Purpose: To analyze the relationships between state (S) and trait (T) anxiety and functional outcome measure performance in patients following total knee arthroplasty (TKA) receiving physical therapy (PT). Methods: Nineteen patients (62.7±9.9 years) who recently underwent TKA completed testing post-TKA and at discharge that included the modified Lower Extremity Functional Scale (mLEFS), Numeric Pain Rating Scale (NPRS), State-Trait Anxiety Inventory (STAI), Pain Catastrophizing Questionnaire (PCQ), knee range of motion (ROM), thirty-second chair stand test (30s-CST), and the timed up and go (TUG) test. Additionally, NPRS, ROM, 30s-CST, and TUG measures were taken at three and five weeks following TKA. Results: Baseline S- and T-anxiety correlated highly with baseline PCQ (ρ= .546-.676, p= .001-.016) and the 30s-CST (S-Anxiety ρ= -0.531, p= .019). Baseline S- and T-anxiety revealed strong correlations with discharge PCQ scores (S-anxiety ρ= .462-.536, p= .018-.046). The discharge S- and T-anxiety surveys also correlated with discharge measures of mLEFS (ρ= .606-.675, p= .002-.006) and NPRS (ρ= .588-.707, p= .001-.008). Conclusions and Recommendations: This study of S- and T-anxiety and its effects on outcomes following TKA procedures revealed patients’ pain, ROM, and functional outcome measures improved, while S-anxiety, T-anxiety, and PCQ scores had no significant changes from baseline to discharge. Knowing this, clinicians could be proactive and incorporate relaxation techniques, stretching, and massage as a standard means of care.

Author Bio(s)

Alma Kathryn Crouch, PT, DPT is an acute care Physical Therapist at Vidant Medical Center in Greenville, NC. She graduated from Campbell University's Doctor of Physical Therapy program in December 2020 where the research for this article was first instituted.

Jennifer Bunn, PhD is the Associate Dean for the College of Health Sciences at Sam Houston State University and a Fellow of the American College of Sports Medicine (ACSM).

Michelle Green, PT, DPT, c-NDT, NCS is an Assistance Professor for the College of Pharmacy and Health Sciences at Campbell University's Doctor of Physical Therapy school. Dr. Green is also a practicing American Physical Therapy Association (APTA) neurological certified specialist in the state of North Carolina.




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