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Guided Imagery for Total Knee Replacement: A Randomized, Placebo-Controlled Pilot Study.

Ann F Jacobson1, Wendy A Umberger1, Patrick A Palmieri2

  • 11 Kent State University College of Nursing , Kent, OH.

Journal of Alternative and Complementary Medicine (New York, N.Y.)
|May 24, 2016
PubMed
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This summary is machine-generated.

Guided imagery (GI) improved gait velocity in total knee replacement (TKR) patients but not patient-reported function. This pilot study suggests GI may reduce stress post-TKR, warranting further investigation.

Area of Science:

  • Orthopedic Surgery
  • Rehabilitation Medicine
  • Psychoneuroimmunology

Background:

  • Total knee replacement (TKR) is a common procedure to manage severe knee arthritis.
  • Functional recovery and psychological well-being after TKR are critical for patient outcomes.
  • Exploring non-pharmacological interventions like guided imagery (GI) can enhance recovery.

Purpose of the Study:

  • To evaluate the impact of guided imagery (GI) on functional outcomes following total knee replacement (TKR).
  • To investigate potential psychological and neuroimmune pathways mediating GI effects.
  • To assess the feasibility of implementing a GI study in the TKR population.

Main Methods:

  • An investigator-blinded, randomized, placebo-controlled pilot study.

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  • 82 participants undergoing TKR received either TKR-specific GI or placebo audio recordings.
  • Primary outcomes included gait velocity and WOMAC Function score, analyzed at 6 months post-surgery.

    • Main Results:

    • Guided imagery significantly improved gait velocity at 6 months post-TKR.
    • The GI group showed reduced pain scores at 3 weeks and lower hair cortisol concentrations at 6 months compared to baseline.
    • While adherence was lower, treatment credibility was higher in the GI group.

    Conclusions:

    • Guided imagery interventions are feasible in TKR patients, though attrition can be influenced by study criteria.
    • GI may improve objective functional outcomes (gait velocity) but not necessarily patient-reported outcomes (WOMAC Function).
    • Findings suggest GI may contribute to stress reduction post-TKR, necessitating further research on optimal protocols.