McDevitt Amy, Cleland Joshua, Hiefield Paisley, Bravman Jonathan, Snodgrass Suzanne
Physical Medicine and Rehabilitation University of Colorado Denver.
Department of Public Health and Community Medicine Tufts University School of Medicine.
Int J Sports Phys Ther. 2024 Nov 1;19(11):1477-1489. doi: 10.26603/001c.123950. eCollection 2024.
Surgery for the management of individuals with long head of the biceps tendon (LHBT) tendinopathy is common. Little is known about physical therapy (PT) utilization prior to surgery. The purpose of this review was to investigate the use of PT prior to biceps tenodesis and tenotomy surgeries by assessing the number of visits and the types of interventions. A secondary objective was to report on themes of PT interventions.
A retrospective observational cohort study design was used to analyze medical records and report on patient visits, procedure codes based on active or passive interventions, and themes of interventions utilized by PT.
Patient records (n=308) were screened for eligibility, n=62 (20.1%) patients attended PT prior to surgery. The median number of PT visits was four (IQR=3.5), and 39/62 (63%) patients had four or more visits to PT. Active interventions were used in 54.5% (533/978) of the codes billed; passive interventions were used in 45.5% (445/978) of the codes. There was high utilization of therapeutic exercise [93.4% (498/533) of active procedure codes] including muscle performance/resistance, functional activity, motor control and stretching. Manual therapy [84.3% (375/445) of passive procedure codes] included soft tissue mobilization, non-thrust manipulation (glenohumeral joint and cervical spine) and thrust manipulation (thoracic spine).
PT was not commonly utilized prior to undergoing biceps tenodesis and tenotomy surgery. Further research is needed to understand the reasons for low utilization.
3b.
对肱二头肌长头肌腱（LHBT）病患者进行手术治疗很常见。关于手术前物理治疗（PT）的使用情况知之甚少。本综述的目的是通过评估就诊次数和干预类型，调查在肱二头肌固定术和肌腱切断术之前PT的使用情况。第二个目标是报告PT干预的主题。
采用回顾性观察队列研究设计，分析病历并报告患者就诊情况、基于主动或被动干预的程序代码以及PT使用的干预主题。
筛选患者记录（n = 308）以确定 eligibility，62名（20.1%）患者在手术前接受了PT治疗。PT就诊的中位数为4次（IQR = 3.5），62名患者中有39名（63%）就诊4次或更多次。在开具账单的代码中，54.5%（533/978）使用了主动干预；45.5%（445/978）使用了被动干预。治疗性运动的使用率很高[主动程序代码的93.4%（498/533）]，包括肌肉性能/阻力、功能活动、运动控制和拉伸。手法治疗[被动程序代码的84.3%（375/445）]包括软组织松动术、非推力手法（盂肱关节和颈椎）和推力手法（胸椎）。
在接受肱二头肌固定术和肌腱切断术之前，PT的使用并不普遍。需要进一步研究以了解使用率低的原因。
3b。
