THU0737-HPR The effectiveness of relaxation exercises on pain, functional level and muscle strength in patients with total knee arthroplasty: a preliminary results

Background

Total Knee Arthroplasty (TKA) is a common procedure performed mainly due to advanced osteoarthritis (OA), pain, physical disability and reduced quality of life. However, approximately 20% of the patients respond poorly to the surgery and chronic pain and disability following TKA remains a major health burden for many patients. Among the most well documented predictors of poor outcome following TKA is pain catastrophizing. Inadequate pain relief can cause impaired functional performance, increased skeletal muscles tension which are close to surgery related incision site, longer length of hospital stay, unnecessary psychological distress and decreased patient satisfaction. There is high need of developing treatments aimed at improving self-management for patient with TKA at early postoperative period.

Objectives

The aim of this study is to investigate the effectiveness of progressive muscle relaxations exercises (PMR) on pain coping, physical function and muscle strength among patients with TKA due to OA.

Methods

The study group consisted of 22 patients (33 knees), who underwent primary TKA because of OA were consecutively allocated to an intervention group (n=11, with mean age; 66.18±13.29 years), and were allocated to a control group (n=11, with mean age; 62.45±7.28 years). After surgery, all patients underwent the same rehabilitation program. The intervention group also was instructed preoperative patient education about PMR exercises, and the intervention group received PMR exercises focusing on reducing overall body tension, anxiety and pain managed by a physiotherapist. Patients were evaluated regarding the pain (Numeric Pain Rating Scale (NPRS)), muscle strength, knee function score (Hospital for Special Surgery (HSS) score), pain-related fear (Tampa Scale for Kinesiophobia (TSK)), anxiety and depressive symptoms (Hospital Anxiety and Depression Scale (HADS)) and quality of life (Short-Form 12 Health Survey (SF-12)). Functional activities were evaluated using the Iowa Level of Assistance Scale and walking speed was evaluated using the Iowa Ambulation Velocity Scale. Also functional outcomes were evaluated with timed up and go (TUG) test and 10-metre walk test (10 MWT). Patients were evaluated preoperatively and at discharge.

Results

At baseline, demographic characteristics were similar in groups and there was no statistically difference between groups (p>0.05). It was determined at postoperatively that; the intervention group had better results in terms of reduction of pain severity (p=0.001), improvement of HADS anxiety level (p<0.030), pain-related TKS level (p<0.035) and SF-12 mental component score (p<0.011). When the HSS knee scores and quadriceps muscle strength were compared, there was statistically difference between groups and the two outcomes scores were lower in control group after surgery (p<0.040, p<0.012, respectively). There were no statistical differences between groups for other outcomes after TKA (p>0.05).

Conclusions

The current results suggest that the PMR exercises at early stage after TKA might be an effective method for patient rehabilitation outcomes. However, in this comparison to obtain more comprehensive results studies on larger series are needed. In this way, a more uniform and objective data can be achieved.

Disclosure of Interest

None declared