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Background: Athroplastic surgery often results in acute post-operative pain, hindering rehabilitation compliance. To improve pain management and functional recovery, guided and motor imagery (GMI) exercises were introduced in hip and knee arthroplasty. Methods: A pragmatic prospective mixed-methods implementation evaluation was conducted at the orthopaedic department of Schakelring, the Netherlands. 80 subjects underwent a 4-week rehabilitation program including GMI after knee or hip arthroplasty. Outcomes included self-reported pain, Timed Up & Go test, 10-meter walk test, and medication use compared with a historical control group. A process evaluation was based on 6 meeting reports, a focus group and 8 interviews. Results: = 0,027). Thematic analysis of meetings, focus group and interviews resulted in the following critical themes for implementation were: individual adaptation, embedding in the rehabilitation program, motivation and attitudes of staff, perceived support, monitoring of outcome and creating a learning history, perceived effects. Conclusions: Monitoring and evaluating the implementation process and positive clinical results facilitated the implementation of GMI in the rehabilitation setting in the Netherlands.
Wietmarschen et al. (Tue,) studied this question.