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术后依从性和肩袖修复术后重返工作岗位:在工人赔偿治疗下,交互式在线康复计划对患者的价值。

Postoperative Compliance and Return to Work After Rotator Cuff Repair: Value of an Interactive Online Rehabilitation Program Among Patients Treated Under Workers' Compensation.

出版信息

Orthopedics. 2021 Mar-Apr;44(2):e197-e202. doi: 10.3928/01477447-20201119-07. Epub 2020 Nov 25.

Abstract

Outcomes after rotator cuff repair (RCR) typically are poorer for workers' compensation (WC) than for patients with private insurance. This study examined augmentation of the traditional rehabilitation protocol with an online exercise program. Between March 2016 and July 2018, 48 WC patients who underwent RCR were introduced to a digital rehabilitation program (application). Patients were divided into patients who used the application along with traditional physical therapy (PT) (group 1) and patients who underwent only traditional PT (group 2). Patient performance was assessed using standardized patient-reported outcome measures (PROMs), return-to-work (RTW) status, number of PT sessions, and complication/revision rate. Patients were monitored for a minimum of 1 year postoperatively. A significant improvement in RTW period was noted for group 1 patients, who resumed modified duty 10 weeks earlier than group 2 patients. A positive trend also was noted for return to full duty, with group 1 resuming full duty 7 weeks before group 2. There were no complications or reoperations in group 1 compared with 4 (16%) complications in group 2. The 2 groups underwent the same average number of PT sessions (27 sessions). Patient-reported outcome measures were captured only for group 1, which demonstrated average postoperative improvement of 3 points on a visual analog scale and 32.5 points in American Shoulder and Elbow Surgeons scores. Incorporating an online exercise program within the traditional rehabilitation protocol for WC patients undergoing RCR resulted in earlier return to work and was associated with better pain relief, greater return of function, and lower complication rate. [. 2021;44(2):e197-e202.].

摘要

肩袖修复 (RCR) 的术后结果通常对工人赔偿 (WC) 患者比私人保险患者更差。本研究考察了在传统康复方案中加入在线运动方案对结果的影响。2016 年 3 月至 2018 年 7 月,48 例接受 RCR 的 WC 患者被引入数字康复方案(应用程序)。患者被分为使用应用程序加传统物理治疗 (PT) 的组 1 和仅接受传统 PT 的组 2。使用标准化的患者报告结局测量 (PROMs)、重返工作 (RTW) 状态、PT 次数和并发症/再手术率评估患者的表现。患者术后至少随访 1 年。组 1 患者的 RTW 期显著缩短,比组 2 患者提前 10 周恢复修正后的工作。恢复全负荷工作也呈积极趋势,组 1 比组 2 提前 7 周。组 1 中无并发症或再手术,而组 2 中有 4 例(16%)并发症。2 组接受的平均 PT 次数相同(27 次)。仅对组 1 患者进行了 PROMs 评估,发现术后平均视觉模拟评分改善 3 分,美国肩肘外科评分改善 32.5 分。将在线运动方案纳入接受 RCR 的 WC 患者的传统康复方案中,可更早地恢复工作,且与更好的疼痛缓解、更大程度的功能恢复和更低的并发症发生率相关。[2021;44(2):e197-e202.]。

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