Telerehabilitation after arthroscopic subacromial decompression is effective and not inferior to standard practice: Preliminary results

J Telemed Telecare. 2018 Jul;24(6):428-433. doi: 10.1177/1357633X17706583. Epub 2017 Apr 27.

Abstract

Background Telerehabilitation promises to improve quality, increase patient access and reduce costs in health care. Physiotherapy with exercises is generally recommended to restore function after surgery in patients with chronic subacromial syndrome. Relatively few studies have investigated the feasibility of telerehabilitation interventions in musculoskeletal and orthopaedic disorders. The aim of this study was to evaluate the feasibility and effectiveness of a customizable telerehabilitation intervention and compare with traditional care. Methods This research includes 18 consecutive patients with subacromial impingement who underwent arthroscopic subacromial decompression in a controlled clinical prospective study. Patients were randomized to either a 12-week telerehabilitation programme or the usual face-to-face physical therapy for immediate postoperative rehabilitation. We have developed a telerehabilitation system to provide services to patients who have undergone shoulder arthroscopy. An independent blinded observer performed postoperative follow-up after 4, 8, and 12 weeks. Results The preliminary efficacy of this telerehabilitation programme in terms of both physical and functional objective outcome measures was assessed on eight patients. Using the Constant-Murley score to evaluate functional outcome, patients in the telerehabilitation group were shown to have improved from a mean 43.50 ± 3.21 points to a mean 68.50 ± 0.86 points after 12 weeks. The physical and functional improvements in the telerehabilitation group were similar to those in the control group ( p = 0.213). There was a non-significant trend for greater improvements in the telerehabilitation group for most outcome measurements. Conclusion The results of this study provide evidence for the efficacy of telerehabilitation after shoulder arthroscopy in shoulder impingement syndrome. A telerehabilitation programme with range of motion, strengthening of the rotator cuff and scapula stabilizers exercises seems to be similar and not inferior to traditional face-to-face physiotherapy after subacromial arthroscopic decompression. Through this study, we are developing our preliminary dataset to evaluate the efficacy of telerehabilitation programmes following surgical procedures in musculoskeletal injuries and for comparison with more traditional interventions.

Keywords: Telerehabilitation; arthroscopic subacromial decompression; physiotherapy; shoulder impingement syndrome; telemedicine.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Arthroscopy*
  • Decompression, Surgical* / methods
  • Exercise Therapy* / methods
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Prospective Studies
  • Shoulder Impingement Syndrome / surgery*
  • Single-Blind Method
  • Spain
  • Telerehabilitation* / economics