State-Trait Anxiety and the Relationship with Patient Outcomes Following TKA

Purpose: To analyze the relationships between state (S) and trait (T) anxiety and functional outcome measure performance in patients following total knee arthroplasty (TKA) receiving physical therapy (PT). Methods: Nineteen patients (62.7±9.9 years) who recently underwent TKA completed testing post-TKA and at discharge that included the modified Lower Extremity Functional Scale (mLEFS), Numeric Pain Rating Scale (NPRS), State-Trait Anxiety Inventory (STAI), Pain Catastrophizing Questionnaire (PCQ), knee range of motion (ROM), thirty-second chair stand test (30s-CST), and the timed up and go (TUG) test. Additionally, NPRS, ROM, 30s-CST, and TUG measures were taken at three and five weeks following TKA. Results: Baseline S- and T-anxiety correlated highly with baseline PCQ (ρ= .546-.676, p= .001-.016) and the 30s-CST (S-Anxiety ρ= -0.531, p= .019). Baseline S- and T-anxiety revealed strong correlations with discharge PCQ scores (S-anxiety ρ= .462-.536, p= .018-.046). The discharge S- and T-anxiety surveys also correlated with discharge measures of mLEFS (ρ= .606-.675, p= .002-.006) and NPRS (ρ= .588-.707, p= .001-.008). Conclusions and Recommendations: This study of S- and T-anxiety and its effects on outcomes following TKA procedures revealed patients’ pain, ROM, and functional outcome measures improved, while S-anxiety, T-anxiety, and PCQ scores had no significant changes from baseline to discharge. Knowing this, clinicians could be proactive and incorporate relaxation techniques, stretching, and massage as a standard means of care.