Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Wilrijk, Belgium.
Pain in Motion, International Research Group, Belgium.
Clin Rehabil. 2022 Oct;36(10):1369-1399. doi: 10.1177/02692155221106627. Epub 2022 Jun 13.
To summarize factors that are associated with a better treatment outcome after post-operative physical therapy in patients with shoulder arthroplasty.
PubMed, Cochrane, and Web of Science.
Studies examining factors that are associated with a better outcome after post-operative physical therapy interventions in patients with shoulder arthroplasty were included. Two independent reviewers performed screening, extracted data, and assessed the risk of bias and level of evidence, using the Quality In Prognosis Studies tool and Evidence-Based Guideline Development checklist. PRISMA guidelines were followed.
In total, 460 articles were found and 14 studies were included. Two of the included articles had a moderate risk of bias, 12 high. The overall number of patients in the included studies varied from 20 to 2053. Patients had either a reverse ( = 1863), an anatomic total shoulder arthroplasty ( = 1029) or, a hemiarthroplasty ( = 133). Anatomic total shoulder arthroplasty patients with a neutral rotation sling position showed less night pain and greater range of motion, which was awarded moderate evidence. Other modifiable and non-modifiable factors such as telemedicine, immediate range of motion exercises, and pre-operative function were only awarded preliminary or conflicting evidence.
Mainly preliminary and conflicting evidence was found. The possible causes of the conflicting evidence were the different measurement methods, implant types, and follow-up times used. The methodological quality was low and physical therapy protocols differed greatly. More high-quality research with standardized protocols is needed to determine the association of various factors with treatment outcomes after post-operative physical therapy in patients with shoulder arthroplasty.
总结肩关节置换术后物理治疗疗效相关的影响因素。
PubMed、Cochrane 和 Web of Science。
纳入评估肩关节置换术后物理治疗干预与疗效相关性的研究。由 2 名独立评审员进行筛选、数据提取和偏倚风险评估，并使用预后研究质量工具和循证指南制定清单评估证据质量。
共检索到 460 篇文献，最终纳入 14 项研究。其中 2 项研究存在中度偏倚，12 项研究存在高度偏倚。纳入研究的患者总数从 20 例至 2053 例不等，分别接受反向肩关节置换术（ = 1863 例）、解剖型全肩关节置换术（ = 1029 例）或半肩关节置换术（ = 133 例）。解剖型全肩关节置换术患者中立位旋转吊带固定可减少夜间疼痛和改善活动范围，获得中等质量证据。其他可改变和不可改变的因素，如远程医疗、即刻关节活动度锻炼和术前功能，仅获得初步或相互矛盾的证据。
本研究主要为初步和相互矛盾的证据。造成相互矛盾证据的可能原因是使用了不同的测量方法、假体类型和随访时间。研究方法质量低，物理治疗方案差异较大。需要更多高质量、标准化方案的研究来确定各种因素与肩关节置换术后物理治疗疗效的相关性。
