Preoperative Home-Based Physiotherapy for High Pain Catastrophizing Before Knee Replacement

Physical therapists and physical therapist assistants who work with adults before and after total knee arthroplasty, in outpatient, home health, or perioperative settings.

Licensed physical therapists and physical therapist assistants involved in preoperative education, prehabilitation, or postoperative rehabilitation for knee arthroplasty. Physical therapist assistants participate under the direction and supervision of a physical therapist, who retains responsibility for examination, evaluation, and the plan of care.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course reports on a single-blinded, three-arm randomized controlled trial conducted at Hospital Germans Trias i Pujol between September 2019 and January 2023, registered with the United States Clinical Trials Registry (NCT03847324). Forty adults with symptomatic knee osteoarthritis scheduled for total knee arthroplasty, all screened as having at least moderate pain catastrophizing, were allocated to usual care, a three-session home therapeutic patient education program, or an eight-session home multimodal physiotherapy program. Outcomes were collected before and after the preoperative program and at one, three, and six months after surgery.

All findings, figures, and conclusions described in this course come from that trial report. Nothing has been added from other literature.

After completing this course, you will be able to:

1. Describe the population, the three study arms, and the primary outcome of this preoperative physiotherapy trial in knee arthroplasty candidates who catastrophize about their pain.
2. State what the trial found for pain catastrophizing before surgery and for pain, fear of movement, self-efficacy, and balance through six months after surgery.
3. Explain the authors' conclusions and the limits they placed on those conclusions, including what more sessions and closer supervision did and did not add.

1. Start Here: how this course works and what the source is
2. Podcast: Preoperative Physiotherapy for the Catastrophizing Knee Replacement Patient (about nine minutes)
3. Why Pain Catastrophizing Before Knee Replacement Was Targeted
4. Three Arms, Two Home Programs, and How Outcomes Were Tracked
5. What Changed Before Surgery and Through Six Months After
6. Small Sample, One Hospital, and a Pandemic: Reading the Findings Carefully
7. Screening and Preoperative Care: What the Authors Took From the Trial
8. Key Takeaways
9. Post-test and course evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 0.5 contact hours (30 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. This course reports on a single-blinded, three-arm randomized controlled trial conducted at Hospital Germans Trias i Pujol between September 2019 and January 2023, registered with the United States Clinical Trials Registry (NCT03847324). Forty adults with symptomatic knee osteoarthritis scheduled for total knee arthroplasty, all screened as having at least moderate pain catastrophizing, were allocated to usual care, a three-session home therapeutic patient education program, or an eight-session home multimodal physiotherapy program. Outcomes were collected before and after the preoperative program and at one, three, and six months after surgery.
2. All findings, figures, and conclusions described in this course come from that trial report. Nothing has been added from other literature.