Article

OBJECTIVES: To (1) describe a behavioral intervention designed for patients with
elevated pain catastrophizing who are scheduled for knee arthroplasty, and (2)
use a quasi-experimental design to evaluate the potential efficacy of the
intervention on pain severity, catastrophizing cognitions, and disability. DESIGN: Quasi-experimental nonequivalent control group design with a 2-month
follow-up. SETTING: Two university-based orthopedic surgery departments.
PARTICIPANTS: Adults (N=63) scheduled for knee replacement surgery who reported
elevated levels of pain catastrophizing. Patients were recruited from 2 clinics
and were assessed prior to surgery and 2 months after surgery. INTERVENTIONS: A
group of 18 patients received a psychologist-directed pain coping skills training
intervention comprising 8 sessions. The other group, a historical cohort of 45
patients, received usual care. MAIN OUTCOME MEASURES: Western Ontario and
McMaster Universities Arthritis Index Pain and Disability scores, as well as
scores on the Pain Catastrophizing Scale.
RESULTS: Two months after surgery, the
patients who received pain coping skills training reported significantly greater
reductions in pain severity and catastrophizing, and greater improvements in
function as compared to the usual care cohort. CONCLUSIONS:
Pain catastrophizing
is known to increase risk of poor outcome after knee arthroplasty. The findings
provide preliminary evidence that the treatment may be highly efficacious for
reducing pain, catastrophizing, and disability, in patients reporting elevated
catastrophizing prior to knee arthroplasty. A randomized controlled trial is warranted to confirm these effects.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS