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- Title
Effectiveness of early versus delayed rehabilitation following total shoulder replacement: A systematic review.
- Authors
Moffatt, Maria; Whelan, Gareth; Gill, Peter; Mazuquin, Bruno; Edwards, Peter; Peach, Chris; Davies, Ronnie; Morgan, Marie; Littlewood, Chris
- Abstract
Objective: To investigate the effectiveness of early versus delayed rehabilitation following total shoulder replacement. Design: Intervention systematic review with narrative synthesis. Literature search: MEDLINE, EMBASE, CINAHL, Scopus and the Cochrane Library were searched from inception to the 29th of July 2021. Study selection criteria: Randomised controlled trials comparing early versus delayed rehabilitation following primary anatomic, primary reverse, or revision total shoulder replacement. Data synthesis: A revised Cochrane risk of bias assessment tool for randomised controlled trials was used, as well as the Grading of Recommendations Assessment, Development and Evaluation approach to evaluate the quality of evidence. A narrative synthesis was undertaken. Results: Three eligible randomised controlled trials (n = 230) were included. There was very low-quality evidence of no statistically significant difference (P > 0.05) in pain, shoulder function, health-related quality of life or lesser tuberosity osteotomy healing at 12 months between early or delayed rehabilitation. There was conflicting and very low-quality evidence of a difference between the effect of early and delayed rehabilitation on shoulder range of movement. There was limited, very low-quality evidence of statistically significantly improved pain and function (P < 0.05) in the early post-operative period with early rehabilitation following anatomic total shoulder replacement. Conclusions: No differences were seen in patient-reported or clinician-reported outcomes at 12 months post-surgery between early and delayed rehabilitation following total shoulder replacement. There is very low-quality evidence that early rehabilitation may improve shoulder pain and function in the early post-operative phase following anatomic total shoulder replacement.
- Subjects
SHOULDER physiology; CINAHL database; SHOULDER pain; WOUND healing; MEDICAL information storage &; retrieval systems; INFORMATION storage &; retrieval systems; MEDICAL databases; RANGE of motion of joints; TIME; SYSTEMATIC reviews; OSTEOTOMY; REVERSE total shoulder replacement; POSTOPERATIVE care; TREATMENT effectiveness; REOPERATION; DESCRIPTIVE statistics; QUALITY of life; MUSCLE strength; MEDLINE; TOTAL shoulder replacement; REHABILITATION; EVALUATION
- Publication
Clinical Rehabilitation, 2022, Vol 36, Issue 2, p190
- ISSN
0269-2155
- Publication type
Article
- DOI
10.1177/02692155211044137