Physiotherapy intervention on the improvement of post-surgical outcomes in patients with reverse total shoulder arthroplasty: a systematic review.

Abstract

To analyze the most current evidence to evaluate the effectiveness of physiotherapy interventions in improving post-surgical functional outcomes in patients who had undergone reverse total shoulder arthroplasty (RTSA). This systematic review was conducted by searching the PubMed and Embase databases and selecting studies including subjects who had undergone post-surgical rehabilitation after RTSA. Nine studies were selected with a total sample size of 394 patients followed during a period that varies between 3 and 24 months. All studies indicated substantial functional improvement in patients after a physiotherapy program. Regarding the American Shoulder and Elbow Surgeons scale, the multimodal physiotherapy intervention based on kinesiotherapy plus strengthening showed a small to moderate effect size (d Cohen = 0.47 - 0.56). This clinical relevance was very strong (d Cohen = 2.35) in the only study that included a detailed load progression together with functional activities. Furthermore, early intervention has been demonstrated to be effective with a moderate effect size (d Cohen = 0.52). The current evidence may confirm that an intervention based on early motion and strength exercise seems to be beneficial in functionality and range of motion in patients with reverse total shoulder arthroplasty.