자기효능감 이론을 적용한 인공슬관절치환술 환자를 위한 수술 전·후 운동프로그램의 효과

Abstract

Purpose: This study aimed to develop the perioperative exercise program for total knee arthroplasty and to test the program’s effects on knee pain, knee function(knee range of motion, lower-extremity strength, 3m walking time, Korean Western Ontario and McMaster Index 〔WOMAC〕), exercise self efficacy, total length of hospital stay.

Methods: This perioperative exercise program was developed according to the five-step ADDIE (analysis, design, development, implementation and evaluation)model. This study was a quasi-experimental research of non-equivalent control group pretest-posttest design. It was applied for self-efficacy reinforcement strategies based on self-efficacy theory. This perioperative exercise program consisted of the overall contents of total knee arthroplasty, education to prevent complications after surgery, and muscle strength exercise. Exercise video and exercise posters were used for exercise The participants were 29 for the experimental group and 27 for the control group. The experimental group was received perioperative exercise program total of 7weeks from 3 weeks before total knee arthroplasty to 4 weeks after surgery. The control group was received routine care. The data was analysed with the use of SPSS 23.0 program. The homogeneity of two groups was found by a chi-square, Shapiro-Wilk test, and t-test. Hypothesis testing of the effects of the perioperative exercise program was performed Mann-Whitney U-test, Ranked ANCOVA, and t-test.

Results: The experimental group showed significant improvement lower-extremity muscle strength, 3m walking time, WOMAC index, exercise self efficacy, and total length of hospital stay compared to control group after 7 weeks. No significant effects was found the knee pain and knee range of motion.

Conclusion: The finding presented above, the perioperative exercise program is helpful for improving lower-extremity exercise function, and self efficacy for total knee arthroplasty patients. Therefore the perioperative exercise program is recommended as an effective exercise intervention.