Patient Perceptions of Acute Phases of Rehabilitation Following Shoulder Arthroplasty

Stith, Elizabeth Horrall; Borrero, Lisa; Santurri, Laura; Breeden, Lori; Shemanski, Sarah

doi:10.15453/2168-6408.1642

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…Sleep disturbances have been attributed to a positional requirement, inability to sleep in the preferred position and temperature cha nges. 7 Weinberg et al showed a progressive improvement of sleep quality after TSA, which returned to normal limits at 12 months after surgery. 15 In this study, we demonstrate that sleep disturbances peak before 6 weeks and are much less thereafter, which could reflect the association of sleep disturbances with sling use and restrictions related to positioning of the arm.…”

Section: Discussionmentioning

confidence: 94%

Patterns of limitations in activities of daily living, sleep, and pain in the early postoperative period following total shoulder arthroplasty: a prospective study

Kolade¹,

Ghosh²,

Buchalter³

et al. 2023

JSES International

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Section: Discussionmentioning

confidence: 94%

Patterns of limitations in activities of daily living, sleep, and pain in the early postoperative period following total shoulder arthroplasty: a prospective study

Kolade¹,

Ghosh²,

Buchalter³

et al. 2023

JSES International

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“…In contrast, some patients in the early rehabilitation group felt more confident and had the perception that moving their shoulder was contributing to their recovery. Another qualitative study [ 44 ] exploring patients perceptions of rehabilitation after shoulder arthroplasty reported that the sling, especially when using an abduction component, was impairing their sleep. Patients reported that they were unable to sleep because of the position, itching and temperature changes.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of early versus delayed rehabilitation following rotator cuff repair: Systematic review and meta-analyses

et al. 2021

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Objective To investigate the effectiveness of early rehabilitation compared with delayed/standard rehabilitation after rotator cuff repair for pain, function, range of movement, strength, and repair integrity. Design Systematic review and meta-analyses. Methods We searched databases and included randomised controlled trials (RCTs) comparing early with delayed/standard rehabilitation for patients undergoing rotator cuff repair surgery. We assessed risk of bias of the RCTs using the Cochrane RoB 2 tool. Results Twenty RCTs, with 1841 patients, were included. The majority of the RCTs were of high or unclear risk of overall bias. We found substantial variations in the rehabilitation programmes, time in the sling and timing of exercise progression. We found no statistically significant differences for pain and function at any follow-up except for the outcome measure Single Assessment Numeric Evaluation at six months (MD: 6.54; 95%CI: 2.24–10.84) in favour of early rehabilitation. We found statistically significant differences in favour of early rehabilitation for shoulder flexion at six weeks (MD: 7.36; 95%CI: 2.66–12.06), three (MD: 8.45; 95%CI: 3.43–13.47) and six months (MD: 3.57; 95%CI: 0.81–6.32) and one year (MD: 1.42; 95%CI: 0.21–2.64) and similar differences for other planes of movement. In terms of repair integrity, early mobilisation does not seem to increase the risk of re-tears (OR:1.05; 95%CI: 0.64–1.75). Discussion Current approaches to early mobilisation, based largely on early introduction of passive movement, did not demonstrate significant differences in most clinical outcomes, although we found statistically significant differences in favour of early rehabilitation for range of movement. Importantly, there were no differences in repair integrity between early and delayed/standard rehabilitation. Most rehabilitation programmes did not consider early active movement as soon as the patient feels able. With ongoing variation in rehabilitation protocols there remains a need for large high quality RCT to inform the optimal approach to rehabilitation after rotator cuff repair surgery.

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“…In contrast, those patients in the early group felt more confident and had the perception that moving their shoulder was contributing to their recovery. Another qualitative study (43) exploring patients perceptions of rehabilitation after shoulder arthroplasty reported that the sling, especially when using an abduction component, was impairing patients sleep. Patients reported that they were unable to sleep because of the position, itching and temperature changes.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of early versus delayed rehabilitation following rotator cuff repair: systematic review and meta-analyses

Mazuquin

Moffatt

Gill

et al. 2021

Preprint

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Objective: To investigate the effectiveness of early rehabilitation compared with delayed/standard rehabilitation after rotator cuff repair for pain, function, range of movement, strength, and repair integrity. Design: Systematic review and meta-analyses. Methods: We searched databases and included randomised controlled trials (RCTs) comparing early with delayed/standard rehabilitation for patients undergoing rotator cuff repair surgery. We assessed risk of bias of the RCTs using the Cochrane RoB 2 tool. Results: Twenty RCTs, with 1841 patients, were included. The majority of the RCTs were of high or unclear risk of overall bias. We found substantial variations in the rehabilitation programmes, time in the sling and timing of exercise progression. We found no statistically significant differences for pain and function at any follow-up except for the outcome measure Single Assessment Numeric Evaluation at six months (MD: 6.54; 95%CI: 2.24-10.84) in favour of early rehabilitation. We found statistically significant differences in favour of early rehabilitation for shoulder flexion at six weeks (MD: 7.36; 95%CI: 2.66-12.06), three (MD: 8.45; 95%CI: 3.43-13.47) and six months (MD: 3.57; 95%CI: 0.81-6.32) and one year (MD: 1.42; 95%CI: 0.21-2.64) and similar differences for other planes of movement. In terms of repair integrity at one year, regarding early mobilisation, the number needed to harm was 651. Discussion: Current approaches to early mobilisation, based largely on early introduction of passive movement, did not demonstrate significant differences in most clinical outcomes, although we found statistically significant differences in favour of early rehabilitation for range of movement. Importantly, there were no differences in repair integrity between early and delayed/standard rehabilitation. Most rehabilitation programmes did not consider early active movement as soon as the patient feels able. With ongoing variation in rehabilitation protocols there remains a need for large high quality RCT to inform the optimal approach to rehabilitation after rotator cuff repair surgery.

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Patient Perceptions of Acute Phases of Rehabilitation Following Shoulder Arthroplasty

Cited by 5 publications

References 25 publications

Patterns of limitations in activities of daily living, sleep, and pain in the early postoperative period following total shoulder arthroplasty: a prospective study

Patterns of limitations in activities of daily living, sleep, and pain in the early postoperative period following total shoulder arthroplasty: a prospective study

Effectiveness of early versus delayed rehabilitation following rotator cuff repair: Systematic review and meta-analyses

Effectiveness of early versus delayed rehabilitation following rotator cuff repair: systematic review and meta-analyses

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