Davis Daniel E, Cox Ryan, Patel Manan S, Lazarus Mark, Ramsey Matthew, Namdari Surena
The Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA.
Arch Bone Jt Surg. 2020 Nov;8(6):661-667. doi: 10.22038/abjs.2020.42832.2164.
The primary goals of total shoulder arthroplasty (TSA) are to relieve pain, improve range of motion, and restore function. Physical therapy is commonly used to help achieve these goals. Recent evidence has pointed to the success and safety of a purely physician-guided, home-based or internet-based, program versus the traditional therapist guided program. The purpose of this study was to evaluate outcomes of TSA in patients using a web-based, home therapy program.
A retrospective review was performed of TSA patients who were given the option of using a web-based, home therapy program. Functional outcomes were collected preoperatively, 6-month, and 12-month post-operative examinations. Physical examination parameters were recorded at preoperative, 3-month, 6-month, and 12-month time-points.
Forty-seven patients used the web-based, home therapy program and had complete follow-up data at all time intervals. All mean range of motion parameters and functional scores improved significantly from preoperatively to postoperatively. There was one reported complication in a patient who sustained a subscapularis rupture and underwent subsequent open repair at 10 months postoperatively.
This study demonstrates successful improvements in range of motion and functional outcomes in a subset of patients who utilized an online therapy program after TSA. Future study will be necessary to directly compare results in patients enrolled in formal, outpatient therapy programs and to determine barriers to utilization of web-based therapy programs.
全肩关节置换术（TSA）的主要目标是缓解疼痛、改善活动范围并恢复功能。物理治疗通常用于帮助实现这些目标。最近的证据表明，与传统的治疗师指导方案相比，纯粹由医生指导的、基于家庭或基于互联网的方案具有成功性和安全性。本研究的目的是评估使用基于网络的家庭治疗方案的TSA患者的治疗效果。
对接受基于网络的家庭治疗方案选择的TSA患者进行回顾性研究。在术前、术后6个月和12个月的检查中收集功能结果。在术前、3个月、6个月和12个月的时间点记录体格检查参数。
47例患者使用了基于网络的家庭治疗方案，并在所有时间间隔都有完整的随访数据。从术前到术后，所有平均活动范围参数和功能评分均有显著改善。有1例患者报告出现并发症，该患者肩胛下肌破裂，术后10个月接受了开放修复。
本研究表明，一部分TSA术后使用在线治疗方案的患者在活动范围和功能结果方面取得了成功改善。未来有必要进行研究，以直接比较参加正规门诊治疗方案的患者的结果，并确定使用基于网络的治疗方案的障碍。
