A novel integrative approach to improve the quality of life by reducing pain and kinesiophobia in patients undergoing TKA: the IARA Model

Introduction: Postoperative complications in TKA are well-known, especially regarding kinesiophobia which affects both perception of pain and good post-operation recovery, preventing the normal course and sometimes leading to a new intervention even in the presence of a technically successful operation. Methods: The study had a quasi-experimental, controlled, before-and-after design and was conducted on 84 patients; 44 were assigned to IARA and 40 to control group. According to IARA model three meetings were performed (two pre- and one postoperative). The control group received normal preand postoperative interaction. With the purpose of evaluating pain, kinesiophobia and health-related Quality of Life (QoL), we used respectively the NRS 0-10, TSK, and KOOS questionnaires. Results: Applying two-way mixed design ANOVA we found significant Time x Group interaction in all KOOS subscales: Pain (F1,82=10.808, p<0.001); Symptom (F1,82=15.497, p<0.001); ADL (F1,82=20.342, p<0.001); Sport/Rec (F1,82=20.451, p<0.001); QOL (F1,82=4.275, p<0.001) and also in TSK questionnaire (F1,82=4.275, p=0.042). Conclusion: IARA turned out to be a short and effective approach to reducing kinesiophobia and pain at 40th day after surgery, significantly improving QoL indexes in patient undergoing TKA. Level of evidence: III. © 2018, CIC Edizioni Internazionali s.r.l.