Pain, function and health-related quality of life in total knee arthroplasty

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Date
2021-11
Authors
Van De Wall, Helena
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Publisher
University of the Free State
Abstract
Introduction: Physiotherapists daily treat patients who undergo a total knee arthroplasty (TKA) and find that certain patients tend to function better during their rehabilitation than others. Although it is a successful procedure, some of the patients are not totally satisfied with the outcomes and develop chronic pain and limitations in activities of daily living (ADL). Aim: The aim of the study was therefore to determine the pain intensity, functionality, and health-related quality of life (pre-operatively and post-operatively), in persons undergoing a total knee arthroplasty. Methodology: A prospective cohort analytical study design was utilised. The cohort period was six weeks. Fifty (50) participants participated in this study. All participants were assessed after six weeks by completing several questionnaires and evaluations. Data were analysed by a biostatistician using descriptive statistics; namely, percentages and frequencies for categorical data and means and standard deviations or medians and percentiles for continuous data calculated per collection time point. The change between time points was calculated by means of 95% confidence intervals. Inferential analysis and significance testing was done. Results: There were statistically significant improvements in oedema of the knee, knee extension, average pain experienced daily, pain relief with medication, enjoyment of life, relations with other people, normal work ability, walking ability, mood, total WOMAC (Western Ontario and McMaster Universities Arthritis Index) score and subdivisions and in the Hospital Anxiety and Depression Score (HADS - anxiety and depression). Conclusion: The study describes the characteristics of the individuals who received an elective TKA in a private hospital in Bloemfontein. The importance of physiotherapy management pre-operatively and post-operatively is undeniable, as most of the patients experienced pain and decreased function that impacted their quality of life. Specific recommendations for further research have been put forward as well as clinical recommendations. This is to improve not only the outcomes of a TKA, but also to create awareness amongst physiotherapists regarding the challenges that individuals experience after a TKA and the importance of appropriate and relevant pre-rehabilitation and post-rehabilitation.
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Keywords
Dissertation (M.Sc. Physiotherapy))--University of the Free State, 2021, Knee arthroplasty, Physiotherapists, Rehabilitation, Anxiety and depression
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