Patients' perception of physical therapy after shoulder surgery

Formal physical therapy (PT) traditionally has been a critical part of postoperative recovery, but recently, because of cost containment, coverage of PT has become limited. Alternatives to formal PT have been proposed, including telerehabilitation, internet-based PT (IBPT), and home-based physician-guided PT. The purpose of this study was to understand patient perceptions of PT, the benefits, perception of improvements, access to PT, and alternative forms of PT after shoulder surgery.

Eighty patients who underwent orthopedic shoulder surgery were anonymously surveyed at one institution. Demographics, PT access, number of PT sessions, insurance, copayment, patients' perceptions of improvement, and their opinion about IBPT were collected. Answers were designed using Likert-scale or open-ended questions. Descriptive statistics were used to report survey data. Analyses were performed based on demographic variables using independent t-test, chi-square tests, and analysis of variance.

Patients attended an average of 16.3 ± 13.8 PT sessions, with 65% ± 32.2 attributing average improvement to their sessions. Average copay was $18 ± 20.8 per session, which 56.1% agreed was reasonable. Almost all patients (94.8%) agreed their therapist took time to educate them. Half (52.5%) disagreed that successful PT could be achieved by IBPT, and 68.6% of patients responded they would not consider using IBPT even after a few in-person sessions.

Patients have a positive perception of their therapist, cost, number of sessions, and utility of PT to impact improvements after orthopedic shoulder surgery. For IBPT to be a viable alternative, it should involve close engagement of a physical therapist given patients' perceptions of PT.