The effect of mindfulness training prior to total joint arthroplasty on post-operative pain and physical function: A randomised controlled trial.
Study Goal
The researchers aimed to evaluate the efficacy of Mindfulness-Based Stress Reduction (MBSR) in improving pain and physical function in patients undergoing total joint arthroplasty (TJA) with psychological distress.
Results Summary
The MBSR group showed significantly greater improvements in knee pain, function, and global scores at 12 months post-surgery compared to the treatment-as-usual group, though no differences were observed in secondary outcomes.
Population
Patients with arthritis scheduled for TJA and a well-being score <40 (Short Form-12 Survey).
Effective Dosage
Eight-week MBSR program (specific frequency not detailed).
Duration
Eight weeks pre-surgery.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Mindfulness-Based Stress Reduction (MBSR) | decrease | knee pain | people with arthritis scheduled for TJA with a well-being score <40 | mean difference, -10.3 points, 95% CI -19.0 to -1.6; P = 0.021 | Greater improvements in knee pain | #1 |
Mindfulness-Based Stress Reduction (MBSR) | increase | function | people with arthritis scheduled for TJA with a well-being score <40 | mean difference, -10.2 points, 95% CI -19.2 to -1.3; P = 0.025 | Greater improvements in function | #2 |
Mindfulness-Based Stress Reduction (MBSR) | decrease | global scores | people with arthritis scheduled for TJA with a well-being score <40 | -9.5 points, 95% CI -17.9 to -1.1; P = 0.027 | A between group difference in global scores | #3 |
Mindfulness-Based Stress Reduction (MBSR) | no change | secondary outcomes (knee stiffness, global improvement, physical and psychological well-being, self-efficacy, mindfulness) | people with arthritis scheduled for TJA with a well-being score <40 | no significant change | No other differences in secondary outcomes were observed | #4 |
OBJECTIVE: To evaluate the efficacy of Mindfulness-Based Stress Reduction (MBSR) in improving pain and physical function following total joint arthroplasty (TJA). DESIGN: Two-group, parallel-group, randomised controlled trial, conducted between September 2012 and May 2017. SETTING: Single centre study conducted at a University-affiliated, tertiary hospital. INTERVENTION: People with arthritis scheduled for TJA, with a well-being score <40 (Short Form-12 Survey) were randomly allocated to a pre-surgery eight-week MBSR program or treatment as usual (TAU). OUTCOME MEASURES: Self-reported joint pain and function at 12 months post-surgery, assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes were knee stiffness and global improvement (WOMAC); physical and psychological well-being (Veterans RAND 12-item Health Survey); self-efficacy (Arthritis Self-Efficacy Scale); and mindfulness (5-Factor Mindfulness Questionnaire). RESULTS: 127 participants were randomised; 65 to MBSR and 62 to TAU, of which 45 participants allocated to the intervention and 56 participants allocated to usual care proceeded to surgery and 100 (99%) completed primary outcome measures. Greater improvements in knee pain (mean difference, -10.3 points, 95% CI -19.0 to -1.6; P = 0.021) and function (mean difference, -10.2 points, 95% CI -19.2 to -1.3; P = 0.025) at 12 months post-surgery were observed in the MBSR group compared to the TAU group. A between group difference in global scores (-9.5 points, 95% CI -17.9 to -1.1; P = 0.027) was also observed. No other differences in secondary outcomes were observed. CONCLUSION: MBSR improves post-surgery pain and function in people with psychological distress undergoing TJA. Further research is required to examine potential barriers to broader implementation and uptake.