Physiotherapy Rehabilitation Strategies to Improve Clinical Outcomes Following Joint Debridement in the Case of Shoulder Joint Tuberculosis

Abstract

Background: The shoulder joint tuberculosis (TB) is a rare disease. The shoulder joint is involved in 1–10.5% of the population with skeletal tuberculosis. The diagnosis of disease at an early stage is difficult, delaying the treatment and leading to poor quality of life. Case summary: A 48-year-old female with shoulder joint debridement in a case of right shoulder joint tuberculosis presented with complaints of pain, weakness, and functional immobility of the right shoulder. Physiotherapy rehabilitation was given to her three days a week for the period of four months, including electrotherapeutic modality, electrical stimulation, therapeutic exercises, and upper body ergometer training. Range of motion (ROM), muscle strength, and shoulder pain and disability index (SPADI) were used as outcome measures .As a result of physiotherapy rehabilitation, patient was able to achieve an optimal functional range of motion of flexion (from 10⁰ to 100⁰), abduction (from 20⁰ to 85⁰), extension (from 5⁰ to 15⁰), internal rotation (from 28⁰ to 35⁰) and external rotation (from 35⁰ to 40⁰), overall improvement in shoulder joint muscles strength from grade 2 to 3, and reduction in shoulder pain and disability index from 86% to 41% despite having marked bony destruction. Conclusion: Physiotherapy rehabilitation strategies were found to be effective for improving shoulder joint function after joint debridement in the case of shoulder joint tuberculosis. The patient achieved a functional state sooner than the patients documented in currently available literature for this diagnosis. KEY WORDS: Tuberculosis, Extra-pulmonary, Shoulder joint, Physiotherapy.