公开发布的解剖全肩关节置换术康复方案与 2020 ASSET 建议存在很大差异,且经常出现分歧。

IF 1.6 Q3 SPORT SCIENCES
International Journal of Sports Physical Therapy Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI:10.26603/001c.118926
Nabil Mehta, Alexander J Acuna, Johnathon R McCormick, William E Harkin, Hasani W Swindell, Steven F Defroda, Mike Reinold, Gregory P Nicholson, Grant E Garrigues
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引用次数: 0

摘要

背景:2020年,美国肩肘治疗师协会(ASSET)发布了一份循证共识声明,概述了解剖型全肩关节置换术(TSA)术后康复指南。目的:本研究旨在(1)量化在线解剖型TSA康复方案的差异性,(2)评估其与ASSET共识指南的一致性:本研究是一项横断面调查,调查对象是可公开获得的在线解剖 TSA 康复方案。2022 年 4 月,我们在网上搜索了可公开获得的 TSA 康复方案。每份收集到的方案都由两位作者独立审核,以确定有关固定、被动活动范围(PROM)和主动活动范围(AROM)的启动和进展,以及加强和术后锻炼和活动的启动和进展的建议。各种康复项目的开始时间记录为方案允许的活动或运动阈值的时间。对 ASSET 的开始时间和所纳入方案的平均开始时间进行了比较:结果:在纳入的 191 家学术机构中,有 46 家(24.08%)在网上公开了协议,共有 91 份独特的协议被纳入最终分析。所纳入的方案在术后固定的持续时间和类型、开始早期拉伸、PROM、AROM、阻力练习和恢复运动方面存在很大差异。在 ASSET 和收录方案报告的 37 项建议中,有 31 项(83.78%)在组间存在显著差异(P/结论:发现在线 TSA 术后方案之间存在很大差异,与 ASSET 指南有很大偏差。这些发现凸显了解剖TSA术后康复方案缺乏标准化:3b.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Publicly Available Anatomic Total Shoulder Arthroplasty Rehabilitation Protocols Show High Variability and Frequent Divergence from the 2020 ASSET Recommendations.

Background: In 2020, the American Society of Shoulder and Elbow Therapists (ASSET) published an evidence-based consensus statement outlining postoperative rehabilitation guidelines following anatomic total shoulder arthroplasty (TSA).

Purpose: The purpose of this study was to (1) quantify the variability in online anatomic TSA rehabilitation protocols, and (2) assess their congruence with the ASSET consensus guidelines.

Methods: This study was a cross-sectional investigation of publicly available, online rehabilitation protocols for anatomic TSA. A web-based search was conducted in April 2022 of publicly available rehabilitation protocols for TSA. Each collected protocol was independently reviewed by two authors to identify recommendations regarding immobilization, initiation, and progression of passive (PROM) and active range of motion (AROM), as well as the initiation and progression of strengthening and post-operative exercises and activities. The time to initiation of various components of rehabilitation was recorded as the time at which the activity or motion threshold was permitted by the protocol. Comparisons between ASSET start dates and mean start dates from included protocols were performed.

Results: Of the 191 academic institutions included, 46 (24.08%) had publicly available protocols online, and a total of 91 unique protocols were included in the final analysis. There were large variations seen among included protocols for the duration and type of immobilization post-operatively, as well as for the initiation of early stretching, PROM, AROM, resistance exercises, and return to sport. Of the 37 recommendations reported by both the ASSET and included protocols, 31 (83.78%) were found to be significantly different between groups (p\<0.05).

Conclusion: Considerable variability was found among online post-operative protocols for TSA with substantial deviation from the ASSET guidelines. These findings highlight the lack of standardization in rehabilitation protocols following anatomic TSA.

Level of evidence: 3b.

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来源期刊
CiteScore
2.50
自引率
5.90%
发文量
124
审稿时长
16 weeks
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