Optimizing Outcomes After Reverse Total Shoulder Arthroplasty: Rehabilitation, Expected Outcomes, and Maximizing Return to Activities

Howard, Mark; Trasolini, Nicholas A.; Waterman, Brian R.

doi:10.1007/s12178-023-09823-5

Cited by 3 publications

(5 citation statements)

References 53 publications

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“…Despite the increasing use of RSA, the optimal postoperative management regimen ensuring the best patient outcomes is still debated. The literature regarding the various possibilities of rehabilitation is heterogeneous in methods and quality, and scant highquality evidence guides current rehabilitation protocols [8]. For instance, there is no clear consensus regarding the type of immobilization, the timing of rehabilitation, or the convenience of supervised versus home programs.…”

Section: Discussionmentioning

confidence: 99%

“…Despite remarkable benefits in terms of pain, function, and quality of life [3,4], there may be complications [5][6][7]. Optimal postoperative management is still debated; for instance, the impact of immobilization times and rehabilitation procedures on clinical outcomes [8]. In addition, there is no clear consensus on the rehabilitation guidelines.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, there is no clear consensus on the rehabilitation guidelines. However, rehabilitation is considered essential to maximize the Bioengineering 2024, 11, 152 2 of 12 return to basic daily functional activities or even more complex activities, such as sports practice [8].…”

Section: Introductionmentioning

confidence: 99%

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A Virtual Assistant to Guide Early Postoperative Rehabilitation after Reverse Shoulder Arthroplasty: A Pilot Randomized Trial

Blasco,

Navarro-Bosch,

Aroca-Navarro

et al. 2024

Bioengineering

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Introduction: Rehabilitation can improve outcomes after reverse shoulder arthroplasty (RSA). However, low adherence to rehabilitation and compliance rates are some of the main barriers. To address this public health issue, the goal of this research was to pilot test and evaluate the effectiveness of a chatbot to promote adherence to home rehabilitation in patients undergoing RSA. Methods: A randomized pilot trial including patients undergoing RSA and early postoperative rehabilitation was performed. The control group received standard home rehabilitation; the experimental group received the same intervention supervised with a chatbot, with automated interactions that included messages to inform, motivate, and remember the days and exercises for 12 weeks. Compliance with rehabilitation and clinical measures of shoulder function, pain, and quality of life were assessed. Results: 31 patients (17 experimental) with an average age of 70.4 (3.6) completed the intervention. Compliance was higher in the experimental group (77% vs. 65%; OR95% = 2.4 (0.5 to 11.4)). Statistically significant between-group differences with a CI of 95% were found in the QuickDASH questionnaire and self-reported quality of life. No differences were found in the rest of the measures. Conclusions: This pilot study suggests that the chatbot tool can be useful in promoting compliance with early postoperative home rehabilitation in patients undergoing RSA. Future randomized trials with adequate power are warranted to determine the clinical impact of the proposal.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Virtual Assistant to Guide Early Postoperative Rehabilitation after Reverse Shoulder Arthroplasty: A Pilot Randomized Trial

Blasco,

Navarro-Bosch,

Aroca-Navarro

et al. 2024

Bioengineering

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“…It is important to strengthen the remaining muscles, such as the deltoid, and protect the joint. While 4-6 weeks of immobilization is often recommended postoperatively, recent prospective studies have shown that early motion can improve patient-reported outcome scores with low complication rates [ 19 ]. TSA is achieved by implanting components into the humerus and the scapula.…”

Section: Discussionmentioning

confidence: 99%

“…THR is characterized by total shoulder arthroplasty (TSA) and total elbow arthroplasty (TEA). Regarding TSA, several studies have reported rehabilitation treatments [16][17][18][19][20][21]. It is important to strengthen the remaining muscles, such as the deltoid, and protect the joint.…”

Section: Rehabilitation Treatment For Thrmentioning

confidence: 99%

Rehabilitation Treatment of a Patient With Total Humeral Endoprosthetic Replacement

Choda,

Kanata,

Kodama

et al. 2024

Cureus

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Total humeral endoprosthetic replacement (THR) is a rare surgery for malignant humeral bone tumors. Studies focusing on its surgical methods and functional status are limited. Furthermore, rehabilitation treatment after THR has not been reported. Therefore, this case report aimed to investigate its postoperative rehabilitation treatment and reinstatement. A 69-year-old woman was diagnosed with chondrosarcoma of her left humerus. THR was performed the day following patient admission. The wide resection caused the loss of her left shoulder motor function. She had a left ulnar nerve disorder and carpal tunnel syndrome. Rehabilitation treatments such as joint range of motion training were initiated on postoperative day (POD) 1. We designed a shoulder abductor brace to maintain her left shoulder in an abducted and flexed position so she could use her left hand effectively. The manual muscle testing scores for elbow joint movements gradually improved. On POD47, she was transferred to a convalescent rehabilitation hospital to receive training in activities of daily living and barber work. The patient was discharged on POD107. The Disabilities of the Arm, Shoulder, and Hand score improved from 86.2 (POD7) to 17.2 (POD107). She continued outpatient rehabilitation and reinstated work on POD143. The use of a brace and seamless rehabilitation from the acute phase to convalescence and community-based rehabilitation enabled the patient with THR to return to work. This study suggests that precise assessment of the disorders and consecutive rehabilitation treatment with a brace should be considered after THR.

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The Effect of Enhanced Rehabilitation Program on Upper Limb Function in Patients Undergoing Abdominal Pedicle Flap Surgery

Chen,

Huang,

et al. 2024

Journal of Burn Care &Amp; Research

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To investigate the effect of an enhanced rehabilitation program on upper limb function in patients with abdominal pedicle flap surgery, we retrospectively analyzed 70 patients received abdominal pedicled flap surgery between 2017 and 2022. Patients were categorized into the traditional rehabilitation group (rehabilitation initiated after the stage Ⅱ pedicle dissection of the abdominal pedicle flap) and the enhanced rehabilitation group (rehabilitation initiated on the first day following the stage Ⅰ abdominal pedicle flap surgery). All the patients received identical rehabilitation protocols. PROM, ADL, FIM, and MMT were assessed at five days and one month following the stage Ⅱ surgery. The main causes of injury were electrical burns in both groups. The hospital stay of patients in the enhanced group was significantly shorter than the traditional group. One month assessment indicated both groups showed significant improvements in the PROM of shoulder flexion, abduction, and elbow extension compared to the five days assessment. Notably, at five days assessment, the enhanced group had significantly higher PROM in shoulder abduction and elbow extension compared to the traditional group. Furthermore, the enhanced group continued to exhibit higher PROM in shoulder flexion and abduction than the traditional group at one month assessment. At one month assessment, a significant increase was observed in the ADL, FIM, and MMT of both groups compared to the five days. The study indicated the enhanced rehabilitation program immediately following the stage Ⅰ surgery can effectively improve the PROM of the shoulder and elbow and reduce the length of hospital stay for patients.

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Optimizing Outcomes After Reverse Total Shoulder Arthroplasty: Rehabilitation, Expected Outcomes, and Maximizing Return to Activities

Cited by 3 publications

References 53 publications

A Virtual Assistant to Guide Early Postoperative Rehabilitation after Reverse Shoulder Arthroplasty: A Pilot Randomized Trial

A Virtual Assistant to Guide Early Postoperative Rehabilitation after Reverse Shoulder Arthroplasty: A Pilot Randomized Trial

Rehabilitation Treatment of a Patient With Total Humeral Endoprosthetic Replacement

The Effect of Enhanced Rehabilitation Program on Upper Limb Function in Patients Undergoing Abdominal Pedicle Flap Surgery

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