Brief preoperative mind-body therapies for total joint arthroplasty patients: a randomized controlled trial
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2021;9(15):6 Pain. 2021 Jun 1;162(6): 1749-1757.What this means for my practice?
Results of this study suggest that a 15 min session of mindfulness meditation or hypnotic suggestion before patients undergo a hip or knee total joint arthroplasty can help reduce pain, unpleasantness, and anxiety compared to a cognitive-behavioural pain psychoeducation program. Moreover, implementing mindfulness meditation pre-total joint arthroplasty can significantly improve self-reported physical function at 6 weeks follow-up compared to either hypnotic suggestion or cognitive-behavioural pain psychoeducation. Yet, this trial was limited by the small sample size, and subjective outcomes used as these were self-reported (e.g., physical function). Therefore, future randomized controlled trials with larger sample size of patients and objective clinical measures are needed to confirm the findings of this study.
Resumen del estudio
Three hundred and sixteen patients scheduled to undergo a total hip or knee arthroplasty were randomized to receive a pre-operative 15 min session of mind-body therapies including either mindfulness meditation (MM), hypnotic suggestion, or cognitive-behavioural (CB) pain psychoeducation. Outcomes of interest included pre-operative pain intensity, pain unpleasantness, anxiety, and pain medication desire measured on a numeric rating scale as well as self-reported physical function measured using the Patient-Reported Outcomes Measurement Information System Physical Function, at 6 weeks follow-up. Results of this trial revealed that pain intensity, pain unpleasantness, and anxiety were significantly lower in the MM group and hypnosis group when compared to the CB-pain group (p<0.05 for all). However, pain medication desire was only significantly lower in the MM group vs CB-pain group, whereas no significant difference was observed between the hypnosis and CB-pain group or MM vs hypnosis group (p>0.05). At 6 weeks follow-up, physical function was significantly improved in the MM group when compared to both the hypnosis and CB groups (p>0.05 for all).
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