Effects of IMB model-based rehabilitation on exercise compliance and knee function after total knee arthroplasty: a randomized controlled trial

基于IMB模型的康复对全膝关节置换术后运动依从性和膝关节功能的影响:一项随机对照试验

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Abstract

OBJECTIVE: To evaluate the effectiveness of rehabilitation training measures under the Information-Motivation-Behavioral Skills (IMB) model on rehabilitation training compliance and knee function of patients after total knee arthroplasty (TKA). METHODS: A randomized controlled trial was performed. A total of 90 patients who underwent TKA at our hospital between June 2022 and June 2023 were randomly assigned to either a control group (n = 45, conventional nursing care), or an observation group (n = 45, rehabilitation training based on the IMB model). Patient compliance (Orthopedic Functional Exercise Compliance Scale), knee joint function (Hospital for Special Surgery (HSS) Knee Rating Scale), symptoms and functional status [the Knee Injury and Osteoarthritis Outcome Score (KOOS)], pain intensity [Visual Analog Scale (VAS)], and exercise tolerance [the 6-min walk distance (6MWD) test] were assessed at discharge, as well as at 1 and 3 months postoperatively. RESULTS: A significant Group × Time interaction (p < 0.001) for all outcomes, indicating different recovery trajectories between groups. While groups were comparable at discharge (p > 0.05), the IMB-based intervention group demonstrated significantly greater improvement than the control group at both 1 and 3 months. Specifically, the observation group had higher functional exercise compliance (1-month: 60.89 vs. 50.11; 3-month: 70.07 vs. 61.87), better knee function (HSS: 1-month: 72.31 vs. 62.04; 3-month: 80.82 vs. 69.29; KOOS also significantly higher), lower pain scores (VAS: 1-month: 3.89 vs. 4.82; 3-month: 2.00 vs. 3.84), and longer 6MWD (1-month: 416.02 m vs. 373.09 m; 3-month: 530.82 m vs. 459.67 m) (all between-group p < 0.001). CONCLUSION: Rehabilitation training interventions based on the IMB model can significantly enhance patients' compliance with postoperative rehabilitation exercises and effectively improve knee joint function, reduce pain intensity, and enhance exercise tolerance, demonstrating the practical utility and value of the IMB model in promoting functional recovery after TKA.

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