Effectiveness of formal physical therapy following total shoulder arthroplasty: A systematic review

Edwards, Peter K.; Ebert, Jay R.; Littlewood, Chris; Ackland, Tim; Wang, Allan

Abstract

Background: Physical therapy is considered routine practice following total shoulder arthroplasty. To date, current regimens are based on clinical opinion, with evidence-based recommendations. The aim of this systematic review was to evaluate the effectiveness of total shoulder arthroplasty physical therapy programmes with a view to inform current clinical practice, as well as to develop a platform upon which future research might be conducted.

Methods: An electronic search of MEDLINE, EMBASE, CINAHL and Cochrane Library to March 2018 was complemented by hand and citation-searching. Studies were selected in relation to pre-defined criteria. A narrative synthesis was undertaken.

Results: A total of 506 papers were identified in the electronic database search, with only one study showing moderate evidence of early physical therapy promoting a more rapid return of short-term improvement in function and pain. No studies evaluated the effectiveness of physical therapy programmes in reverse total shoulder arthroplasty procedures.

Discussion: Restoring range of motion and strength following total shoulder arthroplasty is considered important for patients to obtain a good outcome post-surgery and, when applied early, may offer more rapid recovery. Given the rising incidence of total shoulder arthroplasties, especially reverse total shoulder arthroplasty, there is an urgent need for high-quality, adequately powered randomised controlled trials to determine the effectiveness of rehabilitation programmes following these surgeries.

Citation

Edwards, P. K., Ebert, J. R., Littlewood, C., Ackland, T., & Wang, A. (2018). Effectiveness of formal physical therapy following total shoulder arthroplasty: A systematic review. Shoulder and Elbow, 12(2), 136-143. https://doi.org/10.1177/1758573218812038

• Journal Article Type: Article
• Acceptance Date: Oct 9, 2018
• Online Publication Date: Nov 25, 2018
• Publication Date: Nov 25, 2018
• Deposit Date: Nov 25, 2024
• Publicly Available Date: Nov 29, 2024
• Journal: Shoulder & Elbow
• Print ISSN: 1758-5732
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 12
• Issue: 2
• Pages: 136-143
• DOI: https://doi.org/10.1177/1758573218812038
• Keywords: physical therapy, rehabilitation, reverse shoulder arthroplasty, total shoulder arthroplasty