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Immediate preoperative outcomes of pain neuroscience education for patients undergoing total knee arthroplasty: A case series

机译：膝关节关节置换术患者疼痛神经科学教育的立即术前结果：案例系列

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Background: Standard preoperative education for total knee arthroplasty (TKA) has been shown to have no effect on postoperative outcomes. This may be because such education programs fail to educate patients about pain. Pain neuroscience education (PNE) focuses on teaching people more about pain from a neurobiological and neurophysiological perspective. Design and setting: Case Series. Aim: To determine the immediate effects, if any, of providing PNE before TKA surgery on patient self-report measures. Participants: Twelve patients (female = 10) prior to TKA for knee osteoarthritis (OA). Intervention: Preoperative educational session by a physical therapist on the neuroscience of pain, accompanied by an evidence-based booklet. Main outcome measures: Comparison of pre- and post-PNE self-report measures on knee pain (NPRS), Pain Catastrophization Scale (PCS), fear of movement (TSK), and beliefs about TKA; as well as three physical performance measures - knee flexion active range of motion, 40 m self-paced walk, and pressure pain threshold (PPT). Results: Immediately following the PNE, patients had statistically significant lower TSK scores, increased PPT, and improved beliefs about their upcoming surgery. There were no significant changes in knee pain, function, or flexion active range of motion. Conclusions: Results appear to suggest that immediately after PNE, patients scheduled for TKA had statistically significant changes in fear of movement, decreased sensitivity to pain and positive shifts in their beliefs about their future knee surgery. Larger trials with control/comparison groups are warranted to determine the true effects of preoperative PNE for patients about to undergo TKA.
机译：背景：已显示出对膝盖关节置换术（TKA）的标准术前教育对术后结果没有影响。这可能是因为这些教育计划未能教育患者疼痛。止痛神经科学教育（PNE）侧重于从神经生物学和神经生理学的角度来看患有更多关于疼痛的人。设计和设置：案例系列。目的：确定在TKA手术前提供PNE的直接影响，患者自我报告措施。参与者：TKA膝关节骨关节炎（OA）之前的12名患者（女性= 10）。干预：物理治疗师对疼痛神经科学师的术前教育课程，伴随着基于证据的小册子。主要观察措施：对膝关节疼痛（NPRS），疼痛灾害尺度（PC），恐惧运动（TSK）的比较，以及关于TKA的信仰;以及三种物理性能措施 - 膝关节屈曲活动的运动范围，40米自定步步行和压力疼痛阈值（PPT）。结果：PNE紧接立即，患者在统计上显着的较低的TSK评分，增加了PPT，以及对即将到来的手术的改善的信念。膝关节疼痛，功能或屈曲活动范围没有显着变化。结论：结果似乎暗示PNE后，安排TKA的患者在恐惧运动方面具有统计学意义的变化，对其未来膝关节手术的信仰中对疼痛和积极变化的敏感性降低。有必要对对照/比较组进行较大的试验，以确定术前PNE用于患者的真实效果。

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