Article

OBJECTIVE: To compare the improvement in disability, kinesiophobia, pain, and
quality of life obtained by means of home-based functional exercises aimed at
managing kinesiophobia with that obtained by giving subjects undergoing total
knee arthroplasty (TKA) advice to stay active after discharge from a
rehabilitation unit. DESIGN: Randomized controlled trial with 6-months'
follow-up. SETTING: Patients' homes. PARTICIPANTS: Patients (N=110; 40 men; mean
age, 67y) at the end of a 15-day period of in-hospital rehabilitation after
undergoing primary TKA. INTERVENTIONS: In the experimental group, before
returning home, the patients were asked to continue the functional exercises
learned during hospitalization in twice-weekly 60-minute sessions for 6 months,
and were given a book containing theoretical information about the management of
kinesiophobia. In the control group, the patients were advised to stay active and
gradually recover their usual activities. MAIN OUTCOME MEASURES:
Repeated-measures analysis of covariance with baseline values as the covariates
(P<.05) was used to assess the effect of treatment on disability, fear-avoidance
beliefs, pain intensity, and quality of life. RESULTS:
The analysis revealed a
significant time by group interaction in all the variables in favor of the
experimental group. Post hoc analysis showed that the effect of the group was
statistically significant at the end of home training and follow-up. The
treatment effect was clinically tangible in terms of disability and quality of
life, and persisted for 6 months after the intervention ended. CONCLUSIONS: A
home-based program based on functional exercises and the management of
kinesiophobia was useful in changing the course of disability, fear-avoidance
beliefs, pain, and the quality of life in patients with TKA.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS