Department of Rehabilitation Medicine, Dokkyo Medical University Saitama Medical Center, Saitama, Japan.
First Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan.
J Back Musculoskelet Rehabil. 2021;34(5):829-835. doi: 10.3233/BMR-200017.
Some patients with end-stage osteoarthritis of the knee remain unsatisfied after total knee arthroplasty (TKA). We postulated that to increase satisfaction, self-efficacy (SE) for physical activity should receive more attention in rehabilitative intervention, alongside the management of patient expectations, pain, and function.
We examined the relative impact of Physical Activity SE on Health-Related Quality of Life (HRQOL) alongside other factors such as pain and physical function which are well-addressed by current interventions.
One hundred and six first-TKA recipients (15 Male/91 Female, age 73.6 ± 7.2) were evaluated at 3 and 6 months post-operatively using the Medical Outcomes Study 36-Item Health Survey (SF-36v2) for HRQOL, knee extension strength measurement, Timed Up and Go test (TUG), One Leg Standing time test (OLS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for pain and function, and an instrument for measuring Physical Activity SE among the frail elderly in Japan.
Significant improvement over pre-operative values was found at 3 and 6 months in TUG, OLS, WOMAC Pain and Function, and the 8 subscales of the SF-36v2. Factors found to significantly impact SF-36v2 subscale scores at 6 months post-operatively were found to be knee pain, knee function, and SE for physical activity.
These results support our postulation that interventions to improve SE for physical activity could have comparable impact alongside interventions for knee pain and knee function, on the advancement of HRQOL among TKA recipients.
一些膝关节终末期骨关节炎患者在接受全膝关节置换术（TKA）后仍不满意。我们推测，为了提高满意度，除了管理患者的期望、疼痛和功能外，还应更加关注身体活动的自我效能（SE）。
我们研究了身体活动 SE 对健康相关生活质量（HRQOL）的相对影响，以及疼痛和身体功能等其他因素的影响，这些因素在当前的干预措施中得到了很好的解决。
106 例初次 TKA 患者（15 例男性/91 例女性，年龄 73.6±7.2 岁）在术后 3 个月和 6 个月时使用医疗结局研究 36 项健康调查（SF-36v2）进行 HRQOL 评估，包括膝关节伸展力量测量、计时起立行走测试（TUG）、单腿站立时间测试（OLS）、西部安大略省和麦克马斯特大学骨关节炎指数（WOMAC）用于评估疼痛和功能，以及一种用于测量日本脆弱老年人身体活动 SE 的仪器。
在 TUG、OLS、WOMAC 疼痛和功能以及 SF-36v2 的 8 个分量表中，与术前值相比，术后 3 个月和 6 个月时均有显著改善。在术后 6 个月时，发现对 SF-36v2 分量表评分有显著影响的因素是膝关节疼痛、膝关节功能和身体活动 SE。
这些结果支持我们的假设，即改善身体活动 SE 的干预措施可以与改善膝关节疼痛和膝关节功能的干预措施具有相当的影响，从而提高 TKA 患者的 HRQOL。
