Analgesic effect by exercise therapy on the healthy side to pain during exercise training after total knee arthroplasty

Research Project

Project/Area Number	18K10779
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 59010:Rehabilitation science-related
Research Institution	Saga University
Principal Investigator	Sonohata Motolki 佐賀大学, 医学部, 准教授 (50304895)
Project Period (FY)	2018-04-01 – 2021-03-31
Project Status	Completed (Fiscal Year 2020)
Budget Amount *help	¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000) Fiscal Year 2020: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000) Fiscal Year 2019: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000) Fiscal Year 2018: ¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000)
Keywords	術後疼痛 / リハビリテーション / 運動療法 / 運動誘発性鎮痛 / 可動域訓練 / 人工膝関節全置換術 / 人工膝関節
Outline of Final Research Achievements	Total knee arthroplasty (TKA) is an excellent treatment, however, pain associated with postoperative rehabilitation is a major problem. Exercise is known to lower pain thresholds throughout the body, and by applying this mechanism to pain reduction during range of motion (ROM) exercise after TKA, rehabilitation may be smoother. Patients scheduled for unilateral TKA were divided into two groups by block randomization: a unilateral group in which continuous passive motion (CPM) was performed on the affected side only, and a bilateral group in which CPM was performed on both the affected and healthy sides. Visual Analog Scale (VAS) and ROM were compared before and after CPM. VAS decreased and ROM increased in the bilateral group. The results suggest that CPM on the healthy side may lower the pain threshold and reduce pain during exercise after unilateral TKA surgery. Based on the results of this study, a new rehabilitation method is expected to be developed.
Academic Significance and Societal Importance of the Research Achievements	人工膝関節全置換術(TKA)は優れた治療法であるが、術後のリハビリテーションに伴う疼痛は大きな問題である。今回、手術後のリハビリテーション時に手術部以外の運動を同時に行うことによって術部の疼痛は軽減し、さらに可動域の獲得も良好であることが明らかとなった。本結果より、手術後のリハビリテーションにおいても手術部位のみならず全身運動を勘案した計画を立てることにより、患者にとってより苦痛の少ない効果的なリハビリテーションの実践が可能であると推察される。今後のデータ蓄積により、術後リハビリテーションの新たなストラテジーが確立される可能性がある。