Martinez-Rico Sandra, Lizaur-Utrilla Alejandro, Sebastia-Forcada Emilio, Vizcaya-Moreno Maria F, de Juan-Herrero Joaquin
Sandra Martinez-Rico, OrthPT, Shoulder Unit, Department of Orthopaedic Surgery, Elda University Hospital, Ctra Elda-Sax s/n, Elda, Alicante, Spain. Alejandro Lizaur-Utrilla, PhD, Shoulder Unit, Department of Orthopaedic Surgery, Elda University Hospital, Ctra Elda-Sax s/n, Elda, Alicante, Spain; and Nursing Department, Faculty of Health Sciences, University of Alicante, Ctra San Vicente Raspeig s/n, Alicante, Spain. Emilio Sebastia-Forcada, MD, Shoulder Unit, Department of Orthopaedic Surgery, Elda University Hospital, Ctra Elda-Sax s/n, Elda, Alicante, Spain. Maria F. Vizcaya-Moreno, PhD, Nursing Department, Faculty of Health Sciences, University of Alicante, Ctra San Vicente Raspeig s/n, Alicante, Spain. Joaquin de Juan-Herrero, PhD, Nursing Department, Faculty of Health Sciences, University of Alicante, Ctra San Vicente Raspeig s/n, Alicante, Spain.
Orthop Nurs. 2018 Nov/Dec;37(6):372-378. doi: 10.1097/NOR.0000000000000501.
The purpose of this study was to assess the impact of a phone assistance nursing program as an adjunct to conventional physiotherapy to increase adherence to a home exercise program on functional outcomes of patients who underwent shoulder instability surgery.
A randomized controlled study of 70 patients allocated to a phone assistance program (study group, n = 36 patients) or conventional postoperative management (control group, n = 34 patients) was conducted. All patients in both groups received conventional rehabilitation at the outpatient clinic after surgery. In addition, patients in the study group received phone calls from a nurse (who had access to a physiotherapist) 3 days per week. During the calls these patients received a coaching session about self-care and support with the home exercise program. Evaluations were performed during a follow-up of 12 months for range of motion (ROM), pain (visual analog scale [VAS] score), Disability of the Arm, Shoulder, and Hand (DASH) score, Oxford Shoulder Instability Score (OSIS), and Rowe score.
All scores significantly improved from preoperative to the final follow-up in both groups (p = .001). At the final follow-up, there were no significant differences between groups in VAS, DASH, or Rowe scores. However, those in the study group had significantly better OSIS (p = .013) and ROM (p = .001), particularly for anterior forward motion (p = .001). Likewise, the study group achieved full motion and function significantly faster than the control group (p = .002). The amount of rehabilitation sessions at the outpatient clinic was 1.7 times higher in the control group (p = .004) than in the study group.
The phone assistance nursing program was an effective procedure to significantly improve the outcomes of conventional physiotherapy in patients who have undergone an operation for shoulder instability.
本研究旨在评估电话协助护理计划作为传统物理治疗辅助手段，对接受肩关节不稳定手术患者家庭锻炼计划依从性及功能结局的影响。
对70例患者进行随机对照研究，分为电话协助计划组（研究组，n = 36例患者）和传统术后管理组（对照组，n = 34例患者）。两组所有患者术后均在门诊接受传统康复治疗。此外，研究组患者每周3天会接到护士（可联系物理治疗师）的电话。通话期间，这些患者会接受关于自我护理的指导以及家庭锻炼计划的支持。在12个月的随访期间，对活动范围（ROM）、疼痛（视觉模拟量表[VAS]评分）、手臂、肩部和手部功能障碍（DASH）评分、牛津肩关节不稳定评分（OSIS）和罗伊评分进行评估。
两组患者从术前到最终随访时所有评分均显著改善（p = .001）。在最终随访时，两组在VAS、DASH或罗伊评分方面无显著差异。然而，研究组患者的OSIS（p = .013）和ROM（p = .001）显著更好，尤其是前向运动（p = .001）。同样，研究组比对照组显著更快地实现了完全活动和功能（p = .002）。对照组在门诊的康复治疗次数比研究组高1.7倍（p = .004）。
电话协助护理计划是一种有效的方法，可显著改善接受肩关节不稳定手术患者的传统物理治疗效果。
