Cryotherapy, Emotional Support, Exercise for TKR Recovery: A Report

This report investigates the impact of various interventions on mobility and pain management following total knee replacement (TKR). The study explores the use of cryotherapy, emotional support, and exercise as alternative therapies to improve patient outcomes. Cryotherapy, including the application of cold and compression, is examined for its pain-suppressing effects and its potential to reduce tissue trauma. The role of emotional support, provided by a healthcare team, is highlighted to address the psychological factors influencing recovery. Additionally, the importance of physiotherapy and exercise in enhancing physical function and mobility is discussed. The report synthesizes existing research to provide insights into effective strategies for optimizing post-TKR recovery and improving patients' quality of life. It emphasizes the need for a comprehensive approach that combines physical and emotional support to achieve the best possible outcomes for individuals undergoing TKR.

Effect of cryotherapy, emotional support and exercises on mobility after total
knee replacement
Total knee replacement (TKR) is one of the most common surgical procedures to rectify the
pain associated with joints, and has been predicted to be increase (Kurtz et al., 2007) in
future. Following TKR, patients frequently experience intense levels of pain, stress, and
anxiety that may reduce their self-efficacy and thus affect their postoperative recovery. The
intent of TKR is to provide relief from chronic pain and improve function. However, most
patients experience chronic post-surgical pain. To control pain perception, centrally acting
pain suppressants such as opioid based drugs can be given by epidural route and is popularly
known as patient controlled analgesia (PCA) (ASATF, 2012). The drugs act centrally by
binding to receptors, named mu, kappa, sigma, delta, and epsilon. Continuous infusion of
morphine as a part of PCA can cause respiratory depression therefore the patients have to be
carefully monitored. To avoid such adverse events it would be desired to use alternative
therapies such as cryotherpy. Therefore, it was aimed to describe the alternative modes of
therapy in TKR to improve the mobility of patients with TKR and reduce the pain perception.
Cryotherapy (use of cold utilities, ice bags or cooled water) promotes vasoconstriction, and
reduces the tissue trauma after surgery thereby it minimizes the extent of tissue trauma after
knee surgery (Adie et al., 2009). However researchers opined that the use of ice alone show
swelling due cold induced ischemic damage to blood vessels and recommending using
simultaneously the application of cold and compression (Kullenberg et al., 2006).
Cryotherapy offers pain suppression similar to that of PCA (Holmstrom, & Hardin, 2005), so
the administration of morphine can be avoided. From the evidences, it can be understood that
the cold alone not suffices to improve the range of motion. Both cold and compression
appears to be showing an improvement of range of motion (Markert, 2011). Despite the
overwhelming success of TKR, functional improvement after surgery varies widely. Poor
functional results have been associated with poor emotional health, such as anxiety,
depression, poor coping skills, and poor social support (Ayers et al., 2005). The patients who
are at risk of having less functional improvement after orthopaedic surgery can be identified
preoperatively. Accordingly, support would be extended to increase the level of confidence
so that the patients with TKR are recovered easily. The heath care team of clinicians, physical
therapists, behavioral psychologists, and other support professionals involves in providing the
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emotional support. The rehabilitation, with an accentuation on physiotherapy and exercise, is
broadly promoted mode of intervention after TKR with varying content and duration.
According to the randomized controlled trail, the physical exercise or physiotherapy had
showed an improvement in physical function (Evgeniadis et al., 2008). It indicates that the
physiotherapy exercise influences the recovery and mobility of the patients. In case of
exercise as the intervention, it is desired to know content and duration of physiotherapy
exercise for the improvement of short and long-term outcomes. In conclusion, diverse modes
of interventions are available for the recovery and suppression of pain after TKR.
References
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