Brief Mindfulness-Based Cognitive Behavioral Therapy is Associated with Faster Recovery in Patients Undergoing Total Knee Arthroplasty: A Pilot Clinical Trial.
Bethany D Pester, Jenna M Wilson, Jihee Yoon, Asimina Lazaridou, Kristin L Schreiber, Marise Cornelius, Claudia M Campbell, Michael T Smith, Jennifer A. Haythornthwaite, Robert R Edwards, Samantha M Meints
Pain Medicine June 1, 2023 DOI: 10.1093/pm/pnac183 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Pilot clinical trial Peer reviewed |
|---|---|
| Sample size | 44 |
| Population | Patients undergoing total knee arthroplasty at an academic teaching hospital in the Boston, Massachusetts area |
| Intervention | Mindfulness-based cognitive behavioral therapy (MBCBT) |
| Duration | Four 60-minute sessions during the perioperative period; assessments at baseline and 6 weeks, 3 months, and 6 months after surgery |
| Topics | Meditation |
| Keywords | Humans Osteoarthritis, knee Treatment outcome Arthroplasty, replacement, knee Cognitive behavioral therapy Postoperative pain Knee osteoarthritis Total knee arthroplasty Pain catastrophizing |
| Key findings | Patients who received brief MBCBT had lower pain severity and pain interference at 6 weeks after total knee arthroplasty than matched controls receiving treatment-as-usual, but outcomes were similar at 3 and 6 months. Changes in pain catastrophizing, not depression or anxiety, mediated the early benefits, suggesting MBCBT may speed recovery. |
Abstract
Objective: To assess whether brief mindfulness-based cognitive behavioral therapy (MBCBT) could enhance the benefits of total knee arthroplasty (TKA) in improving pain and pain-related disability. Specifically, to determine 1) whether patients who received MBCBT differed from matched controls who received treatment-as-usual with regard to postsurgical pain outcomes and 2) whether changes in pain catastrophizing, depression, or anxiety explained the potential effects of MBCBT on pain outcomes.
Design: Pilot clinical trial.
Setting: An academic teaching hospital serving a large urban and suburban catchment area surrounding the Boston, Massachusetts metropolitan region. Subjects: Sample of 44 patients undergoing TKA. Patients who completed a brief MBCBT intervention (n = 22) were compared with age-, race-, and sex-matched controls who received treatment-as-usual (n = 22).
Methods: The MBCBT intervention included four 60-minute sessions delivered by a pain psychologist in person and via telephone during the perioperative period. Participants were assessed at baseline and at 6 weeks, 3 months, and 6 months after surgery.
Results: Compared with matched controls, patients who received MBCBT had lower pain severity and pain interference at 6 weeks after surgery. Group differences in outcomes were mediated by changes in pain catastrophizing but not by changes in depression or anxiety. The MBCBT group had similar reductions in pain severity and interference as the control group did at 3 and 6 months after surgery.
Conclusions: This work offers evidence for a safe and flexibly delivered nonpharmacological treatment (MBCBT) to promote faster recovery from TKA and identifies change in pain catastrophizing as a mechanism by which this intervention could lead to enhanced pain-related outcomes.
Comparable studies
Other non-randomized and open-label trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients Early-stage breast and prostate cancer patients | 2003 | Pre-post intervention study | n = 59 |
| Exploring self‐compassion and empathy in the context of mindfulness‐based stress reduction (MBSR) Community sample | 2010 | Pre-post intervention study | |
| Mindfulness-Based Stress Reduction Lowers Psychological Distress In Medical Students Second-year medical students | 2003 | Prospective nonrandomized cohort-controlled study | n = 302 |
| Intensive meditation training, immune cell telomerase activity, and psychological mediators. Retreat participants and matched controls | 2011 | Controlled trial with wait-list control group | n = 60 |
| The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents Children aged 8-12 with ADHD and their parents | 2011 | Within-group waitlist controlled trial | n = 22 |
Citations in the library
Cited by 2
Cites 4
- Mindfulness-based cognitive therapy for depression August 21, 2006
- To be mindful of the breath or pain: Comparing two brief preoperative mindfulness techniques for total joint arthroplasty patients. Journal of Consulting and Clinical Psychology June 24, 2021
- Mechanisms of Mindfulness Meditation, Cognitive Therapy, and Mindfulness-based Cognitive Therapy for Chronic Low Back Pain Clinical Journal of Pain October 1, 2020
- A Pilot Randomized Controlled Trial Comparing Mindfulness Meditation, Cognitive Therapy, and Mindfulness-Based Cognitive Therapy for Chronic Low Back Pain Pain Medicine November 1, 2019