manan s. patel

The primary goals of total shoulder arthroplasty (TSA) are to relieve pain, improve range of motion,and restore function. Physical therapy is commonly used to help achieve these goals. Recent evidence has pointedto the success and safety of a purely physician-guided, home-based or internet-based, program versus the traditionaltherapist guided program.The purpose of this study was to evaluate outcomes of TSA in patients using a web-based, home therapy program.

A retrospective review was performed of TSA patients who were given the option of using a web-based,home therapy program. Functional outcomes were collected preoperatively, 6-month, and 12-month post-operativeexaminations. Physical examination parameters were recorded at preoperative, 3-month, 6-month, and 12-month timepoints.

Forty-seven patients used the web-based, home therapy program and had complete follow-up data at alltime intervals. All mean range of motion parameters and functional scores improved significantly from preoperatively topostoperatively. There was one reported complication in a patient who sustained a subscapularis rupture and underwentsubsequent open repair at 10 months postoperatively.

This study demonstrates successful improvements in range of motion and functional outcomes in asubset of patients who utilized an online therapy program after TSA. Future study will be necessary to directly compareresults in patients enrolled in formal, outpatient therapy programs and to determine barriers to utilization of web-basedtherapy programs.Level of evidence: IV