJECTIVE: To explore the effectiveness of CBT on patients with kinesiophobia after TKA.

METHODS: 108 patients with kinesiophobia after TKA were recruited from Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University, China between March 2014 and January 2015, and were then equivalently randomized into experimental and control groups using random number table. Both groups were subjected to conventional treatment, while the experimental group received extra CBT. The scores of Tampa Scale of Kinesiophobia and American Knee Society were evaluated immediately, 1, 3, and 6 months after hospital discharge; the hospitalization time and total hospitalization expenditure were compared between two groups immediately after discharge.

RESULTS AND CONCLUSION: The scores of Tampa Scale of Kinesiophobia in the experimental group were significantly lower than those in the control group at different time points postoperatively (P < 0.05). The scores of American Knee Society in the experimental group were significantly higher than those in the control group at 3 and 6 months after discharge and kept on rising (P < 0.01), but showed no significant difference at discharge and 1 month after discharge (P > 0.05). (2) The hospitalization time and total hospitalization expenditure in the experimental group were significantly lower than those in the control group (P < 0.01). (3) To conclude, CBT cannot only shorten the hospitalization time and total hospitalization expenditure, but also relieve kinesiophobia, which is conductive for functional recovery of the knee.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Arthroplasty, Replacement, Knee, Prosthesis Implantation, Cognitive Therapy, Tissue Engineering

CLC Number:

R318

Cai Li-bai, Liu Yan-jin, Zhao Hui, Xu Hui-ping, Gao Huan-huan, Dong Yue-zhi. Cognitive behavior therapy alleviates kinesiophobia after total knee arthroplasty [J]. Chinese Journal of Tissue Engineering Research, 2017, 21(23): 3658-3663.

Figures/Tables 2

References

[1] 徐高伟,董斌,崔海勇,等. 有限元分析全膝关节置换股骨假体置入定位参数及临床优化验证[J].中国组织工程研究, 2016, 20(17): 4411-4418.

[2] Aumiller WD, Dollahite HA. Advances in total knee arthroplasty. JAAPA. 2016;29(3):27-31.

[3] Canata GL, Casale V, Chiey A. Pain management in total knee arthroplasty: efficacy of a multimodal opiate-free protocol. Joints. 2016;4(4):222-227.

[4] Baert I A, Lluch E, Mulder T, et al. Does pre-surgical central modulation of pain influence outcome after total knee replacement? A systematic review. Osteoarthritis Cartilage. 2016;24(2):213-223.

[5] Doury-Panchout F, Metivier JC, Fouquet B. Kinesiophobia negatively influences recovery of joint function following total knee arthroplasty. Eur J Phys Rehabil Med. 2015;51(2):155-161.

[6] Kori SH, Miller RP, Todd DD. Kinisophobia: A new view of chronic pain behavior. 1990;3(1):35-43.

[7] Lee DY, Karim SA, Chang HC. Return to sports after anterior cruciate ligament reconstruction-a review of patients with minimum 5-year follow-up. Ann Acad Med Singapore. 2008; 37(4):273-278.

[8] Wood DW, Haig AJ, Yamakawa KS. Fear of movement/(re)injury and activity avoidance in persons with neurogenic versus vascular claudication. Spine J. 2012;12(4):292-300.

[9] 李星凤,熊钰,邓诗佳,等. 腰椎间盘突出症患者疼痛信念与生活质量的相关性分析[J].护理学杂志,2016,31(2):51-53.

[10] 刘丽丽,王维宁. 疼痛日记对腰椎间盘突出症患者恐动症和恐惧回避信念的影响[J]. 护理学杂志, 2015,30(10):25-28.

[11] 伍青,郭爱敏. 慢性阻塞性肺疾病患者呼吸困难信念的相关概念及测量[J]. 中华护理杂志, 2015,50(4):454-459.

[12] Murphy WJ, Altman RD. Updated osteoarthritis reference standard. J Rheumatol Suppl. 1995;43:56-59.

[13] Vlaeyen JW, Crombez G. Fear of movement/(re)injury, avoidance and pain disability in chronic low back pain patients. Man Ther. 1999;4(4):187-195.

[14] 杜慧晴,梅迎雪,代文娟,等. 非药物干预对人工全膝关节置换术后患者疼痛的影响[J]. 宁夏医学杂志, 2016,38(4):349-350.

[15] 唐侠. 早期功能锻炼对膝关节置换术后功能恢复的影响[J]. 中华全科医学, 2014,12(8):1331-1332,1343.

[16] Severijns P, Vanslembrouck M, Vermulst J, et al. High-demand motor tasks are more sensitive to detect persisting alterations in muscle activation following total knee replacement . Gait Posture. 2016;50(3):151-158.

[17] Fiala B, Rhodes RE, Blanchard C, et al. Using social-cognitive constructs to predict preoperative exercise before total joint replacement. Rehabil Psychol, 2013;58(2): 137-147.

[18] Morone NE, Abebe KZ, Morrow LA, et al. Pain and decreased cognitive function negatively impact physical functioning in older adults with knee osteoarthritis. Pain Med. 2014;15(9): 1481-1487.

[19] Focht BC, Garver MJ, Devor ST, et al. Improving maintenance of physical activity in older, knee osteoarthritis patients trial-pilot (IMPACT-P): design and methods. Contemp Clin Trials. 2012;33(5):976-982.

[20] Kavak F, Unal S, Yilmaz E. Effects of Relaxation Exercises and Music Therapy on the Psychological Symptoms and Depression Levels of Patients with Schizophrenia. Arch Psychiatr Nurs. 2016;30(5):508-512.

[21] 刘薇,周小萍,邵艳霞,等. 放松训练对急性创伤患者心理健康的影响[J]. 第三军医大学学报, 2015,37(21):2169-2173.

[22] Neblett R, Hartzell MM, Mayer TG, et al. Establishing clinically meaningful severity levels for the Tampa Scale for Kinesiophobia (TSK-13). Eur J Pain. 2016;20(5):701-710.

[23] Koho P, Borodulin K, Kautiainen H, et al. Finnish version of the Tampa Scale of Kinesiophobia: Reference values in the Finnish general population and associations with leisure-time physical activity . J Rehabil Med. 2015;47(3):249-255.

[24] Acar S, Savci S, Keskinoglu P, et al. Tampa Scale of Kinesiophobia for Heart Turkish Version Study: cross-cultural adaptation, exploratory factor analysis, and reliability. J Pain Res. 2016;9(1):445-451.

[25] 胡文. 简体中文版TSK和FABQ量表的文化调适及其在退行性腰腿痛中的应用研究[D]. 第二军医大学, 2012.

[26] nsall JN, Dorr LD, Scott RD, et al. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989; (248):13-14.

[27] Tjong VK, Devitt BM, Murnaghan ML, et al. A Qualitative Investigation of Return to Sport After Arthroscopic Bankart Repair: Beyond Stability. Am J Sports Med. 2015;43(8): 2005-2011.

[28] Maempel JF, Clement ND, Brenkel IJ, et al. Validation of a prediction model that allows direct comparison of the Oxford Knee Score and American Knee Society clinical rating system . Bone Joint J. 2015;97-B(4):503-509.

[29] Civinini R, Carulli C, Matassi F, et al. The Survival of Total Knee Arthroplasty: Current Data from Registries on Tribology: Review Article. HSS J. 2017;13(1):28-31.

[30] Bunzli S, Smith A, Watkins R, et al. What Do People Who Score Highly on the Tampa Scale of Kinesiophobia Really Believe? A Mixed Methods Investigation in People With Chronic Nonspecific Low Back Pain . Clin J Pain. 2015;31(7): 621-632.

[31] Tait MA, Dredge C, Barnes CL. Preoperative Patient Education for Hip and Knee Arthroplasty: Financial Benefit? J Surg Orthop Adv.2015;24(4):246-251.

[32] Aasvang EK, Luna IE, Kehlet H. Challenges in postdischarge function and recovery: the case of fast-track hip and knee arthroplasty. Br J Anaesth. 2015;115(6):861-866.

[33] Monticone M, Ambrosini E, Cazzaniga D, et al. Adults with idiopathic scoliosis improve disability after motor and cognitive rehabilitation: results of a randomised controlled trial . Eur Spine J. 2016;25(10):3120-3129.

[34] Richmond H. Using a CBT approach to manage low back pain. Nurs Times.2016;112(18):12-14.

[35] Bragard I, Etienne AM, Faymonville ME, et al. A Nonrandomized Comparison Study of Self-Hypnosis, Yoga, and Cognitive-Behavioral Therapy to Reduce Emotional Distress in Breast Cancer Patients. Int J Clin Exp Hypn. 2017;65(2):189-209.

[36] Tanuma K, Watanabe F, Maeda H, et al. Development and Validation of a Training Program Using a Cognitive Behavioral Therapy Approach with the Purpose of Enabling Community Pharmacists to Provide Empathic Patient Counseling. Yakugaku Zasshi. 2017;137(2):227-240.

[37] Fagevik OM, Slobo M, Klarin L, et al. Physical function and pain after surgical or conservative management of multiple rib fractures - a follow-up study. Scand J Trauma Resusc Emerg Med. 2016;24(1):128.

[38] Brown ML, Plate JF, Von Thaer S, et al. Decreased Range of Motion After Total Knee Arthroplasty Is Predicted by the Tampa Scale of Kinesiophobia. J Arthroplasty. 2016;31(4): 793-797.

[39] Filardo G, Roffi A, Merli G, et al. Patient kinesiophobia affects both recovery time and final outcome after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2016; 24(10):3322-3328.

[40] Schotanus MG, Boonen B, Kort NP. Patient specific guides for total knee arthroplasty are ready for primetime. World J Orthop. 2016;7(1):61-68.