Preoperative Home-Based Multimodal Physiotherapy in Patients Scheduled for a Knee Arthroplasty Who Catastrophize About Their Pain: A Randomized Controlled Trial.

研究概要

Forty patients with symptomatic knee osteoarthritis and Pain Catastrophizing Scale (PCS) ≥ 20 were randomized to usual care control (n=15), therapeutic patient education (TPE; 3 one-to-one home sessions with pain neuroscience education + coping skills; n=13), or multimodal physiotherapy (MPT; 8 one-to-one home sessions adding supervised therapeutic exercise and manual therapy; n=12). The primary outcome was PCS. Secondary outcomes were pain (VAS rest/walk), WOMAC (total and pain), kinesiophobia (TSK-11), self-efficacy (CPSES), 4-m walk speed, and Y-Balance (anterior/medial/lateral). Outcomes were assessed pre-intervention, post-intervention, and at 1, 3, and 6 months after surgery. Overall, the results revealed significant between-group differences favoring both active programs at multiple time points, with TPE showing lower PCS and rest pain at several postoperative assessments and MPT showing earlier gains in PCS, kinesiophobia, self-efficacy, dynamic balance, and faster gait at 6 months. In short, targeted preoperative, home-based physiotherapy meaningfully reduced catastrophizing and improved pain-related behaviors and function versus usual care.