Comparing Outcomes After Referral to Physical Therapy for Patients With Glenohumeral Osteoarthritis Based on the Radiographic Osteoarthritis Severity: A Retrospective Analysis.

Autor:	Baumann AN; Department of Rehabilitation Services, University Hospitals, Cleveland, USA., Indermuhle T; College of Medicine, Northeast Ohio Medical University, Rootstown, USA., Oleson CJ; College of Medicine, Northeast Ohio Medical University, Rootstown, USA., Callaghan ME; College of Medicine, Case Western Reserve University, Cleveland, USA., Rogers H; College of Medicine, Northeast Ohio Medical University, Rootstown, USA., Pennacchio C; College of Medicine, Case Western Reserve University, Cleveland, USA., Curtis DP; College of Medicine, Northeast Ohio Medical University, Rootstown, USA., Leland JM 3rd; Department of Orthopedic Surgery, University Hospitals, Cleveland, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Aug 06; Vol. 15 (8), pp. e43027. Date of Electronic Publication: 2023 Aug 06 (Print Publication: 2023).
DOI:	10.7759/cureus.43027
Abstrakt:	Introduction Glenohumeral osteoarthritis (GHOA) is a common cause of musculoskeletal pain (MSP) that can frequently lead to pain and functional disability in patients throughout the world. GHOA can be managed with conservative or surgical interventions, although conservative interventions, such as physical therapy (PT), are generally first-line interventions depending on the severity of GHOA. The purpose of this retrospective analysis was to examine how conventional PT impacts outcomes for patients with GHOA based on the severity of radiographic GHOA findings. Methods This study is a retrospective chart review of patients who were referred to PT for MSP and received PT in the outpatient setting between 2016 and 2022. Inclusion criteria were patients who received PT in the outpatient setting, received PT for MSP, had shoulder radiograph imaging within two years of initial PT evaluation, had more than one PT visit (i.e. attended a follow-up session after initial evaluation), and did not have a history of shoulder surgery. Primary outcome measures were pain, abduction active range-of-motion (AROM), and disability via the quick disabilities of the arm, shoulder, and hand (DASH). Patients were divided into the No GHOA group (n=104), Mild GHOA group (n=61), and Moderate/Severe GHOA group (n=55) based on the radiographic GHOA severity. Results All included patients (n=220) had a mean age of 62.2 ± 12.4 years old with a mean number of PT visits of 7.8 ± 4.5 visits. There was initially a significant difference in the magnitude of pain improvement between the three groups based on radiographic severity of GHOA (Kruskal-Wallis H=6.038; p=0.049); however, post hoc testing revealed no significant difference between any of the three groups for pain improvement (p=0.061 to p=1.000). There was also no significant difference in the magnitude of abduction AROM improvement between the three groups based on the radiographic severity of GHOA (Kruskal-Wallis H=2.887; p=0.236). Finally, there was no significant difference in the magnitude of disability improvement via the Quick DASH between the three groups based on the radiographic severity of GHOA (Kruskal-Wallis H=0.156; p=0.925). Conclusion Patients with GHOA referred to PT experience small but statistically significant short-term improvements in pain, abduction AROM, and disability regardless of GHOA radiographic severity. There is no significant association between the magnitude of clinical improvement and the severity of radiographic GHOA. However, despite statistically significant improvements in pain, only patients with mild GHOA experienced clinically significant improvements in pain. Patients with GHOA, regardless of severity, may or may not experience clinically significant improvements in disability after PT. Competing Interests: The authors have declared financial relationships, which are detailed in the next section. (Copyright © 2023, Baumann et al.)
Databáze:	MEDLINE
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