Examining the effects of total knee arthroplasty enhanced with a brief mindfulness-based cognitive behavioral therapy on pain and pain-related outcomes following surgery: a pilot study
Notice bibliographique
Résumé
BACKGROUND: Total knee arthroplasty (TKA) is one of the most common surgical treatments for patients with end-stage knee osteoarthritis (KOA). Although most patients benefit from this treatment, approximately 10-34% report poor postoperative outcomes, including persistent pain. Studies have shown that psychological distress (e.g., depression and anxiety) and pain catastrophizing (PC) contribute to worse pain-related outcomes in participants undergoing TKA. To address this, recent efforts have focused on optimizing TKA by incorporating psychological intervention into the perioperative period. Prior research indicates that cognitive behavioral therapy (CBT) and mindfulness-based interventions (MBIs) may improve postoperative pain and pain-related outcomes following TKA. More work is needed to understand the effects of these types of non-pharmacological interventions on various postsurgical outcomes. OBJECTIVE: The current study examined whether participants experienced changes in pain, physical functioning, psychosocial, and psychophysical outcomes after undergoing TKA enhanced with a brief perioperative mindfulness-based CBT (MBCBT). DESIGN: Uncontrolled quasi-experimental design with follow-up 3 months after surgery. METHODS: Participants (N = 22) with KOA undergoing TKA completed a baseline assessment 1-4 weeks prior to surgery, then attended a total of 4 sessions of MBCBT pre- and postoperatively. Participants were reassessed approximately 3 months after surgery. Self-reported pain and physical functioning were assessed using the Brief Pain Inventory (BPI) scale and the Western Ontario and McMaster University of Osteoarthritis (WOMAC)-index scale including 3 subscales (i.e., pain, physical function, and stiffness). Psychological distress was measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) depression and anxiety scales, and PC was measured using the Pain Catastrophizing Scale (PCS). Objective measures of physical performance were assessed using the 6-minute walk test (6MWT) and stair climbing task (SCT). Lastly, pain sensitization was measured using a battery of quantitative sensory testing (QST) including pressure pain thresholds (PPThs) using mechanical stimuli, temporal summation of pain (TSP) using mechanical stimuli, and conditioned pain modulation (CPM) using a mechanical and temperature stimulus. Paired sample t-tests were used to assess changes in outcome measures from baseline to 3-month post-surgery. RESULTS: Analyses showed that participants who received TKA enhanced with perioperative MBCBT (TKA+MBCBT) reported a significant reduction in BPI pain severity scores, BPI pain interference scores, total WOMAC scores, WOMAC pain scores, WOMAC function scores, and PCS scores at 3 months after surgery. CONCLUSION: The results from our study suggest that TKA enhanced with a brief psychosocial intervention targeting postoperative pain prevention may improve pain, self-reported functioning, and pain catastrophizing following surgery. Nevertheless, without the control comparison group, it is impossible to determine how much of these improvements can be attributed to the MBCBT intervention alone. It is possible that participants may have achieved similar gains without such intervention. Thus, larger studies with an appropriate comparator arm are needed to discern the isolated effects of MBCBT in improving postoperative outcomes following surgery.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».