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J. Chepeha1, A. Silveira1, D. Sheps2, L. Beaupre1
1University of Alberta, Department of Physical Therapy, Edmonton, Canada, 2University of Alberta, Department of Surgery, Division of Orthopaedics, Edmonton, Canada
Background: Shoulder pain and dysfunction represent two common patient complaints. No clear evidence exists on best rehabilitation practices for managing shoulder injuries.
Purpose: To determine best practices for managing patients with shoulder pathology. Specific questions were: (1) What impact does a standardized rehabilitation program have on pain, range of motion (ROM), strength and health related quality of life (HRQL)? (2) What proportion of patients recover when following the standardized program?
Methods: 143 participants with shoulder pathology requiring treatment for the first time were enrolled in a standardized active rehabilitation program that consisted of shoulder and upper trunk ROM, scapular stabilization training and rotator cuff strength exercises.
Outcomes of interest were pain, ROM, strength, HRQL. The program was considered unsuccessful if participants showed <15% change on the global Western Ontario Rotator Cuff [WORC] score within 6-months. Analyses used independent t-tests and Chi-square tests.
Outcomes of interest were pain, ROM, strength, HRQL. The program was considered unsuccessful if participants showed <15% change on the global Western Ontario Rotator Cuff [WORC] score within 6-months. Analyses used independent t-tests and Chi-square tests.
Results: The standardized rehabilitation program improved pain (p<0.001), ROM (p<0.04), strength (p<0.001), WORC (p<0.001) and quick-DASH scores (p<0.001) over a period of 6-months. The majority of participants (89%) improved with rehabilitation.
Conclusion(s): Appropriate active shoulder rehabilitation is effective in managing the large majority of patients presenting with generalized shoulder pathology. Significant improvements in pain, ROM, strength and HRQL occurred within 6-months.
Implications: Physical therapy is a common intervention used to treat patients with shoulder complaints. Standardized rehabilitation with an accompanying home program is effective in improving patient outcomes.
Funding, acknowledgements: This research was funded through the Workers' Compensation Board of Alberta in Alberta, Canada.
Keywords: Shoulder, Rehabilitation, Guidelines
Topic: Musculoskeletal: upper limb
Did this work require ethics approval? Yes
Institution: University of Alberta, Health Research Ethics Board (HREB)
Committee: HREB - Biomedical Panel
Ethics number: Pro00052670
All authors, affiliations and abstracts have been published as submitted.
