Clinical Observation On The Intervention Of TCM Comprehensive Therapy In Early Functional Outcomes Of Patients With Kinesiophobia After Total Knee Arthroplasty

Objective:To explore the prevention and treatment of kinesiophobia after total knee arthroplasty with TCM comprehensive therapy.To observe and compare the differences of routine postoperative treatment,cognitive behavioral therapy and TCM comprehensive therapy in the first postoperative ambulation time,pain perception,knee function score and so on.To evaluate the influence of the new comprehensive intervention method of TCM on the early functional rehabilitation of knee joint,and to provide reference for optimizing the prevention and treatment of kinesiophobia.Methods:According to inclusion and exclusion criteria,60 patients who underwent total knee arthroplasty for knee osteoarthritis from January 2021 to December 2021 were selected,and they had postoperative kinesiophobia.According to random number table method,the patients were divided into control group,cognitive behavior intervention group(observation group 1)and TCM comprehensive therapy group(observation group 2),with 20 cases in each group.All patients were given routine treatment after TKA.Observation group 1 was given cognitive behavioral intervention on the basis of routine treatment,mainly including cognitive correction and reconstruction,progressive muscle relaxation,etc.Observation group 2 received TCM comprehensive therapy intervention on the basis of conventional treatment,mainly including Yijing Bianqi and Chinese medicinal formulae.The time of first postoperative ambulation,discharge date,visual analogue pain score and American Knee Society Knee Score at first visit were recorded to evaluate the early functional recovery level of patients in the three groups.Finally,SPSS26.0 was used for statistical analysis of the above data.Results:None of the enrolled patients were lost to follow-up,and no serious complications or adverse reactions occurred during the study.The P values of age,sex and surgical site in the three groups were all greater than 0.05,which was comparable.1.Comparison of the first postoperative ambulation time of patients in the three groups:the average first ambulation time of control group,observation group 1 and observation group 2 were 24.05±2.19 h,22.10±2.67 h and 21.30±2.49 h,respectively.There was statistical significance in the time of first postoperative ambulation among the three groups(P < 0.05).The time of first ambulation in control group was later than that in observation group 1 and observation group 2(P < 0.05).There was no significant difference in the time of first ambulation between observation group 1 and observation group 2(P > 0.05).2.Comparison of visual analog pain scores among the three groups: VAS pain scores of patients in control group,observation group 1 and observation group 2 on discharge day were 5.10±0.79,4.30±0.87 and 4.15±0.88,respectively,with statistical differences among the scores of the three groups(P < 0.05).On discharge day,VAS pain scores of observation group 1 and 2 was lower than that of control group(P < 0.05),but there was no statistical significance between observation group 1 and observation group 2(P > 0.05).The VAS pain scores of patients in the control group,observation group 1 and observation group 2 were3.15±0.81,2.55±0.83 and 2.05±0.60 in the first review,respectively,and the scores of the three groups were statistically different(P < 0.05).At the first review,VAS pain scores were statistically different among the three groups(P < 0.05),and control group > observation group 1 > observation group 2.3.Comparison of American Knee Association Knee scores among the three groups: at the first review,there were statistical differences in American Knee Association clinical scores and American Knee Association functional scores among the three groups(P < 0.05),and observation group 2 > observation group 1 > control group.Conclusion:Both cognitive behavioral therapy and TCM comprehensive therapy can improve the pain perception,shorten the first time to get out of bed and speed up the knee function recovery of patients with kinesiophobia after TKA.And TCM comprehensive therapy has more advantages in improving the early rehabilitation level of knee joint.