Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Apr 18, 2017; 8(4): 336-341
Published online Apr 18, 2017. doi: 10.5312/wjo.v8.i4.336
Associations among pain catastrophizing, muscle strength, and physical performance after total knee and hip arthroplasty
Kazuhiro Hayashi, Masato Kako, Kentaro Suzuki, Keiko Hattori, Saori Fukuyasu, Koji Sato, Izumi Kadono, Tadahiro Sakai, Yukiharu Hasegawa, Yoshihiro Nishida
Kazuhiro Hayashi, Masato Kako, Kentaro Suzuki, Keiko Hattori, Saori Fukuyasu, Koji Sato, Izumi Kadono, Yoshihiro Nishida, Department of Rehabilitation, Nagoya University Hospital, Aichi 466-8550, Japan
Izumi Kadono, Tadahiro Sakai, Yukiharu Hasegawa, Yoshihiro Nishida, Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Aichi 466-8560, Japan
Author contributions: All the authors contributed to this paper.
Institutional review board statement: This study was reviewed and approved by the by the Ethics Committee of Nagoya University Hospital (No. 328).
Informed consent statement: All the participants provided written informed consent.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
Data sharing statement: The original anonymous dataset is available on request from the corresponding author at hayashi.k@med.nagoya-u.ac.jp.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kazuhiro Hayashi, PT, MSc, Department of Rehabilitation, Nagoya University Hospital, 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan. hayashi.k@med.nagoya-u.ac.jp
Telephone: +81-52-7442687 Fax: +81-52-7442686
Received: October 9, 2016
Peer-review started: October 10, 2016
First decision: December 13, 2016
Revised: December 25, 2016
Accepted: February 8, 2017
Article in press: February 13, 2017
Published online: April 18, 2017
Abstract
AIM

To investigate whether reductions in pain catastrophizing associated with physical performance in the early period after total knee arthroplasty (TKA) or total hip arthroplasty (THA).

METHODS

The study group of 46 participants underwent TKA or THA. The participants were evaluated within 7 d before the operation and at 14 d afterwards. Physical performance was measured by the Timed Up and Go (TUG) test, and 10-m gait time was measured at comfortable and maximum speeds. They rated their knee or hip pain using a visual analog scale (VAS) for daily life activities. Psychological characteristics were measured by the Pain Catastrophizing Scale (PCS). Physical characteristics were measured by isometric muscle strength of knee extensors and hip abductors on the operated side. The variables of percent changes between pre- and post-operation were calculated by dividing post-operation score by pre-operation score.

RESULTS

Postoperative VAS and PCS were better than preoperative for both TKA and THA. Postoperative physical performance and muscle strength were poorer than preoperative for both TKA and THA. The percent change in physical performance showed no correlation with preoperative variables. In TKA patients, the percent change of PCS showed correlation with percent change of TUG (P = 0.016), 10-m gait time at comfortable speeds (P = 0.003), and 10-m gait time at maximum speeds (P = 0.042). The percent change of muscle strength showed partial correlation with physical performances. The percent change of VAS showed no correlation with physical performances. On the other hand, in THA patients, the percent change of hip abductor strength showed correlation with percent change of TUG (P = 0.047), 10-m gait time at comfortable speeds (P = 0.001), and 10-m gait time at maximum speeds (P = 0.021). The percent change of knee extensor strength showed partial correlation with physical performances. The percent change of VAS and PCS showed no correlation with physical performances.

CONCLUSION

Changes in pain catastrophizing significantly associated with changes in physical performance in the early period after TKA. It contributes to future postoperative rehabilitation of arthroplasty.

Keywords: Gait, Hip arthroplasty, Knee arthroplasty, Osteoarthritis, Pain, Pain management, Postoperative care

Core tip: This clinical trial investigated whether reductions in pain catastrophizing are associated with physical performance in the early period after total knee arthroplasty (TKA) or total hip arthroplasty (THA). We found that changes in pain catastrophizing were significantly associated with physical performance in the early period after TKA. These findings may contribute to future postoperative rehabilitation of the arthroplasties in lower limbs. Treatment based on cognitive-behavioral therapy might be useful in the early period, particularly after TKA.