Physical Therapy vs Home Exercise for Shoulder Arthritis

Not currently recruiting at 7 trial locations
AJ
Overseen ByAmanda J Naylor, MA
Age: Any Age
Sex: Any
Trial Phase: Academic
Sponsor: Rush University Medical Center
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial compares two types of recovery exercises for individuals who have undergone reverse total shoulder arthroplasty (a type of shoulder replacement). Participants will either perform home exercises guided by their surgeon (home therapy) or attend formal physical therapy sessions. The trial aims to determine which method better relieves pain and improves shoulder movement after surgery, and whether formal physical therapy might lead to more complications, such as certain types of fractures or dislocations. Individuals who had shoulder replacement surgery due to specific conditions, like irreparable rotator cuff tears or severe arthritis, may be suitable candidates. As an unphased trial, this study provides a unique opportunity to contribute to valuable research that could enhance recovery options for future patients.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that these rehabilitation methods are safe for shoulder arthritis patients?

Studies have shown that physical therapy, which includes exercises to improve movement and reduce pain, is generally safe for those recovering from shoulder surgery. Research suggests these exercises can alleviate pain and enhance shoulder function without causing major issues. For example, one study found that starting exercises soon after surgery led to better short-term results in reducing pain and improving shoulder movement.

In another study, patients who followed a physical therapy program specifically for shoulder problems did not experience significant negative side effects. This indicates that physical therapy, when done correctly, is well-tolerated and safe.

For home therapy, which involves exercises at home as instructed by a healthcare provider, no specific evidence of safety issues exists. Generally, exercise programs designed for home use after surgery are made to be safe and easy to follow.

Overall, both physical therapy and home therapy exercises appear to be safe options for those recovering from shoulder surgery, with physical therapy having strong support from studies demonstrating its benefits and safety.12345

Why are researchers excited about this trial?

Researchers are excited about this trial because it aims to discover the most effective way to manage shoulder arthritis post-surgery using either home-based exercises or formal physical therapy. Unlike traditional options that often involve medications or injections, this trial compares two non-drug approaches to see which offers better mobility and pain relief. Home therapy allows patients to perform exercises at their convenience, potentially increasing adherence and comfort. Meanwhile, formal physical therapy provides structured, supervised sessions, which might ensure proper technique and progress. This study could reveal whether a guided or self-directed approach is more beneficial, ultimately improving quality of life for those with shoulder arthritis.

What evidence suggests that this trial's treatments could be effective for shoulder arthritis?

This trial will compare Physical Therapy (PT) with Home Therapy (HT) for shoulder arthritis. Studies have shown that PT can reduce pain and improve movement in the short term after shoulder surgery. Research suggests that starting with gentle exercises, where a therapist assists in moving the shoulder, can lead to better results. Some experts believe PT might be less effective for individuals with severe shoulder arthritis, but it still aids in recovery. Participants in the PT group will attend formal physical therapy sessions, while those in the HT group will perform exercises independently after receiving instructions from healthcare staff. Although less research specifically addresses HT, it employs well-known exercises that can aid recovery. Both PT and HT aim to improve movement and reduce pain, and the choice between them may depend on individual needs.16789

Who Is on the Research Team?

GE

Grant E Garrigues, MD

Principal Investigator

Rush University Medical Center

Are You a Good Fit for This Trial?

This trial is for individuals who have undergone reverse total shoulder arthroplasty (RSA) due to cuff tear arthropathy, massive irreparable rotator cuff tears, or primary osteoarthritis. Participants must be able to speak, read, and write English without cognitive deficits that limit following directions. They should not require skilled nursing facilities or in-patient rehab post-surgery.

Inclusion Criteria

I am having shoulder replacement for specific shoulder issues.

Exclusion Criteria

I have difficulty understanding or following instructions due to cognitive issues.
I cannot go to physical therapy due to transportation or money issues.
Subjects who cannot speak, read, or write the English language
See 2 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Surgery and Initial Recovery

Participants undergo reverse total shoulder arthroplasty and initial recovery

1-2 weeks

Rehabilitation

Participants engage in either home therapy or formal physical therapy to improve motion and function

6 weeks
Varies by group: Home therapy or regular PT visits

Follow-up

Participants are monitored for safety, effectiveness, and complications such as acromial stress fractures and dislocations

up to 2 years
Regular follow-up visits and assessments

What Are the Treatments Tested in This Trial?

Interventions

  • Home Therapy
  • Physical Therapy
Trial Overview The study compares formal clinic-based physical therapy (PT) with surgeon-directed home therapy (HT) after RSA. It measures pain relief, range of motion, and functional outcomes using specific scores over a period up to 24 months postoperatively. The risk of complications like acromial stress fractures or dislocation is also assessed.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Physical Therapy (PT) GroupExperimental Treatment1 Intervention
Group II: Home Therapy (HT) GroupActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Rush University Medical Center

Lead Sponsor

Trials
448
Recruited
247,000+

Orthopedic Research and Education Foundation

Collaborator

Trials
23
Recruited
6,200+

Published Research Related to This Trial

In a survey of 80 patients who underwent shoulder surgery, 65% reported that their physical therapy sessions contributed to their recovery, attending an average of 16.3 sessions, which highlights the perceived efficacy of traditional in-person physical therapy.
Despite the potential for alternatives like internet-based physical therapy (IBPT), 68.6% of patients expressed reluctance to consider IBPT, indicating a strong preference for in-person therapy and the importance of therapist engagement in the recovery process.
Patients' perception of physical therapy after shoulder surgery.Sabesan, VJ., Dawoud, M., Stephens, BJ., et al.[2022]
Only one study out of 506 reviewed provided moderate evidence that early physical therapy after total shoulder arthroplasty can lead to quicker improvements in function and pain relief.
There is a significant gap in research regarding the effectiveness of physical therapy for reverse total shoulder arthroplasty, highlighting the need for more high-quality studies to guide rehabilitation practices.
Effectiveness of formal physical therapy following total shoulder arthroplasty: A systematic review.Edwards, PK., Ebert, JR., Littlewood, C., et al.[2022]

Citations

Effectiveness of formal physical therapy following total ...The findings from this study suggest that immediate provision of passive- and active-assisted ROM exercises provides short-term benefits in pain and function, ...
Provider opinions on effectiveness of physical therapy as ...Conclusion. Both surgeons and therapists agreed that PT may be less beneficial for patients with more advanced radiographic arthritis and that ...
Physical therapy prehabilitation on a reverse total shoulder ...The purpose of this report is to describe the PT evaluation, prehab interventions, and outcomes of a patient pursuing reverse total shoulder replacement (rTSR)
Effectiveness of nonoperative treatment in patients with ...A combination of conservative therapies has been shown to be efficacious in reducing shoulder pain and improving function up to 3 years. Furthermore, failure ...
The Efficacy of Exercise Therapy for Rotator Cuff–Related ...These exercise programs are proposed to reduce pain and disability, increase muscle strength and endurance, improve neuromuscular control, and ...
Physical therapist management of glenohumeral ...The strengths of this study were we described the physical therapist management and outcomes of patients with clinical findings consistent with ...
Prehabilitation for Patients Undergoing Orthopedic SurgeryThe prehabilitation intervention significantly improved function, health-related quality of life, muscle strength, and back pain prior to surgery.
Telerehabilitation After Shoulder ArthroplastyThe project will be a randomized control trial evaluating formal in-person physical therapy versus telerehabilitation after shoulder arthroplasty.
Knee osteoarthritis rehabilitation: an integrated framework of ...Exercise therapy for KOA should improve joint range of motion, muscle and tendon extensibility, strength and endurance, and reduce pain and load ...
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