Park Kyung-Hye, Kang Hee-Young
Department of Nursing, Chonnam National University Bitgoel Hospital, Gwangju, Korea.
Department of Nursing, Chosun University, Gwangju, Korea.
J Korean Acad Nurs. 2024 Nov;54(4):547-562. doi: 10.4040/jkan.24027.
This study was performed to develop a self-efficacy theory-based exercise program for total knee arthroplasty (TKA) and to test the program's efficacy in ameliorating knee pain and restoring function as measured by lower extremity muscle strength, 3 meter walking time, Korean Western Ontario McMaster Index (WOMAC), exercise self-efficacy, and length of hospital stay for TKA patients.
This quasi-experimental study incorporating a non-equivalent control group and pretest-posttest non-synchronized design non-synchronous design was applied to assess self-efficacy reinforcement strategies based on self-efficacy theory. The exercise program consisted of the following steps: TKA, education to prevent postoperative complications, and muscle strength exercises. Respective exercise and control groups included 29 and 27 participants. The experimental group received eight sessions of the program from three weeks before TKA to four weeks after TKA. Collected data were analyzed using the chi-square test, Mann-Whitney U test, and ranked ANCOVA and t-tests using IBM SPSS Statistics 23.
Experimental group showed significant improvement in lower extremity muscle strength (F = 8.63, = .005), 3 meter walking time (z = -5.02, < .001), WOMAC index (z = -2.22, = .027), self-efficacy for exercise (z = -3.29, = .001), and length of hospital stay (t = -2.11, = .040) compared to the control group. No significant differences in knee pain and range of motion were observed.
These findings indicate that a self-efficacy theory-based exercise program can be an effective exercise strategy that patients undergoing TKA can easily follow at home without assistance. It is thus recommended as an exercise intervention for TKA patients.
本研究旨在制定一项基于自我效能理论的全膝关节置换术(TKA)锻炼计划,并测试该计划在改善膝关节疼痛以及恢复功能方面的效果,这些功能通过下肢肌肉力量、3米步行时间、韩国西部安大略麦克马斯特指数(WOMAC)、运动自我效能以及TKA患者的住院时间来衡量。
本准实验研究采用非等效对照组和前测-后测非同步设计,以评估基于自我效能理论的自我效能强化策略。锻炼计划包括以下步骤:TKA、预防术后并发症教育以及肌肉力量锻炼。锻炼组和对照组分别有29名和27名参与者。实验组在TKA术前3周至术后4周接受8次该计划。使用卡方检验、曼-惠特尼U检验以及使用IBM SPSS Statistics 23进行的秩协方差分析和t检验对收集的数据进行分析。
与对照组相比,实验组在下肢肌肉力量(F = 8.63,P = .005)、3米步行时间(z = -5.02,P < .001)、WOMAC指数(z = -2.22,P = .027)、运动自我效能(z = -3.29,P = .001)以及住院时间(t = -2.11,P = .040)方面有显著改善。未观察到膝关节疼痛和活动范围的显著差异。
这些结果表明,基于自我效能理论的锻炼计划可以成为一种有效的锻炼策略,TKA患者无需协助就能轻松在家中进行。因此,建议将其作为TKA患者的锻炼干预措施。