Is trait mindfulness associated with pain interference in patients undergoing total knee arthroplasty? A prospective cohort study.
William Egan, Patricia Crane, John C. Morris, Jodi L Young, Daniel I Rhon
Physiotherapy Theory and Practice April 13, 2026 DOI: 10.1080/09593985.2026.2656341 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Prospective cohort study Peer reviewed |
|---|---|
| Sample size | 248 |
| Population | Patients undergoing total knee arthroplasty in the Bellin Health System during 2022 (59% female, mean age 66.4 years) |
| Duration | 12-week postoperative follow-up |
| Measures | Mindfulness Attention Awareness Scale (MAAS) |
| Topics | Meditation |
| Keywords | Opioids Physical function Total knee arthroplasty Pain interference |
| Key findings | Higher baseline trait mindfulness (MAAS) was associated with lower pain interference and better physical function at baseline but not with opioid use. Baseline MAAS scores did not significantly predict pain, function, or opioid use at 12 weeks postoperatively, suggesting trait mindfulness may relate to outcomes at assessment but not longer-term recovery. |
Abstract
Introduction: About 20% of individuals undergoing total knee arthroplasty (TKA) report ongoing pain and poor function. Trait mindfulness - a person's inherent ability to be attentive to the present - has been linked to reduced pain in other conditions but not yet studied in TKA.
Objective: This study examined whether higher trait mindfulness was associated with less pain interference at baseline and 12 weeks post-TKA. Secondary aims included associations with physical function and opioid use at 12 weeks.
Methods: This prospective cohort study included 248 patients (59% female, mean age 66.4 years) undergoing TKA in the Bellin Health System during 2022. Trait mindfulness was measured preoperatively using the Mindfulness Attention Awareness Scale (MAAS). Researchers analyzed associations between baseline MAAS scores and outcomes at 12 weeks.
Results: Higher baseline MAAS scores were significantly associated with lower pain interference (β = -1.24, p = .004) and better physical function (β = 0.92, p = .03) at baseline, but not with opioid use. However, MAAS scores did not significantly predict pain, function, or opioid use at 12 weeks postoperatively.
Conclusion: This is the first study exploring trait mindfulness in relation to pain outcomes after TKA. Findings suggest trait mindfulness is related to pain and function at the time of assessment but may not predict longer-term recovery. Additional research into this topic is warranted to determine the value and impact of assessing trait mindfulness in individuals undergoing TKA.
Comparable studies
Other observational and cohort studies on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Using Self-Report Assessment Methods to Explore Facets of Mindfulness Undergraduate students | 2006 | Observational cohort | |
| Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders Patients with generalized anxiety disorder or panic disorder with or without agoraphobia | 1992 | Observational cohort | n = 22 |
| Meditation experience is associated with increased cortical thickness Participants with extensive Insight meditation experience and matched controls | 2005 | Observational cohort | n = 20 |
| Meditation experience is associated with differences in default mode network activity and connectivity Experienced meditators and matched meditation-naive controls | 2011 | Observational cohort | |
| Long-term meditators self-induce high-amplitude gamma synchrony during mental practice Long-term Buddhist practitioners and controls | 2004 | Observational cohort |
Citations in the library
Cites 16
- The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology 2003
- Construct Validity of the Five Facet Mindfulness Questionnaire in Meditating and Nonmeditating Samples Assessment February 29, 2008
- Meditation Programs for Psychological Stress and Well-being JAMA Internal Medicine January 6, 2014
- Meta-analytic evidence for effects of mindfulness training on dimensions of self-reported dispositional mindfulness. Psychological Assessment 2016
- Mindfulness meditation–based pain relief: a mechanistic account Annals of the New York Academy of Sciences June 1, 2016
and 11 more in the library