Is a formal physical therapy program necessary after total shoulder arthroplasty for osteoarthritis?
| Autor: | Page Dunning, Derek Pupello, Mark A. Frankle, Jason O. Holcomb, R. Kent Bogle, Michele Pliner, Philip J. Mulieri |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment Patient satisfaction Surveys and Questionnaires Arthropathy Osteoarthritis Medicine Humans Orthopedics and Sports Medicine Arthroplasty Replacement Range of Motion Articular Physical Therapy Modalities Aged Retrospective Studies Rehabilitation business.industry Shoulder Joint Retrospective cohort study General Medicine Recovery of Function Middle Aged medicine.disease Arthroplasty Surgery medicine.anatomical_structure Treatment Outcome Sample size determination Patient Satisfaction Physical therapy Shoulder joint Female business Range of motion Follow-Up Studies Program Evaluation |
| Zdroj: | Journal of shoulder and elbow surgery. 19(4) |
| ISSN: | 1532-6500 |
| Popis: | Hypothesis A retrospective analysis was conducted of 2 consecutive groups of patients undergoing total shoulder arthroplasty (TSA) for primary osteoarthritis. One group was treated with formal physical therapy (PT), and one group was treated with home-based, physician-guided PT. We hypothesized that patients with a formal postoperative PT protocol would have significantly better postoperative clinical outcomes than patients with no formal PT. Methods Group A (43 patients) had a standard PT program. Group B (38 patients) had a home-based, physician-guided PT program. Clinical outcomes (preoperatively, 3, 6, and 12 months and most recent follow-up) were analyzed. A minimum sample size of 31 patients gives power to detect a 10-point American Shoulder and Elbow Surgeons (ASES) score (α = 0.05, β = 0.80). Results ASES and Simple Shoulder Test (SST) scores significantly improved in both groups at all follow-up periods. Forward flexion and abduction were significantly improved in group B at all time points, whereas an initial improvement in forward flexion and abduction in group A was lost at final follow-up. There were no significant differences in final ASES or SST scores between groups at final follow-up. However, forward flexion, abduction, and the Short Form-36 physical component summary in group B were significantly better than group A at final follow-up. No significant improvements in internal rotation or SF-36 mental component summary were seen within or between the groups at final follow-up. Overall, there was no difference in patient satisfaction, with 88% satisfaction in group A and 95% satisfaction in group B (χ 2 = 0.471, P = .4924). Conclusions A home-based, physician-guided therapy program may provide adequate rehabilitation after TSA, allowing for a reduction in cost for the overall procedure. |
| Databáze: | OpenAIRE |
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