Distraction Techniques for Postoperative Pain After Total Knee Arthroplasty: A Randomized Controlled Trial

NCT07375472 | Completed

• 1 other identifier: İzmirTınaztepeÜ-B.Dizer-003
• Study Type: interventional
• Target: 140
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial evaluates the effectiveness of three distraction techniques-virtual reality (VR) headset, squishy (squeeze toy), and poetry reading-on postoperative pain control in adults undergoing total knee arthroplasty. Participants are randomized into four parallel groups (three intervention arms and one usual care control). Pain intensity is assessed using the Visual Analog Scale (VAS), with primary assessment at 24 hours after surgery.

Conditions

Postoperative Pain; Total Knee Arthroplasty

Keywords

virtual reality; distraction technique; postoperative pain; total knee arthroplasty; nursing intervention

Outcome Measures

Primary Outcomes (1)

• Pain Intensity (VAS)

  Visual Analog Scale pain score (0=no pain, 10=worst pain).

  24 hours after surgery

Secondary Outcomes (1)

• Pain Intensity (VAS) by Pain Severity Strata

  24 hours after surgery

Study Arms (4)

Virtual Reality (VR) Headset

EXPERIMENTAL

Participants will receive routine postoperative care and standard analgesia according to the hospital protocol. In addition, they will receive a structured distraction intervention using a virtual reality (VR) headset during the postoperative pain period while hospitalized (e.g., within the first 24 hours after surgery). The VR content is delivered under supervision at the bedside as a non-pharmacological distraction method.

Behavioral: VR Distraction

Squishy (Squeeze Toy)

EXPERIMENTAL

Participants will receive routine postoperative care and standard analgesia according to the hospital protocol. In addition, they will use a squishy (squeeze toy) as a tactile distraction method during the postoperative pain period while hospitalized (e.g., within the first 24 hours after surgery). Participants are instructed to use the squeeze toy during episodes of pain/discomfort as a non-pharmacological distraction technique.

Behavioral: Tactile Distraction With Squishy

Poetry Reading

EXPERIMENTAL

Participants will receive routine postoperative care and standard analgesia according to the hospital protocol. In addition, they will perform poetry reading as a cognitive distraction method during the postoperative pain period while hospitalized (e.g., within the first 24 hours after surgery). Poetry reading is provided as a structured non-pharmacological distraction intervention at the bedside.

Behavioral: Poetry Reading Distraction

Usual Care Control

NO INTERVENTION

articipants will receive routine postoperative care and standard analgesia according to the hospital protocol. No structured distraction intervention (VR, squishy, or poetry reading) will be provided.

Interventions

VR Distraction BEHAVIORAL

A supervised virtual reality distraction session delivered via a VR headset during postoperative hospitalization to support non-pharmacological pain management.

Also known as: Virtual Reality (VR) Headset Distraction

Virtual Reality (VR) Headset

Tactile Distraction With Squishy BEHAVIORAL

Use of a squishy (squeeze toy) as a tactile distraction technique during postoperative hospitalization as part of non-pharmacological pain management.

Also known as: Squeeze Toy (Squishy) Distraction

Squishy (Squeeze Toy)

Poetry Reading Distraction BEHAVIORAL

Structured poetry reading conducted during postoperative hospitalization as a cognitive distraction approach to support non-pharmacological pain management.

Also known as: Poetry Reading

Poetry Reading

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 18 years or older
• Undergoing total knee arthroplasty
• Hospitalized in the postoperative period at Osmaniye State Hospital
• Able to communicate and complete pain assessment (Visual Analog Scale)
• Provides written informed consent
• Managed under the same postoperative analgesia protocol and operated by the same surgeon (as per study protocol)

You may not qualify if:

• Severe cognitive impairment or inability to provide valid pain assessment
• Postoperative complications that may interfere with participation or pain assessment
• Contraindication to the assigned distraction method (e.g., intolerance to wearing a VR headset, severe nausea/dizziness, claustrophobia)
• Refusal or withdrawal of consent

Sponsors & Collaborators

• Izmir Tinaztepe University: lead

Study Sites (1)

Osmaniye State Hospital

Osmaniye, 80000, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Study Officials

• Songül Gungor

  Osmaniye State Hospital

  PRINCIPAL INVESTIGATOR

• Berna Dizer

  Izmir Tinaztepe University

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant professor

Study Record Dates

• First Submitted: January 22, 2026
• First Posted: January 29, 2026
• Study Start: January 14, 2025
• Primary Completion: January 10, 2026
• Study Completion: January 10, 2026
• Last Updated: January 30, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)