Variability in physical therapy protocols following total shoulder arthroplasty.

IF 1.8 Q2 ORTHOPEDICS
Samuel Schick, Alex Dombrowsky, Jamal Egbaria, Kyle D Paul, Eugene Brabston, Amit Momaya, Brent Ponce
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引用次数: 0

Abstract

Background: Physical therapy (PT) plays an important role in the recovery of function following anatomic total shoulder arthroplasty (aTSA). While several PT protocols have been published for these patients, there is no standardized protocol for aTSA rehabilitation. This lack of standardization may lead to confusion between patients and physicians, possibly resulting in suboptimal outcomes. This study examines how PT protocols provided by academic orthopedic surgery programs vary regarding therapeutic goals and activities following aTSA.

Methods: PT protocols for aTSA available online from the Accreditation Council for Graduate Medical Education accredited orthopedic surgery programs were included for review. Each protocol was analyzed to evaluate it for differences in recommendation of length of immobilization, range of motion (ROM) goals, start time for and progression of therapeutic exercises, and timing for return to functional activity.

Results: Of 175 accredited programs, 25 (14.2%) had protocols publicly available, programs (92%) recommended sling immobilization outside of therapy for an average of 4.4±2.0 weeks. Most protocols gave recommendations on starting active forward flexion (24 protocols, range 1-7 weeks), external rotation (22 protocols, range 1-7 weeks), and internal rotation (18 protocols, range 4-7 weeks). Full passive ROM was recommended at 10.8±5.7 weeks, and active ROM was 13.3±3.9 weeks, on average. ROM goals were inconsistent among protocols, with significant variations in recommended ROM and resistance exercise start times. Only 13 protocols (52%) gave recommendations on resuming recreational activities (mean, 17.4±4.4 weeks).

Conclusions: Publicly available PT protocols for aTSA rehabilitation are highly variable. Level of evidence: IV.

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Abstract Image

全肩关节置换术后物理治疗方案的可变性。
背景:物理治疗(PT)在解剖性全肩关节置换术(aTSA)术后功能恢复中起着重要作用。虽然针对这些患者已经发布了几种PT方案,但没有标准化的aTSA康复方案。这种缺乏标准化可能导致患者和医生之间的混淆,可能导致不理想的结果。本研究探讨了学术骨科外科项目提供的PT方案在aTSA后的治疗目标和活动方面的差异。方法:纳入经研究生医学教育认证委员会认可的骨科手术项目在线提供的aTSA的PT协议进行审查。对每个方案进行分析,以评估其在推荐的固定时间长度、活动范围(ROM)目标、治疗练习的开始时间和进展以及恢复功能活动的时间方面的差异。结果:175个认可的项目中,25个(14.2%)有公开的方案,项目(92%)推荐治疗外吊带固定平均4.4±2.0周。大多数方案建议开始主动前屈(24个方案,范围1-7周),外旋(22个方案,范围1-7周)和内旋(18个方案,范围4-7周)。全被动ROM平均为10.8±5.7周,主动ROM平均为13.3±3.9周。各方案的ROM目标不一致,推荐的ROM和阻力运动开始时间有显著差异。只有13个方案(52%)建议恢复娱乐活动(平均17.4±4.4周)。结论:公开提供的aTSA康复的PT方案是高度可变的。证据等级:四级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.30
自引率
0.00%
发文量
55
审稿时长
15 weeks
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