Presentation Title

Does Early Mobilization Rehabilitation Protocol Affect Pain Scores, Opioid Consumption, And Return To Activities Of Daily Living In Reverse Shoulder Arthroplasty?

Speaker Credentials

OMS-II

Speaker Credentials

BS

College

Dr. Kiran C. Patel College of Osteopathic Medicine, Medical Education

Location

Nova Southeastern University, Davie, Florida, USA

Format

Poster

Start Date

21-2-2020 8:30 AM

End Date

21-2-2020 4:00 PM

Abstract

INTRODUCTION     Reverse shoulder arthroplasty (RSA) has demonstrated exponential growth in the US over the past two decades. Literature suggests that early range of motion (ROM) may provide more rapid return of function, however, no studies have looked specifically at how this may impact pain and opioid consumption. The purpose of this study was to evaluate the impact of an immediate mobilization rehabilitation program on pain and opioid consumption following RSA.  METHODS  A retrospective case-controlled study was performed on 65 patients who underwent RSA at a single institution by two fellowship trained shoulder surgeons. Two groups included: immediate mobilization (IM) group (n=29) and delayed mobilization (DM) group which started PT after 4-6 weeks (n=36). Pain scores (NRS and ASES), time to return to work, opioid dependency, and opioid consumption were compared using total morphine equivalents (TME). Statistical analyses included Chi-squared, independent and paired t tests.  RESULTS     Preoperatively there was no significant difference seen between groups in NRS (5.77 vs 6.35)(p=0.48), ASES for pain (24.2 vs 17.8) (p=0.15), opioid dependence (IM=13% vs DM=11%) (p=0.82) and opioid consumption (IM=69.93TME vs DM=78.69 TME) (p=0.88). Postoperatively, there was no significant difference in opioid dependence (IM=13% vs DM=19%) (p=0.48), opioid consumption (IM=102.39TME vs 155.39TME) (p=0.41) and ASES for pain (p=0.06) between the groups, however there was a significant difference in NRS with lower scores for the IM group (0.61) compared to DM group (2.79) (p=0.02) at 3 months postoperatively.   CONCLUSION   Our study showed that the immediate mobilization rehab can achieve lower reported pain scores postoperatively, however this advantage did not translate to less opioid consumption or lower rates of dependence.

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Feb 21st, 8:30 AM Feb 21st, 4:00 PM

Does Early Mobilization Rehabilitation Protocol Affect Pain Scores, Opioid Consumption, And Return To Activities Of Daily Living In Reverse Shoulder Arthroplasty?

Nova Southeastern University, Davie, Florida, USA

INTRODUCTION     Reverse shoulder arthroplasty (RSA) has demonstrated exponential growth in the US over the past two decades. Literature suggests that early range of motion (ROM) may provide more rapid return of function, however, no studies have looked specifically at how this may impact pain and opioid consumption. The purpose of this study was to evaluate the impact of an immediate mobilization rehabilitation program on pain and opioid consumption following RSA.  METHODS  A retrospective case-controlled study was performed on 65 patients who underwent RSA at a single institution by two fellowship trained shoulder surgeons. Two groups included: immediate mobilization (IM) group (n=29) and delayed mobilization (DM) group which started PT after 4-6 weeks (n=36). Pain scores (NRS and ASES), time to return to work, opioid dependency, and opioid consumption were compared using total morphine equivalents (TME). Statistical analyses included Chi-squared, independent and paired t tests.  RESULTS     Preoperatively there was no significant difference seen between groups in NRS (5.77 vs 6.35)(p=0.48), ASES for pain (24.2 vs 17.8) (p=0.15), opioid dependence (IM=13% vs DM=11%) (p=0.82) and opioid consumption (IM=69.93TME vs DM=78.69 TME) (p=0.88). Postoperatively, there was no significant difference in opioid dependence (IM=13% vs DM=19%) (p=0.48), opioid consumption (IM=102.39TME vs 155.39TME) (p=0.41) and ASES for pain (p=0.06) between the groups, however there was a significant difference in NRS with lower scores for the IM group (0.61) compared to DM group (2.79) (p=0.02) at 3 months postoperatively.   CONCLUSION   Our study showed that the immediate mobilization rehab can achieve lower reported pain scores postoperatively, however this advantage did not translate to less opioid consumption or lower rates of dependence.