Effects of Integrating Pain Coping Strategies into Occupational Therapy After Total Knee Arthroplasty: A Parallel Mixed-Method Study.

Abstract

Background/Objectives: This study aimed to evaluate whether integrating coping strategies into occupational therapy (OT) enhances functional recovery and psychological adaptation after total knee arthroplasty (TKA). Methods: Twenty-eight patients who underwent TKA were equally assigned to an intervention and control group. Both groups received standard goal-oriented OT, while only the intervention group underwent structured training in pain coping strategies using the "Coping List". Treatment effects were assessed using Canadian Occupational Performance Measure (COPM), pain, anxiety, depression, and pain-related disability scores. Results: A total of 210 coping strategies were identified, with the intervention group adopting an average of 15.1 additional strategies per patient. Strategies were categorized into six domains: physical, psychological and cognitive, social support, relaxation, daily activities, and medication management. The intervention group showed significantly greater improvements in COPM performance scores (7.6 ± 1.7 vs. 5.5 ± 2.6; p = 0.048) and COPM satisfaction scores (7.9 ± 2.0 vs. 5.6 ± 2.8; p = 0.049) compared to the control group. Conclusions: The findings suggest that individualized coping strategies integrated with physical rehabilitation can help patients achieve postoperative goals, enhance recovery, and improve overall well-being. Incorporating such strategies into OT appears to be effective in early-postoperative rehabilitation. Clinical trial number: This study's clinical trial registration information is available online at UMIN (UMIN000050536).