Rehabilitation interventions incorporating self-management improve psychological factors: A non-randomized controlled trial of patients after total Knee arthroplasty

Figures & data

Figure 1. A flow chart outlining participation in this study.

Table 1. Baseline characteristics of patients, by group

Variable	Intervention group (n = 132)	Control group (n = 136)	p-Value	mean difference (95% CI)
Age (years)	76.4 ± 6.4	76.6 ± 7.0	0.598	0.20 (−1.40 to 1.80)
Female, n (%)	116 (87.8)	116 (85.2)	0.776
Body Mass Index	25.3 ± 3.6	26.2 ± 3.8	0.982	0.95 (0.06 to 1.85)
Nonworker (%)	113 (85.6)	122 (89.7)	0.680
Nonsmoker (%)	126 (95.4)	127 (93.3)	0.847
Nondrinker (%)	113 (85.6)	113 (83.0)	0.793
Non-long-term care insurance (%)
Long-term care insurance
No care (%)	130 (98.4)	123 (90.4)	0.112
NRS rest pain (points)	1.7 ± 1.2	1.5 ± 1.2	0.290	0.16 (−0.74 to 0.48)
NRS Walk pain (points)	5.5 ± 2.2	5.4 ± 2.3	0.356	0.10 (−0.44 to 0.44)
TUG	13.2 ± 6.0	17.2 ± 12.5	0.052	4.01 (−0.07 to 7.95)
10-m (s)	11.8 ± 5.1	13.1 ± 6.0	0.065	1.25 (−0.08 to 2.58)
PCS total score (points)	27.4 ± 11.6	27.8 ± 12.3	0.807	0.3 (−2.50 to 3.21)
Rumination score (points)	13.2 ± 4.7	13.2 ± 5.2	0.487	0.01 (−1.20 to 1.16)
Helplessness score (points)	8.9 ± 5.2	9.2 ± 5.2	0.701	0.33 (−0.91 to 1.57)
Magnification score (points)	5.2 ± 3.3	5.3 ± 3.5	0.537	0.03 (−0.77 to 0.85)
PSEQ total score (points)	37.8 ± 12.6	36.2 ± 13.5	0.317	1.58 (−4.69 to 1.52)

Values are expressed as means ± standard deviations.

CI: confidence interval; NRS: numeric rating scale; TUG: Timed Up & Go Test; 10-m: timed 10-m walk test; PCS: Pain Catastrophizing Scale; PSEQ: Pain Self-Efficacy Questionnaire

Figure 2. Record of postoperative rehabilitation using an activity diary.

Table 2. Pre- and post-intervention (four weeks) outcomes, by group

Variable	Intervention group (n = 132)		Control group (n = 136)		Time-by-Group interaction
	Pre-	Post-intervention (4 weeks)	Pre-	Post-intervention (4 weeks)	F-value	p-value
NRS rest pain (points)	1.7 ± 1.2	1.1 ± 0.4	1.5 ± 1.2	1.3 ± 0.8	0.711	0.399
NRS walk pain (points)	5.5 ± 2.2	1.7 ± 1.5	5.4 ± 2.3	2.3 ± 1.0	3.618	0.057
TUG (s)	13.2 ± 6.0	13.0 ± 6.2	17.2 ± 12.5	16.0 ± 9.0	0.169	0.680
10-m (s)	11.8 ± 5.1	12.4 ± 8.3	13.1 ± 6.0	13.7 ± 8.5	0.001	0.968
PCS total score (points)	27.4 ± 11.6	14.9 ± 9.2	27.8 ± 12.3	21.4 ± 12.9	9.288	0.002
Rumination score (points)	13.2 ± 4.7	8.0 ± 4.9	13.2 ± 5.2	10.6 ± 6.0	8.488	0.003
Helplessness score (points)	8.9 ± 5.2	4.2 ± 3.0	9.2 ± 5.2	6.8 ± 5.0	6.851	0.009
Magnification score (points)	5.2 ± 3.3	2.6 ± 2.5	5.3 ± 3.5	4.0 ± 3.0	6.092	0.013
PSEQ total score (points)	37.8 ± 12.6	45.3 ± 11.8	36.2 ± 13.5	41.2 ± 13.2	1.378	0.024

Values are expressed as means ± standard deviations.

NRS: numeric rating scale; TUG: Timed Up & Go Test; 10-m: timed 10-m walk test; PCS: Pain Catastrophizing Scale; PSEQ: Pain Self-Efficacy Questionnaire

Figure 3. Multiple comparisons of intervention and control groups.PCS: Pain Catastrophizing Scale; PSEQ: Pain Self-Efficacy Questionnaire; CI: Confidence Interval** Significant difference in four-week post-intervention results between groups (p < .01)

Table 3. Multiple comparisons of intervention and control groups

		Pre-	Post-intervention (4 weeks)		p-value	Standard mean difference	(95% CI)
PCS total score	Intervention group (n = 132)	27.4 ± 11.6	14.9 ± 9.2	]**	††	−0.58	(−0.82 to −0.33)
	Control group (n = 136)	27.8 ± 12.3	21.4 ± 12.9		††
Rumination score	Intervention group (n = 132)	13.2 ± 4.7	8.0 ± 4.9	]**	††	−0.47	(−0.72 to −0.23)
	Control group (n = 136)	13.2 ± 5.2	10.6 ± 6.0		††
Helplessness score	Intervention group (n = 132)	8.9 ± 5.2	4.2 ± 3.0	]**	††	−0.63	(−0.87 to −0.38)
	Control group (n = 136)	9.2 ± 5.2	6.8 ± 5.0		††
Magnification score	Intervention group (n = 132)	5.2 ± 3.3	2.6 ± 2.5	]**	††	−0.51	(−0.75 to −0.26)
	Control group (n = 136)	5.3 ± 3.5	4.0 ± 3.0		††
PSEQ total score	Intervention group (n = 132)	37.8 ± 12.6	45.3 ± 11.8	]**	††	0.33	(0.09 to 0.57)
	Control group (n = 136)	36.2 ± 13.5	41.2 ± 13.2		††

Values are expressed as means ± standard deviations.

PCS: Pain Catastrophizing Scale; PSEQ: Pain Self-Efficacy Questionnaire; CI: Confidence Interval

* Significant difference in 4-week post-intervention results between groups (p < 0.05)

** Significant difference in 4-week post-intervention results between groups (p < 0.01)

† Significant difference between pre- and 4-week post-intervention results within the group (p < 0.05)

†† Significant difference between pre- and 4-week post-intervention results within the group (p < 0.01)