Preoperative Home-Based Multimodal Physiotherapy in Patients Scheduled for a Knee Arthroplasty Who Catastrophize About Their Pain

Background : Chronic pain affects about 20% of total knee arthroplasty (TKA) patients, with high pain catastrophizing being a key predictor. Screening and addressing this modifiable factor may improve postoperative outcomes. Objective : We aimed to compare the effectiveness of two preoperative home-...

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Autores: Terradas-Monllor, Marc|||0000-0002-2696-9683, Beltran-Alacreu, Hector|||0000-0002-1971-1510, Ochandorena-Acha, Mirari|||0000-0002-1101-9677, Garcia Oltra, Ester|||0000-0002-3752-3310, Aliaga Orduña, Francisco, Hernandez Hermoso, Jose Antonio|||0000-0002-9167-3782
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:dnet:uabarcelona_::b5d104aa113d7631b4bb0bd5eff6776d
Acceso en línea:https://ddd.uab.cat/record/328372
https://dx.doi.org/urn:doi:10.3390/jcm14010268
Access Level:acceso abierto
Palabra clave:Knee osteoarthritis
Total knee arthroplasty
Physiotherapy
Chronic postsurgical pain
Pain catastrophizing
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spelling Preoperative Home-Based Multimodal Physiotherapy in Patients Scheduled for a Knee Arthroplasty Who Catastrophize About Their PainA Randomized Controlled TrialTerradas-Monllor, Marc|||0000-0002-2696-9683Beltran-Alacreu, Hector|||0000-0002-1971-1510Ochandorena-Acha, Mirari|||0000-0002-1101-9677Garcia Oltra, Ester|||0000-0002-3752-3310Aliaga Orduña, FranciscoHernandez Hermoso, Jose Antonio|||0000-0002-9167-3782Knee osteoarthritisTotal knee arthroplastyPhysiotherapyChronic postsurgical painPain catastrophizingBackground : Chronic pain affects about 20% of total knee arthroplasty (TKA) patients, with high pain catastrophizing being a key predictor. Screening and addressing this modifiable factor may improve postoperative outcomes. Objective : We aimed to compare the effectiveness of two preoperative home-based multimodal physical therapy interventions on pain catastrophizing in high-catastrophizing TKA patients. Secondarily, the study aimed to assess postoperative outcomes over six months. Methods : A total of 40 patients with symptomatic osteoarthritis and moderate pain catastrophizing were randomly allocated to the control, therapeutic patient education (TPE), and multimodal physiotherapy (MPT) groups. Preoperative interventions comprised pain neuroscience education, coping skills training, and therapeutic exercise, differing in the number of sessions and degree of supervision. All outcomes were assessed before and after the treatment in the preoperative period, and 1, 3, and 6 months post-surgery. The primary outcome measure was pain catastrophizing. Results : Both intervention groups showed a preoperative reduction in pain catastrophizing. TPE patients had lower pain ratings at rest and lower catastrophizing scores at 1 and 6 months post-surgery, reduced kinesiophobia and improved dynamic balance at 3 and 6 months post-surgery, and higher self-efficacy at 1 month post-surgery. MPT patients exhibited lower pain catastrophizing and pain intensity during walking at 1 month post-surgery, and better outcomes in kinesiophobia, self-efficacy, and dynamic balance at 1, 3, and 6 months post-surgery, along with higher walking speed at 6 months post-surgery. Conclusions : Preoperative physiotherapy reduces preoperative pain catastrophizing and improves postoperative pain-related outcomes, behaviors, and cognitions in high-catastrophizing TKA patients. Registration is with the United States Clinical Trials Registry (NCT03847324).Universitat Autònoma de Barcelona. Departament de Cirurgia 22025-01-0120252025-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/328372https://dx.doi.org/urn:doi:10.3390/jcm14010268reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:dnet:uabarcelona_::b5d104aa113d7631b4bb0bd5eff6776d2026-06-06T12:50:31Z
dc.title.none.fl_str_mv Preoperative Home-Based Multimodal Physiotherapy in Patients Scheduled for a Knee Arthroplasty Who Catastrophize About Their Pain
A Randomized Controlled Trial
title Preoperative Home-Based Multimodal Physiotherapy in Patients Scheduled for a Knee Arthroplasty Who Catastrophize About Their Pain
spellingShingle Preoperative Home-Based Multimodal Physiotherapy in Patients Scheduled for a Knee Arthroplasty Who Catastrophize About Their Pain
Terradas-Monllor, Marc|||0000-0002-2696-9683
Knee osteoarthritis
Total knee arthroplasty
Physiotherapy
Chronic postsurgical pain
Pain catastrophizing
title_short Preoperative Home-Based Multimodal Physiotherapy in Patients Scheduled for a Knee Arthroplasty Who Catastrophize About Their Pain
title_full Preoperative Home-Based Multimodal Physiotherapy in Patients Scheduled for a Knee Arthroplasty Who Catastrophize About Their Pain
title_fullStr Preoperative Home-Based Multimodal Physiotherapy in Patients Scheduled for a Knee Arthroplasty Who Catastrophize About Their Pain
title_full_unstemmed Preoperative Home-Based Multimodal Physiotherapy in Patients Scheduled for a Knee Arthroplasty Who Catastrophize About Their Pain
title_sort Preoperative Home-Based Multimodal Physiotherapy in Patients Scheduled for a Knee Arthroplasty Who Catastrophize About Their Pain
dc.creator.none.fl_str_mv Terradas-Monllor, Marc|||0000-0002-2696-9683
Beltran-Alacreu, Hector|||0000-0002-1971-1510
Ochandorena-Acha, Mirari|||0000-0002-1101-9677
Garcia Oltra, Ester|||0000-0002-3752-3310
Aliaga Orduña, Francisco
Hernandez Hermoso, Jose Antonio|||0000-0002-9167-3782
author Terradas-Monllor, Marc|||0000-0002-2696-9683
author_facet Terradas-Monllor, Marc|||0000-0002-2696-9683
Beltran-Alacreu, Hector|||0000-0002-1971-1510
Ochandorena-Acha, Mirari|||0000-0002-1101-9677
Garcia Oltra, Ester|||0000-0002-3752-3310
Aliaga Orduña, Francisco
Hernandez Hermoso, Jose Antonio|||0000-0002-9167-3782
author_role author
author2 Beltran-Alacreu, Hector|||0000-0002-1971-1510
Ochandorena-Acha, Mirari|||0000-0002-1101-9677
Garcia Oltra, Ester|||0000-0002-3752-3310
Aliaga Orduña, Francisco
Hernandez Hermoso, Jose Antonio|||0000-0002-9167-3782
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona. Departament de Cirurgia
dc.subject.none.fl_str_mv Knee osteoarthritis
Total knee arthroplasty
Physiotherapy
Chronic postsurgical pain
Pain catastrophizing
topic Knee osteoarthritis
Total knee arthroplasty
Physiotherapy
Chronic postsurgical pain
Pain catastrophizing
description Background : Chronic pain affects about 20% of total knee arthroplasty (TKA) patients, with high pain catastrophizing being a key predictor. Screening and addressing this modifiable factor may improve postoperative outcomes. Objective : We aimed to compare the effectiveness of two preoperative home-based multimodal physical therapy interventions on pain catastrophizing in high-catastrophizing TKA patients. Secondarily, the study aimed to assess postoperative outcomes over six months. Methods : A total of 40 patients with symptomatic osteoarthritis and moderate pain catastrophizing were randomly allocated to the control, therapeutic patient education (TPE), and multimodal physiotherapy (MPT) groups. Preoperative interventions comprised pain neuroscience education, coping skills training, and therapeutic exercise, differing in the number of sessions and degree of supervision. All outcomes were assessed before and after the treatment in the preoperative period, and 1, 3, and 6 months post-surgery. The primary outcome measure was pain catastrophizing. Results : Both intervention groups showed a preoperative reduction in pain catastrophizing. TPE patients had lower pain ratings at rest and lower catastrophizing scores at 1 and 6 months post-surgery, reduced kinesiophobia and improved dynamic balance at 3 and 6 months post-surgery, and higher self-efficacy at 1 month post-surgery. MPT patients exhibited lower pain catastrophizing and pain intensity during walking at 1 month post-surgery, and better outcomes in kinesiophobia, self-efficacy, and dynamic balance at 1, 3, and 6 months post-surgery, along with higher walking speed at 6 months post-surgery. Conclusions : Preoperative physiotherapy reduces preoperative pain catastrophizing and improves postoperative pain-related outcomes, behaviors, and cognitions in high-catastrophizing TKA patients. Registration is with the United States Clinical Trials Registry (NCT03847324).
publishDate 2025
dc.date.none.fl_str_mv 2
2025-01-01
2025
2025-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/328372
https://dx.doi.org/urn:doi:10.3390/jcm14010268
url https://ddd.uab.cat/record/328372
https://dx.doi.org/urn:doi:10.3390/jcm14010268
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
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