Physical therapy prehabilitation on a reverse total shoulder replacement candidate: a case study.
James F Villers, Jacob Burch, Mark Scheller and 1 others
PMID 32158084WHAT IT FOUND
A single patient with severe shoulder pain and a recommended replacement surgery completed five weeks of physical therapy exercises.
He reported improved mobility and pain relief, leading him to indefinitely postpone the operation.
Key findings
01The patient completed a five-week prehabilitation program consisting of six home exercises and therapist-delivered spinal mobilization.
02At the end of the program, the patient's shoulder pain and disability index score decreased from 36.0% to 20.8%, and his active shoulder flexion improved from 60 degrees to 163 degrees.
03The patient elected to indefinitely postpone his reverse total shoulder replacement surgery because his goals for pain control and mobility had been met.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a single case report, so the results cannot be generalized to other patients with shoulder pathology. The patient had excellent self-reported compliance (≥90%) with his home exercises, which may not be typical for other patients. There was no control group, so it is impossible to know if the improvement was due to the therapy, natural history, or other factors. The patient did not undergo the surgery, so the effect of the prehabilitation on post-surgical outcomes is unknown.
Declared interests
None declared.
The easy way to misread this
Do not conclude that physical therapy prehabilitation reliably prevents the need for shoulder replacement surgery. This describes the outcome of one highly compliant patient; it is not evidence that this intervention will work for others.