Effects of Stress Ball Use and Breathing Exercises on Pain and Vital Signs During Drain Removal After Total Knee Arthroplasty
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: 3. Control Group Description, 1. Stress Ball Intervention Description, 2. Breathing Exercise Intervention Description.
- Who it may be relevant to
- Registry conditions: Total Knee Arthroplasty, Total Knee Arthroplasty Recovery, Pain After Knee Arthroscop. Basic parameters: No limits · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
The Effect of Stress Ball Use and Breathing Exercises on Procedural Pain and Vital Signs During Drain Removal After Total Knee Arthroplasty: A Randomized Controlled Trial
Overview
This randomized controlled trial aims to evaluate the effects of stress ball use and breathing exercises on procedural pain and vital signs during drain removal in patients undergoing total knee arthroplasty. Although drain removal is a short procedure, it is often associated with sudden and intense pain and may trigger physiological stress responses such as increased heart rate, blood pressure, and respiratory rate. A total of 105 patients will be randomly assigned to three groups: stress ball group, breathing exercise group, and standard care group. The interventions will be applied starting one minute before drain removal, continuing throughout the procedure, and for two minutes afterward. Pain levels will be assessed using the Numeric Rating Scale (NRS), and vital signs (heart rate, blood pressure, respiratory rate, and oxygen saturation) will be measured at predefined time points before, during, and after the procedure. The findings of this study are expected to provide evidence on the effectiveness of simple, non-pharmacological interventions in reducing procedural pain and improving physiological stability during drain removal
Interventions
- Behavioral 3. Control Group Description
Participants will receive standard care, including routine information about the drain removal procedure, without any additional intervention such as stress ball use or breathing exercises. - Behavioral 1. Stress Ball Intervention Description
Participants will be provided with a medium-resistance stress ball and instructed to rhythmically squeeze and release it starting one minute before drain removal, continuing throughout the procedure, and for two minutes after the procedure. A brief explanation will be given prior to the intervention. - Behavioral 2. Breathing Exercise Intervention Description
Participants will be instructed in diaphragmatic breathing techniques before the procedure. They will begin deep breathing one minute before drain removal, continue throughout the procedure, and for two minutes afterward. The technique includes slow inhalation through the nose, holding the breath for a few seconds, and slow exhalation through the mouth.
Primary outcome measures
- Pain Intensity (Numeric Rating Scale, NRS [Time frame: Baseline, immediately after drain removal, 15 minutes, and 30 minutes after the procedur]
- Heart Rate [Time frame: Baseline, immediately after drain removal, 15 minutes, and 30 minutes after the procedur]
- Blood Pressure [Time frame: Baseline, immediately after drain removal, 15 minutes, and 30 minutes after the procedur]
- Oxygen Saturation [Time frame: Baseline, immediately after drain removal, 15 minutes, and 30 minutes after the procedur]
- Respiratory Rate [Time frame: Baseline, immediately after drain removal, 15 minutes, and 30 minutes after the procedur]
Eligibility criteria
Inclusion criteria
- Adults aged 18 years and older undergoing primary total knee arthroplasty
- Patients with a surgical drain in place and scheduled for drain removal in the postoperative period
- Able to provide informed consent
- Able to communicate and understand instructions
Exclusion criteria
- Patients with chronic pain syndromes or regular opioid use
- Patients with cognitive impairment, delirium, or communication difficulties
- Patients with contraindications to drain removal (e.g., active bleeding, hemodynamic instability)
- Patients with neurological conditions affecting pain perception
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Supportive care
Study locations
Center list to be confirmed — check the primary protocol.
Publications
- 17. Ataman Yıldız G, Çınar F, Kadiroğulları E, Eti Aslan F. The effect of applications on pain after open and closed heart surgery: Descriptive research. Turkiye Klinikleri J Cardiovasc Sci. 2024;36(1):1-10.
- Bahar A, Yardimci I. Effect of breathing exercises applied before chest tube removal on pain and anxiety levels: descriptive and correlational research. Psychol Health Med. 2025 Dec;30(10):2388-2398. doi: 10.1080/13548506.2025.2519221. Epub 2025 Jun 25. PMID 40560956
- Genc H, Korkmaz M, Akkurt A. The Effect of Virtual Reality Glasses and Stress Balls on Pain and Vital Findings During Transrectal Prostate Biopsy: A Randomized Controlled Trial. J Perianesth Nurs. 2022 Jun;37(3):344-350. doi: 10.1016/j.jopan.2021.09.006. Epub 2022 Apr 7. PMID 35397973
- 1. Kuzuca BC, Güçlü B. Total diz artroplastisi öncesi planlama. TOTBİD Dergisi. 2021;20:507-514.
Identifiers
NCT: NCT07586436 · HY-TDP-01