Arthroplasty, Replacement, Shoulder
Conditions
Keywords
"Influencing factors", Rehabilitation, "Anatomical shoulder arthroplasty", "Reverse shoulder arthroplasty"
Brief summary
The aim of this study is to investigate pre-, intra- and post-operative factors that influence post-operative outcome (shoulder pain, shoulder function and quality of life) after shoulder arthroplasty.
Detailed description
The aim of this study is to investigate pre-, intra- and post-operative factors that influence post-operative outcome (shoulder pain, shoulder function and quality of life) after shoulder arthroplasty. Therefore, factors such as patient characteristics, indication for procedure, pre-operative shoulder pain, pre-operative shoulder function, patient expectations, psychosocial factors, lifestyle factors, length of immobilization and soft tissue integrity, are subject to study. Secondary aims are to investigate: 1. the influences of early mobilization vs. delayed mobilization of the shoulder after shoulder arthroplasty on post-operative shoulder pain, shoulder function and quality of life. 2. the inter- and intrarater reliability of the test battery used in this project, in the shoulder arthroplasty population. 3. the inter- and intrarater reliability of the shoulder joint position sense (SJPS) test and the shoulder joint force sensation (SFS) test. 4. the routines of the orthopedic shoulder surgeons before, during and after performing a shoulder arthroplasty. 5. the routines of physiotherapists in the post-operative rehabilitation of patients with shoulder arthroplasty. 6. the associations between the Patient Reported Outcome Measures (PROMS) used in AZ Monica and the Constant Murley Score (CS), and the PROMS and the Visual Analogue Scale (VAS). and to conduct a questionnaire - and assess its reliability - measuring the expectations of the shoulder arthroplasty patients. In order to reach the aims of this project, a prospective longitudinal study with randomized group allocation will be carried out over 48 months with estimated starting point in January 2020 and finishing in January 2024.
Interventions
PROCEDUREEarly mobilization
Patients will wear an adduction sling to immobilize the shoulder during the first 4 weeks post-operative
PROCEDUREDelayed mobilization
Patients will wear an abduction sling to immobilize the shoulder during the first 4 weeks post-operative, followed by an adduction sling for 2 weeks.
Sponsors
Universiteit Antwerpen
University Hospital, Antwerp
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Investigator, Outcomes Assessor)
Masking description
The care provider and participant know the duration of the immobilization. The investigator and outcome assessor don't know the duration.
Intervention model description
Prospective longitudinal study with randomised group allocation, based on length of immobilization.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult men and women \>= 18 years of age * Scheduled for primary shoulder arthroplasty
Exclusion criteria
* Revision surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Shoulder Pain and Disability Index (SPADI) | Measured pre-operatively, 6 weeks post-operative, 12 weeks post-operative, 6 months postoperative, 12 months post-operative and 24 months post-operative | There are 13 items, divided in two subscales: pain (5 items) and function (8 items). Each item is scored from 0 (no pain/no difficulty) to 10 (worst imaginable pain/so difficult it requires help) on a NPRS. The final score is a percentage derived from an average of the two subscales, where higher score means worse outcome. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Shoulder pain | Measured pre-operatively, 6 weeks post-operative, 12 weeks post-operative, 6 months postoperative, 12 months post-operative and 24 months post-operative | It is measured with the Visual Analogue Scale (VAS) |
| Shoulder function | Measured pre-operatively, 6 weeks post-operative, 12 weeks post-operative, 6 months postoperative, 12 months post-operative and 24 months post-operative | It is measured with the Constant and Murley Score (CS) |
| Active ROM in shoulder abduction, anteflexion, internal rotation and external rotation | Measured pre-operatively, 6 weeks post-operative, 12 weeks post-operative, 6 months postoperative, 12 months post-operative and 24 months post-operative | It is measured with a Gravity-V inclinometer. The unit of measures is degrees. |
| Shoulder muscle strength in anteflexion, internal rotation, external rotation and the lift-off movement | Measured pre-operatively, 6 weeks post-operative, 12 weeks post-operative, 6 months postoperative, 12 months post-operative and 24 months post-operative | It is measured with a Handheld dynamometer. The unit of the measure is Newton. |
| Proprioception (joint position sense) | Measured pre-operatively, 12 weeks post-operative, 6 months postoperative, 12 months post-operative and 24 months post-operative | Inclinometer and laser pointer are used to measure joint position sense in degrees. |
| Proprioception (muscle force sensation) | Measured pre-operatively, 12 weeks post-operative, 6 months postoperative, 12 months post-operative and 24 months post-operative | A handheld dynamometer is used to measure muscle force sensation in Newton. |
| Patient related outcome measures (PROMS, EQ-D) | Measured pre-operatively, 6 weeks post-operative, 12 weeks post-operative, 6 months postoperative, 12 months post-operative and 24 months post-operative | Questionnaire Lynxcare (Euro Quality of Life, 5 dimensions (EQ-5D) |
| Patient related outcome measures (PROMS, SST) | Measured pre-operatively, 6 weeks post-operative, 12 weeks post-operative, 6 months postoperative, 12 months post-operative and 24 months post-operative | Questionnaire Lynxcare (Simple Shoulder Test (SST)) |
| Patient related outcome measures (PROMS, NRS) | Measured pre-operatively, 6 weeks post-operative, 12 weeks post-operative, 6 months postoperative, 12 months post-operative and 24 months post-operative | Questionnaire Lynxcare (Numeric Rating Scale (NRS)) |
| Patient related outcome measures (PROMS, DASH) | Measured pre-operatively, 6 weeks post-operative, 12 weeks post-operative, 6 months postoperative, 12 months post-operative and 24 months post-operative | Questionnaire Lynxcare (Disabilities of the Arm, Shoulder and Hand (DASH)) |
| Quality of Life (SF-36) | Measured pre-operatively, 6 weeks post-operative, 12 weeks post-operative, 6 months postoperative, 12 months post-operative and 24 months post-operative | It is a questionnaire to measure patient health, comprising mental health as well as physical health. |
Countries
Belgium
Outcome results
None listed