Effectiveness and reporting standards of psychological interventions for improving short-term and long-term pain outcomes after total knee replacement: a systematic review

Whale, Katie; Wylde, Vikki; Beswick, Andrew D; Rathbone, James; Vedhara, Kavita; Gooberman-Hill, Rachael

doi:10.1136/bmjopen-2019-029742

Cited by 28 publications

(14 citation statements)

References 71 publications

(93 reference statements)

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“…Regarding orthopaedic research, Giordano et al [ 21 ] proposed that the application of JRT in postoperative multimodal analgesia in orthopaedic trauma patients reduced average hospital stay length. Whale et al [ 22 ] also found that the application of JRT after total knee arthroplasty was helpful for pain management in a multicenter clinical trial. However, there is no relevant research on the application of JRT in patients with malignant bone and soft-tissue tumors in China.…”

Section: Discussionmentioning

confidence: 99%

A Case-Control Study of the Effects of Implementing the Registered Nurses’ Association of Ontario Guidelines for the Assessment and Management of Postoperative Pain and the Use of Relaxation Therapy in 312 Patients with Bone and Soft-Tissue Malignancy

Gao

Zhou

et al. 2022

Med Sci Monit

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Background The present study aimed to investigate the effects of implementing the Registered Nurses’ Association of Ontario (RNAO) guidelines for the management of postoperative pain and the use of Jacobson’s relaxation technique (JRT) in patients with bone and soft-tissue malignancy at a single center in China. Material/Methods A total of 312 patients were recruited and randomly divided into 2 groups. In the intervention group, the RNAO pain-management technique of JRT was adopted, while the control group received the standard institutional nursing management. Pain scores after the operation, according to the Numerical Rating Scale (NRS) combined with the Wong-Baker Faces Pain Rating Scale and Short-Form McGill Pain Questionnaire, were compared between the 2 groups. Nursing satisfaction was compared as well. Results At 6, 24, and 72 h after the operation, the NRS scores combined with the Wong-Baker Faces Pain Rating Scale in the intervention group were significantly lower than those in the control group ( P <0.001); 72 h after the operation, the Pain Rating Index, Visual Analogue Scale, present pain intensity, and total scores for the intervention group were significantly lower than those for the control group ( P <0.001 for all 4 scores). The scores reported from the patients for nursing response and consequent care ( P <0.001), nursing competence ( P =0.029), and surgical pain-control satisfaction ( P <0.001) in the intervention group were also significantly higher than those in the control group. Conclusions JRT can improve postoperative pain-control and nursing satisfaction in patients with malignant bone and soft-tissue tumors. These data suggest a benefit for application of JRT in clinical care.

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Section: Discussionmentioning

confidence: 99%

A Case-Control Study of the Effects of Implementing the Registered Nurses’ Association of Ontario Guidelines for the Assessment and Management of Postoperative Pain and the Use of Relaxation Therapy in 312 Patients with Bone and Soft-Tissue Malignancy

Gao

Zhou

et al. 2022

Med Sci Monit

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“…To the best of our knowledge, previous systematic reviews regarding psychological interventions in improving outcomes following TKR included musical therapy, hypnosis, guided imagery, and other different types of psychological interventions [33]. Due to its high heterogeneity, attaining a firm conclusion about the effectiveness of musical interventions in those treated with TKR is difficult.…”

Section: Introductionmentioning

confidence: 99%

The effect of musical interventions in improving short-term pain outcomes following total knee replacement: a meta-analysis and systematic review

Zhuo

Feng

et al. 2020

J Orthop Surg Res

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Background A growing number of patients continue to receive total knee replacement (TKR) surgery. Nevertheless, such surgeries result in moderate to severe postoperative pain and difficulty in managing it. Musical interventions are regarded as a type of multimodal analgesia, achieving beneficial results in other clinical treatments. This study aims to evaluate the effect of musical interventions in improving short-term pain outcomes following TKR in order to determine a more reasonable and standard way of delivering musical intervention. Methods A systematic search was conducted to identify available and relevant randomized controlled trials (RCTs) regarding musical interventions compared against non-musical interventions in patients treated with TKR in Embase, MEDLINE, Cochrane Library, Web of Science, CNKI, and Wanfang Med Online up to 8 January 2020. The authors independently assessed study eligibility and risk of bias and collected the outcomes of interest to analyze. The statistical analysis was conducted using the Review Manager (RevMan) version 5.30 software. Results Eight RCTs comprised of 555 patients satisfied the inclusion criteria and were enrolled in the present study. The results showed no significant difference between the music and control groups in pain of the visual analog scale (VAS), during postoperative recovery room, back to the ward after surgery; anxiety degree of VAS; heart rate; respiratory rate; oxygen saturation; blood pressure, systolic blood pressure, and diastolic blood pressure. Nevertheless, significant differences were observed between the two groups in average increase in continuous passive motion (CPM) angles and LF/HF ratio (one kind index of heart rate variability). Conclusions Musical interventions fail to demonstrate an obvious effect in improving short-term pain outcomes following TKR. A reasonable standardization of musical interventions, including musical type, outcome measures used, outcomes measured, duration, timing and headphones or players, may improve pain outcomes with certain advantages and should be further explored after TKR.

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“…Moreover, previous OA studies have illuminated the importance of social relationships in this population; for example, partner-supported interventions demonstrate enhanced benefits in OA patients [ 134 – 136 ]. Other non-pharmacologic treatments that enhance protective factors and reduce psychosocial risk factors (e.g., anxiety, catastrophizing) have shown promise in improving joint replacement outcomes as well [ 137 ].…”

Section: Discussionmentioning

confidence: 99%

Multimodal prediction of pain and functional outcomes 6 months following total knee replacement: a prospective cohort study

Edwards,

Campbell,

Schreiber

et al. 2022

BMC Musculoskelet Disord

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Background Knee osteoarthritis (OA) is among the most common and disabling persistent pain conditions, with increasing prevalence and impact around the globe. In the U.S., the rising prevalence of knee OA has been paralleled by an increase in annual rates of total knee arthroplasty (TKA), a surgical treatment option for late-stage knee OA. While TKA outcomes are generally good, post-operative trajectories of pain and functional status vary substantially; a significant minority of patients report ongoing pain and impaired function following TKA. A number of studies have identified sets of biopsychosocial risk factors for poor post-TKA outcomes (e.g., comorbidities, negative affect, sensory sensitivity), but few prospective studies have systematically evaluated the unique and combined influence of a broad array of factors. Methods This multi-site longitudinal cohort study investigated predictors of 6-month pain and functional outcomes following TKA. A wide spectrum of relevant biopsychosocial predictors was assessed preoperatively by medical history, patient-reported questionnaire, functional testing, and quantitative sensory testing in 248 patients undergoing TKA, and subsequently examined for their predictive capacity. Results The majority of patients had mild or no pain at 6 months, and minimal pain-related impairment, but approximately 30% reported pain intensity ratings of 3/10 or higher. Reporting greater pain severity and dysfunction at 6 months post-TKA was predicted by higher preoperative levels of negative affect, prior pain history, opioid use, and disrupted sleep. Interestingly, lower levels of resilience-related “positive” psychosocial characteristics (i.e., lower agreeableness, lower social support) were among the strongest, most consistent predictors of poor outcomes in multivariable linear regression models. Maladaptive profiles of pain modulation (e.g., elevated temporal summation of pain), while not robust unique predictors, interacted with psychosocial risk factors such that the TKA patients with the most pain and dysfunction exhibited lower resilience and enhanced temporal summation of pain. Conclusions This study underscores the importance of considering psychosocial (particularly positively-oriented resilience variables) and sensory profiles, as well as their interaction, in understanding post-surgical pain trajectories.

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Effectiveness and reporting standards of psychological interventions for improving short-term and long-term pain outcomes after total knee replacement: a systematic review

Cited by 28 publications

References 71 publications

A Case-Control Study of the Effects of Implementing the Registered Nurses’ Association of Ontario Guidelines for the Assessment and Management of Postoperative Pain and the Use of Relaxation Therapy in 312 Patients with Bone and Soft-Tissue Malignancy

A Case-Control Study of the Effects of Implementing the Registered Nurses’ Association of Ontario Guidelines for the Assessment and Management of Postoperative Pain and the Use of Relaxation Therapy in 312 Patients with Bone and Soft-Tissue Malignancy

The effect of musical interventions in improving short-term pain outcomes following total knee replacement: a meta-analysis and systematic review

Multimodal prediction of pain and functional outcomes 6 months following total knee replacement: a prospective cohort study

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