Background Psychological factors have been reported to affect chronic pain and may lead to inactivity after total knee arthroplasty. This study aimed to determine whether the use of an activity diary for goal setting during occupational therapy would reduce pain, and improve psychological and physical performance in patients after total knee arthroplasty. Methods A total of 41 total knee arthroplasty participants from two cohorts were recruited in the study and allocated by convenience to either the experimental group using an activity diary (n = 20) or the control group (n = 21). Occupational therapy intervention (1–2 weeks postoperatively) to promote goal achievement was performed in both groups, and self-monitoring was performed in the diary group by using the activity diary. The outcome indices were Canadian Occupational Performance Measure, pain (resting pain, walking pain), pain catastrophizing (rumination, helplessness, and magnification), anxiety, depression, pain self-efficacy, and physical activity level. Data were evaluated by using analysis of variance analyses with post hoc tests. Results A time-by-group interaction emerged for Canadian Occupational Performance Measure, walking pain, pain catastrophizing, anxiety, depression, and physical activity level (p < 0.05), both favouring the diary group. The diary group also showed greater improvement in Canadian Occupational Performance Measure, walking pain, anxiety, and physical activity levels at four weeks postoperatively, compared to the control group (p < 0.05). Conclusion The use of the activity diary in this study increased occupational therapy effectiveness, reduced patients’ pain, and prevented a decline in physical performance. We believe that the use of an activity diary is an effective and feasible addition for total knee arthroplasty patients.

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Background Psychological factors contribute to chronic pain and may lead to physical inactivity and poor functional outcomes. Purpose We conducted a non-randomized controlled study to evaluate the effectiveness of goal setting and achievement following occupational therapy (OT) intervention to improve pain, psychological factors, and physical activity among patients after high tibial osteotomy (HTO). Method We analyzed the data of 31 patients who underwent HTO, allocated into OT intervention and control groups. Goal achievement was encouraged through OT in the intervention groups; the control groups did not receive OT intervention. Outcome measures included the Canadian Occupational Performance Measure (COPM) score (before and after the OT intervention), walking pain, pain catastrophizing, anxiety, depression, pain self-efficacy, and physical activity level. Results OT significantly improved the COPM score, depression, and physical activity. At the final assessment, the depression score was lower while the step count and physical activity time were significantly higher in the intervention group than in the control group ( p < 0.05). Conclusion Embedding goal setting and achievement as part of an OT intervention improved the outcomes after HTO.

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Background: Psychological factors may induce chronic pain and lead to inactivity after total knee arthroplasty (TKA). The impact of excessive variations in physical activity on psychological factors remains unclear. Aims/Objectives: This study investigated the impact of wide variations in physical activity during occupational therapy (OT) in the early period after TKA. Materials and Methods: We enrolled 30 TKA patients. Activities were measured postoperatively for 1 week. Patients were assigned to "goodpacing" or "poor-pacing" groups based on the correlation between physical activity and OT day. The outcome indices were Canadian occupational performance measure, pain (resting and walking), pain catastrophizing (rumination, helplessness, and magnification), anxiety, depression, and pain self-efficacy. Results: Twenty (66.6%) patients demonstrated good pacing, while ten (33.3%) showed poor pacing. The good-pacing group showed increased physical activity as the OT day increased. On the contrary, physical activity did not increase with OT day in the poor-pacing group, and these patients exhibited significantly higher walking pain, anxiety, and depression than those in the good-pacing group (p < 0.05). Conclusion: TKA patients with excessive variation in physical activity during OT demonstrated higher pain, anxiety, and depression.