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Physical therapy prehabilitation on a reverse total shoulder replacement candidate: a case study.

James F Villers1, Jacob Burch1, Mark Scheller1

  • 1Department of Physical Therapy, Angelo State University: ASU Station No. 10923, San Angelo, TX 76909-0923, USA.

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Physical therapy prehabilitation significantly reduced pain and improved function in a patient awaiting reverse total shoulder replacement (rTSR). This conservative approach allowed the patient to postpone surgery indefinitely.

Keywords:
Physical therapyPrehabilitationTotal shoulder replacement

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Area of Science:

  • Orthopedics
  • Physical Therapy
  • Sports Medicine

Background:

  • A 62-year-old male with rotator cuff tears and arthritis experienced shoulder pain and functional limitations.
  • The patient was scheduled for reverse total shoulder replacement (rTSR) to address his symptoms.

Observation:

  • The patient underwent a physical therapy (PT) prehabilitation program for approximately one month prior to his scheduled surgery.
  • The program included an initial evaluation and six treatment sessions focusing on pain reduction and functional improvement.

Findings:

  • Post-treatment, the patient reported decreased pain, improved posture, range of motion (ROM), and muscle strength.
  • These improvements led to a clinically significant enhancement in function, enabling him to postpone his rTSR.
  • At a three-month follow-up, the patient maintained or improved his functional outcomes and test measures.

Implications:

  • Physical therapy prehabilitation can effectively improve pre-operative outcomes for patients considering rTSR.
  • Prehab interventions may delay or potentially eliminate the need for rTSR surgery.
  • This case highlights the value of conservative management in shoulder osteoarthritis and rotator cuff pathology.