Hara Ryusei, Hiraga Yuki, Hirakawa Yoshiyuki, Babazono Akira
Fukuoka Rehabilitation Hospital, Fukuoka 819-8551, Japan.
Department of Occupational Therapy, Faculty of Medical Science, Fukuoka International University of Health and Welfare, Fukuoka 814-0001, Japan.
Healthcare (Basel). 2025 Mar 13;13(6):627. doi: 10.3390/healthcare13060627.
: This study aimed to evaluate whether integrating coping strategies into occupational therapy (OT) enhances functional recovery and psychological adaptation after total knee arthroplasty (TKA). : Twenty-eight patients who underwent TKA were equally assigned to an intervention and control group. Both groups received standard goal-oriented OT, while only the intervention group underwent structured training in pain coping strategies using the "Coping List". Treatment effects were assessed using Canadian Occupational Performance Measure (COPM), pain, anxiety, depression, and pain-related disability scores. : A total of 210 coping strategies were identified, with the intervention group adopting an average of 15.1 additional strategies per patient. Strategies were categorized into six domains: physical, psychological and cognitive, social support, relaxation, daily activities, and medication management. The intervention group showed significantly greater improvements in COPM performance scores (7.6 ± 1.7 vs. 5.5 ± 2.6; = 0.048) and COPM satisfaction scores (7.9 ± 2.0 vs. 5.6 ± 2.8; = 0.049) compared to the control group. : The findings suggest that individualized coping strategies integrated with physical rehabilitation can help patients achieve postoperative goals, enhance recovery, and improve overall well-being. Incorporating such strategies into OT appears to be effective in early-postoperative rehabilitation. This study's clinical trial registration information is available online at UMIN (UMIN000050536).
本研究旨在评估将应对策略融入职业治疗(OT)是否能增强全膝关节置换术(TKA)后的功能恢复和心理适应能力。28例行TKA的患者被平均分为干预组和对照组。两组均接受标准的目标导向性OT,而只有干预组使用“应对清单”进行疼痛应对策略的结构化训练。使用加拿大职业表现测量量表(COPM)、疼痛、焦虑、抑郁及疼痛相关残疾评分评估治疗效果。共识别出210种应对策略,干预组患者人均额外采用15.1种策略。策略分为六个领域:身体、心理和认知、社会支持、放松、日常活动及药物管理。与对照组相比,干预组在COPM表现评分(7.6±1.7对5.5±2.6;P=0.048)和COPM满意度评分(7.9±2.0对5.6±2.8;P=0.049)方面有显著更大的改善。研究结果表明,将个性化应对策略与身体康复相结合可帮助患者实现术后目标、增强恢复并改善整体幸福感。将此类策略纳入OT在术后早期康复中似乎是有效的。本研究的临床试验注册信息可在UMIN网站(UMIN000050536)在线获取。