Effect of emotional freedom techniques in mitigating pain catastrophizing following total knee arthroplasty

Background

Up to 30 %-42 % of patients with end-stage knee osteoarthritis who undergo total knee arthroplasty may experience chronic pain and even pain catastrophizing following surgery. Pain catastrophizing is a negative thought pattern and cognitive bias that involves rumination,exaggeration,and emotions of powerlessness over pain, resulting in delayed rehabilitation and a lower quality of life.

Objective

To examine the effect of a 4-week combined offline and online Emotional freedom techniques on pain catastrophizing, pain intensity, and pain sensitivity in patients following total knee arthroplasty, assessed at 1 week, 4 weeks, 3 months, and 6 months after surgery.

Methods

This study employed a quasi-experimental repeated-measures design, wherein participants were systematically allocated into a control group (n = 31) and an intervention group (n = 33) based on their chronological admission sequence. The control group received conventional postoperative care following total knee arthroplasty, while the intervention group was administered emotional freedom techniques in conjunction with standard postoperative care over a 4-week intervention period. The efficacy of the intervention was quantitatively evaluated through validated psychometric instruments, including the Pain Catastrophizing Scale, Numeric Pain Rating Scale, and Pain Sensitivity Questionnaire. Assessments were performed on the postoperative day 1, week 1, week 4, month 3, and month 6, to comprehensively evaluate the temporal dynamics of intervention effects.

Results

A statistically significant reduction was observed in both the total pain catastrophizing score and the rumination dimension from baseline to the 6-month post-intervention assessment (P < 0.001). However, no significant changes were detected in the magnification dimension between the 3-month and 6-month follow-up periods, nor in the helplessness dimension from the 4-week to 3-month follow-up. Pain severity demonstrated a significant decrease during the initial 3-month follow-up period, though no significant differences were observed at subsequent time points beyond 3 months.Additionally, pain sensitivity scores exhibited a significant reduction from pre-intervention to the 6-month post-intervention assessment (P < 0.001).

Conclusions

The 4-week emotional freedom techniques demonstrated significant efficacy in reducing pain catastrophization, pain intensity, and pain sensitivity among patients following total knee arthroplasty.Our study incorporated a comprehensive analysis of temporal effects, intergroup variations, and interaction effects to ensure robust and reliable findings.