University of Florida
Difficulty with internal rotation (IR) after reverse shoulder arthroplasty (RSA) is common. Current rehabilitation protocols may not optimize IR. The investigator's objective is to assess the impact of prehabilitation focused on IR strengthening and mobility on RSA outcomes. The investigators will perform a prospective, randomized control trial to achieve the specific aim: assessing range of motion, strength, patient-reported outcomes, and activities of daily living requiring internal rotation between control and prehabilitation cohorts, with the prehabilitation patients receiving 6 weeks of treatment.
Reverse total shoulder arthroplasty (RSA) provides excellent restoration of overhead motion and pain relief, with durability demonstrated up to 20-years postoperatively.6 However, despite advancements in surgical technique and implants, internal rotation (IR) remains challenging for many patients after RSA, with a recent study demonstrating as many as 63% of patients reporting significant difficulty or inability to perform some activities of daily living (ADLs) requiring IR.5 Many studies have been conducted to identify demographic, surgical, and implant-related predictors of improved IR afte…
Inclusion Criteria: • Patients aged 40-80 * Undergoing primary RSA for glenohumeral osteoarthritis or rotator cuff arthropathy * Must be able to read and speak English * Willing and able to attend a monthly therapy session and perform exercises at home for a minimum of 6 weeks before surgery * Willing and able to participate in postoperative monitoring for a minimum of 2 years Exclusion Criteria: * Patients under the age of 40 and over the age of 80. * Diagnosis of septic shoulder, fracture, or fracture sequelae, or tumor pathology of the ipsilateral shoulder * Pre-existing hand, wrist, or…
subjects randomized to the IRTx cohort will also be instructed by a Physical or Occupational Therapist to perform the exercises described in the RSA IR Prehab Exercise Protocol handout, 5-7 times per week for 6 weeks.
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