PAIN EDUCATION’S RIPPLE EFFECT: EXPLORING ITS ROLE IN HOSPITAL STAY AND PHYSICAL CHANGES FOLLOWING TOTAL HIP REPLACEMENT
Main Article Content
Keywords
Abstract
Introduction: Total hip replacement (THR) is a common orthopaedic procedure for individuals suffering from osteoarthritis (OA) in the hip joint. Prevalence rates of OA knee and hip increase with age, causing impaired mobility and pain in the elderly. Preoperative patient education and information have been shown to reduce anxiety, improve preparation for surgery, facilitate efficient discharge planning, reduce the length of hospital stay, and help in cost-cutting of medical equipment. Objective:The primary objective was to determine the effect of preoperative pain education on the physical and psychological dimensions of patients undergoing THR. Methods: The study was conducted in a large orthopaedic inpatient and outpatient centre in Etawa, Uttar Pradesh, India, using a randomized controlled trial method. A total of 150 patients, both male and female, aged above 40 years, and medically fit for surgery, were selected for the study. The patients were randomly assigned to either the experimental group (received preoperative pain education through a booklet along with conventional physiotherapy) or the control group (received only conventional physiotherapy). Preoperative assessments included range of motion, pain visual analog scale (VAS), lower extremity muscle strength, and functional level. Results: The results showed that patients who received preoperative pain education experienced a significant reduction in VAS scores and improvement in lower extremity functional scale (LEFS) scores compared to the control group. Additionally, the experimental group showed better range of motion and muscle strength outcomes post-surgery. The impact of psychoeducational training on postoperative results was also positive. Conclusion: The 4-week pre-rehabilitation program, which includes preoperative pain education through a booklet, has a positive impact on pain management and physical dimensions for patients undergoing total hip replacement. This intervention leads to better coping with pain and faster recovery, resulting in reduced length of hospital stay. The study highlights the importance of multi-modal patient education, tailored to individual preferences and experiences, to optimize patient outcomes in orthopaedic surgery.
Downloads
References
1. Jordan RW, Smith NA, Chahal GS, Casson C, Reed MR, Sprowson AP. Enhanced education, and physiotherapy before knee replacement; is it worth it? A systematic review. Physiotherapy. 2014 Dec;100(4):305-12. doi: 10.1016/j.physio.2014.03.003. Epub 2014 Mar 11. PMID: 24882691. 2. Alghadir A, Iqbal ZA, Anwer S. Comparison of the effect of pre- and post-operative physical therapy versus post-operative physical therapy alone on pain and recovery of function after total knee arthroplasty. J Phys Ther Sci. 2016 Oct;28(10):2754-2758. doi: 10.1589/jpts.28.2754. Epub 2016 Oct 28. PMID: 27821929; PMCID: PMC5088120. 3. Kennedy D, Wainwright A, Pereira L, Robarts S, Dickson P, Christian J, Webster F. A qualitative study of patient education needs for hip and knee replacement. BMC Musculoskelet Disord. 2017 Oct 12;18(1):413. doi: 10.1186/s12891-017-1769-9. PMID: 29025397; PMCID: PMC5639777. 4. Wang L, Lee M, Zhang Z, Moodie J, Cheng D, Martin J. Does preoperative rehabilitation for patients planning to undergo joint replacement surgery improve outcomes? A systematic review and meta-analysis of randomised controlled trials. BMJ Open. 2016 Feb 2;6(2):e009857. doi: 10.1136/bmjopen-2015-009857. PMID: 26839013; PMCID: PMC4746481. 5. Aydin D, Klit J, Jacobsen S, Troelsen A, Husted H. No major effects of preoperative education in patients undergoing hip or knee replacement--a systematic review. Dan Med J. 2015 Jul;62(7):A5106. PMID: 26183051. 6. Majid N, Lee S, Plummer V. The effectiveness of orthopedic patient education in improving patient outcomes: a systematic review protocol. JBI Database System Rev Implement Rep. 2015 Jan;13(1):122-33. doi: 10.11124/jbisrir-2015-1950. PMID: 26447013. 7. Moulton LS, Evans PA, Starks I, Smith T. Pre-operative education prior to elective hip arthroplasty surgery improves postoperative outcome. Int Orthop. 2015 Aug;39(8):1483-6. doi: 10.1007/s00264-015-2754-2. Epub 2015 Apr 11. PMID: 25862634. 8. McDonald S, Page MJ, Beringer K, Wasiak J, Sprowson A. Preoperative education for hip or knee replacement. Cochrane Database Syst Rev. 2014 May 13;2014(5):CD003526. doi: 10.1002/14651858.CD003526.pub3. PMID: 24820247; PMCID: PMC7154584. 9. Nahm, Eun-Shim & Stevens, Lena & Scott, Pamela & Gorman, Kristy. (2012). Effects of a web-based preoperative education program for patients undergoing ambulatory surgery: a preliminary study. Journal of Hospital Administration. 1. 10.5430/jha.v1n1p21 10. Clarke HD, Timm VL, Goldberg BR, Hattrup SJ. Preoperative patient education reduces in-hospital falls after total knee arthroplasty. Clin Orthop Relat Res. 2012 Jan;470(1):244-9. doi: 10.1007/s11999-011-1951-6. PMID: 21691907; PMCID: PMC3237968. 11. Huang SW, Chen PH, Chou YH. Effects of a preoperative simplified home rehabilitation education program on length of stay of total knee arthroplasty patients. Orthop Traumatol Surg Res. 2012 May;98(3):259-64. doi: 10.1016/j.otsr.2011.12.004. Epub 2012 Apr 4. PMID: 22480863. 12. Jones S, Alnaib M, Kokkinakis M, Wilkinson M, St Clair Gibson A, Kader D. Preoperative patient education reduces length of stay after knee joint arthroplasty. Ann R Coll Surg Engl. 2011 Jan;93(1):71-5. doi: 10.1308/003588410X12771863936765. PMID: 21418755; PMCID: PMC3293278. 13. Soever LJ, Mackay C, Saryeddine T, Davis AM, Flannery JF, Jaglal SB, Levy C, Mahomed N. Educational needs of patients undergoing total joint arthroplasty. Physiother Can. 2010 Summer;62(3):206-14. doi: 10.3138/physio.62.3.206. Epub 2010 Jul 23. PMID: 21629598; PMCID: PMC2909857. 14. Yoon RS, Nellans KW, Geller JA, Kim AD, Jacobs MR, Macaulay W. Patient education before hip or knee arthroplasty lowers length of stay. J Arthroplasty. 2010 Jun;25(4):547-51. doi: 10.1016/j.arth.2009.03.012. Epub 2009 May 8. PMID: 19427164. 15. Johansson K, Salanterä S, Katajisto J. Empowering orthopaedic patients through preadmission education: results from a clinical study. Patient Educ Couns. 2007 Apr;66(1):84-91. doi: 10.1016/j.pec.2006.10.011. Epub 2006 Dec 11. PMID: 17161934. 16. Rooks DS, Huang J, Bierbaum BE, Bolus SA, Rubano J, Connolly CE, Alpert S, Iversen MD, Katz JN. Effect of preoperative exercise on measures of functional status in men and women undergoing total hip and knee arthroplasty. Arthritis Rheum. 2006 Oct 15;55(5):700-8. doi: 10.1002/art.22223. PMID: 17013852. 17. Garretson S. Benefits of pre-operative information programmes. Nurs Stand. 2004 Aug 4-10;18(47):33-7. doi: 10.7748/ns2004.08.18.47.33.c3662. PMID: 15357551. 18. Giraudet-Le Quintrec JS, Coste J, Vastel L, Pacault V, Jeanne L, Lamas JP, Kerboull L, Fougeray M, Conseiller C, Kahan A, Courpied JP. Positive effect of patient education for hip surgery: a randomized trial. Clin Orthop Relat Res. 2003 Sep;(414):112-20. doi: 10.1097/01.blo.0000079268.91782.bc. PMID: 12966284. 19. Butler GS, Hurley CA, Buchanan KL, Smith-VanHorne J. Prehospital education: effectiveness with total hip replacement surgery patients. Patient Educ Couns. 1996 Nov;29(2):189-97. doi: 10.1016/0738-3991(96)00883-x. PMID: 9006235. 20. Soever LJ, Mackay C, Saryeddine T, Davis AM, Flannery JF, Jaglal SB, Levy C, Mahomed N. Educational needs of patients undergoing total joint arthroplasty. Physiother Can. 2010 Summer;62(3):206-14. doi: 10.3138/physio.62.3.206. Epub 2010 Jul 23. PMID: 21629598; PMCID: PMC2909857. 21. Claeys M, Mosher C, Reesman D. The POP Program: the patient education advantage. Orthop Nurs. 1998 Jul-Aug;17(4):37-47. PMID: 9814336. 22. Beaupre LA, Lier D, Davies DM, Johnston DB. The effect of a preoperative exercise and education program on functional recovery, health related quality of life, and health service utilization following primary total knee arthroplasty. J Rheumatol. 2004 Jun;31(6):1166-73. PMID: 15170931. 23. Chopra BK. Joint replacement surgery in the Armed Forces Medical Services, India: The journey so far and looking ahead. Med J Armed Forces India. 2015 Jan;71(1):5- 10. doi: 10.1016/j.mjafi.2014.12.012. PMID: 25609855; PMCID: PMC4297840. 24. Maradit Kremers H, Larson DR, Crowson CS, Kremers WK, Washington RE, Steiner CA, Jiranek WA, Berry DJ. Prevalence of Total Hip and Knee Replacement in the United States. J Bone Joint Surg Am. 2015 Sep 2;97(17):1386-97. doi: 10.2106/JBJS.N.01141. PMID: 26333733; PMCID: PMC4551172. 25. Bezerra MJC, Barbosa IM, Sousa TG, Fernandes LM, Maia DLM, Holanda LM. PROFILE OF PATIENTS RECEIVING TOTAL KNEE ARTHROPLASTY: A CROSS-SECTIONAL STUDY. Acta Ortop Bras. 2017 Sep-Oct;25(5):202-205. doi: 10.1590/1413-785220172505168806. PMID: 29081705; PMCID: PMC5608739. 26. Artz N, Elvers KT, Lowe CM, Sackley C, Jepson P, Beswick AD. Effectiveness of physiotherapy exercise following total knee replacement: systematic review and metaanalysis. BMC Musculoskelet Disord. 2015 Feb 7;16:15. doi: 10.1186/s128910150469-6. PMID: 25886975; PMCID: PMC4333167. 27. Rajan P. Physiotherapy in Indian communities: a brief review. Health Promot Perspect. 2017 Jun 14;7(3):111-116. doi: 10.15171/hpp.2017.21. PMID: 28695097; PMCID: PMC5497360. 28. Alghadir A, Iqbal ZA, Anwer S. Comparison of the effect of pre- and post-operative physical therapy versus post-operative physical therapy alone on pain and recovery of function after total knee arthroplasty. J Phys Ther Sci. 2016 Oct;28(10):2754-2758. doi: 10.1589/jpts.28.2754. Epub 2016 Oct 28. PMID: 27821929; PMCID: PMC5088120. 29. Kushwaha N, Gugnani A. To See The Changes Following Physiotherapy In Patients With Modified Radical Mastectomy: A Narrative Review. Mukt Shabd Journal. 2023 Jun; XII (VI):1653–64. 30. Abella MKIL, Lawton DRY, Wong KK, Nishioka ST, Andrews SN, Nakasone CK. Preoperative Educational Classes in Elderly Patients May Not be Necessary Prior to Elective Joint Arthroplasty. Hawaii J Health Soc Welf. 2023 Jun;82(6):135-140. PMID: 37304898; PMCID: PMC10248820. 31. Kashoo FZ, Al-Baradie RS, Alzahrani M, Alanazi A, Manzar MD, Gugnani A, Sidiq M, Shaphe MA, Sirajudeen MS, Ahmad M, Althumayri B. Effect of transcranial direct current stimulation augmented with motor imagery and upper-limb functional training for upper-limb stroke rehabilitation: a prospective randomized controlled trial. International Journal of Environmental Research and Public Health. 2022 Nov 17;19(22):15199. 32. Sahu RK, Gugnani A, Ahluwalia R. Short‐term effectiveness of trunk and bimanual hand training on upper limb motor recovery and function in stroke patients. Int J Health Sci. 2022;6(S1):10058-71.
Article Sidebar
Article Details
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.