Effects of using activity diary for goal setting in occupational therapy on reducing pain and improving psychological and physical performance in patients after total knee arthroplasty: A non-randomised controlled study.
Yuki Hiraga, Shinya Hisano, Katsuhiro Nomiyama and 1 others
PMID 31217762WHAT IT FOUND
Patients after knee replacement who added an activity diary to occupational therapy had better walking pain, anxiety, steps, and physical activity than therapy alone.
Resting pain, helplessness, and pain self-efficacy did not differ.
Key findings
01The diary group, which received occupational therapy plus the activity diary, had better COPM performance and satisfaction scores than the control group, which received occupational therapy alone (8.6 versus 6.3, p=0.001; 8.3 versus 6.1, p=0.007).
02The diary group had lower walking pain scores (1.3 versus 3.2, p=0.010) and lower anxiety scores (1.7 versus 4.4, p=0.031) than the control group.
03There were no significant differences between groups for resting pain, PCS rumination, PCS helplessness, or total pain self-efficacy scores.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The groups were not randomised; patients were assigned by hospitalisation period, so differences between time periods may explain results. The sample was small, and one patient from each group withdrew, leaving 20 diary patients and 21 control patients completed. All patients also received physical therapy, occupational therapy, and pain medication, so the diary's separate contribution cannot be isolated. The study examined only short-term outcomes from 1 to 2 weeks after surgery to 4 weeks after surgery, so longer-term effects are unknown. Some pain and psychological outcomes did not improve more with the diary, including resting pain, rumination, helplessness, and pain self-efficacy. The authors note that history effects of physical therapy and medication therapy were not considered.
Declared interests
No funding or conflict-of-interest declaration is stated in the supplied text.
The easy way to misread this
Do not conclude the diary alone caused the improvements. All patients received physical therapy, occupational therapy, and pain medication, and the diary was added to occupational therapy in one group, so the effect of any single component cannot be separated.