title: Pain coping skills training for patients with elevated pain catastrophizing who are scheduled for knee arthroplasty: a quasi-experimental study.
abstract: OBJECTIVE
  To (1) describe a behavioral intervention designed for patients with elevated pain catastrophizing who are scheduled for knee arthroplasty, and (2) use a quasi-experimental design to evaluate the potential efficacy of the intervention on pain severity, catastrophizing cognitions, and disability.
  
  
  METHODS
  Quasi-experimental nonequivalent control group design with a 2-month follow-up.
  
  
  METHODS
  Two university-based orthopedic surgery departments.
  
  
  METHODS
  Adults (N=63) scheduled for knee replacement surgery who reported elevated levels of pain catastrophizing. Patients were recruited from 2 clinics and were assessed prior to surgery and 2 months after surgery.
  
  
  METHODS
  A group of 18 patients received a psychologist-directed pain coping skills training intervention comprising 8 sessions. The other group, a historical cohort of 45 patients, received usual care.
  
  
  METHODS
  Western Ontario and McMaster Universities Arthritis Index Pain and Disability scores, as well as scores on the Pain Catastrophizing Scale.
  
  
  RESULTS
  Two months after surgery, the patients who received pain coping skills training reported significantly greater reductions in pain severity and catastrophizing, and greater improvements in function as compared to the usual care cohort.
  
  
  CONCLUSIONS
  Pain catastrophizing is known to increase risk of poor outcome after knee arthroplasty. The findings provide preliminary evidence that the treatment may be highly efficacious for reducing pain, catastrophizing, and disability, in patients reporting elevated catastrophizing prior to knee arthroplasty. A randomized controlled trial is warranted to confirm these effects.
authors.affiliation: Department of Physical Therapy and Orthopaedic Surgery, Virginia Commonwealth University, Richmond, VA 23298-0224, USA. dlriddle@vcu.edu
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Riddle
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Keefe
authors.forename: William T
authors.initials: WT
authors.lastname: Nay
authors.forename: Daphne
authors.initials: D
authors.lastname: McKee
authors.forename: David E
authors.initials: DE
authors.lastname: Attarian
authors.forename: Mark P
authors.initials: MP
authors.lastname: Jensen
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000523:psychology* / Q000601:surgery; D010146:Pain / Q000523:psychology*