How shoulder immobilization after surgery influences daily activity - a prospective pedometer-based study

Int Orthop. 2024 Mar;48(3):793-799. doi: 10.1007/s00264-023-06033-z. Epub 2023 Nov 11.

Abstract

Purpose: Immobilization, especially of the lower extremity, after orthopaedic surgery has been associated with reduced physical activity. Previous interventions from our study group showed even in young, healthy people reduced activity levels after immobilization of the shoulder. Therefore, this study investigates the change in physical activity due to shoulder immobilization after a reconstructive surgery.

Methods: This prospective study includes 40 patients undergoing surgery from May 2019 to December 2020. Daily activity was measured before surgery, after discharge and three weeks postoperatively each time for six days. Activity including step counts and active time were measured by Fitbit™ inspire. Range of motion before and after surgery as well as Pain (VAS) were documented.

Results: Steps became significantly less immediately postoperatively with an immobilized shoulder joint than before surgery (9728.8 vs. 6022.6, p < 0.05). At follow-up, the number of steps increased again, but still showed a significantly lower number of steps (mean 8833.2) compared to preoperative. Patients preoperatively showed mostly an "active" activity pattern, whereas postoperatively a "low active" behaviour predominated. The proportion of sedentary behaviour ("basal activity" and "limited activity") was almost three times higher postoperatively (12.5% vs. 30%).

Conclusion: General physical activity is restricted during upper limb immobilization in adults. Therefore, activity-enhancing measures should be implemented in the early phase of rehabilitation after upper extremity surgery.

Keywords: Activity of daily living; Physical activity; Rehabilitation; Rotator cuff; Shoulder arthroplasty; Shoulder immobilization.

MeSH terms

  • Actigraphy
  • Adult
  • Humans
  • Prospective Studies
  • Range of Motion, Articular
  • Rotator Cuff Injuries* / surgery
  • Shoulder / surgery
  • Shoulder Joint* / surgery
  • Treatment Outcome
  • Upper Extremity