Villers James F, Burch Jacob, Scheller Mark, Huang Han-Hung
Department of Physical Therapy, Angelo State University: ASU Station No. 10923, San Angelo, TX 76909-0923, USA.
J Phys Ther Sci. 2020 Feb;32(2):197-205. doi: 10.1589/jpts.32.197. Epub 2020 Feb 14.
[Purpose] The purpose of this report is to describe the PT evaluation, prehab interventions, and outcomes of a patient pursuing reverse total shoulder replacement (rTSR) for pain reduction and functional gains. [Participant and Methods] A 62-year-old male self-referred to PT two months before his right rTSR. His chief complaints were right shoulder pain, stiffness, and functional impairment due to rotator cuff tendon tears and shoulder arthritis. He demonstrated poor posture, limited ROM, decreased strength, and diminished function. The PT prehab program consisted of an initial encounter followed by six treatment sessions across approximately one month. [Results] On the last visit, the patient's pain had meaningfully decreased along with improved posture, AROM, and muscle strength producing a clinically significant improvement in function resulting in the postponing of his rTSR. On a three months follow-up, the patient had maintained or improved in his test and measures and functional outcomes. He expressed satisfaction with the prehab outcomes and that he had indefinitely postponed his rTSR. [Conclusion] PT prehab program improved pre-operative measures on pain, posture, joint mobility, muscle strength, and function on a patient who had been scheduled for rTSR surgery. PT prehab program may delay the need for rTSR surgery.
[目的] 本报告旨在描述一名接受反式全肩关节置换术(rTSR)以减轻疼痛和改善功能的患者的物理治疗(PT)评估、术前康复干预及结果。[参与者与方法] 一名62岁男性在进行右肩rTSR手术前两个月自行前来接受PT治疗。他的主要诉求是由于肩袖肌腱撕裂和肩关节关节炎导致的右肩疼痛、僵硬及功能障碍。他存在姿势不良、活动范围受限、力量下降和功能减退的问题。PT术前康复计划包括初次评估,随后在大约一个月内进行六次治疗。[结果] 在最后一次就诊时,患者的疼痛明显减轻,姿势、主动活动范围(AROM)和肌肉力量均有所改善,功能得到了临床上显著的提升,从而推迟了他的rTSR手术。在三个月的随访中,患者在各项测试和测量以及功能结果方面保持或有所改善。他对术前康复结果表示满意,并已无限期推迟了rTSR手术。[结论] PT术前康复计划改善了一名计划接受rTSR手术患者在疼痛、姿势、关节活动度、肌肉力量和功能方面的术前指标。PT术前康复计划可能会延迟rTSR手术的需求。