Shoulder joint replacement: Physical therapy for optimal patient care

Interview with Christiane Adamczewski, physical therapist

17/11/2016

We use our joints all the time – whether we sit, stand or walk. We don’t just figuratively carry some of the weight of the world on our shoulders. If the weight gets to be too much, medicine can help – for instance with a shoulder endoprosthesis. Find out at the MEDICA PHYSIO CONFERENCE how patients can be optimally prepared for this with preoperative and postoperative physical therapy.

Photo: Christiane Adamczewski; Copyright: beta-web/Dindas

Christiane Adamczewski; © beta-web/Dindas

Christiane Adamczewski is a physical therapist, MSc, and technical director of the Outpatient Rehabilitation Center Virchow. She spoke with MEDICA-tradefair.com about the rehabilitation process after shoulder replacement surgery.

Ms. Adamczewski, what are some typical problems patients experience before and after they get a shoulder endoprosthesis?

Christiane Adamczewski: The typical problems patients have before they receive the endoprosthesis are mainly chronic pain and motion restrictions. Everyday activities are significantly limited. There is postoperative pain after the prosthesis has been implanted, which can be well managed by administering pain relievers and anti-inflammatory drugs. Patients also complain of neck and shoulder tension that results from wearing a shoulder immobilizer to protect the joint in the first few weeks.

How can patients be supported with physical therapy before the actual surgery?

Adamczewski: Prior to the surgery, physical therapy can achieve a posture correction and the start of regaining muscle control. Sensorimotor training teaches shoulder and scapula stabilization exercises. In doing so, patients are already prepared for the postoperative treatment plan.

What are some important aspects to consider in physical therapy after shoulder replacement surgery?

Adamczewski: After the prosthesis implant, it is essential to follow the surgeon’s specified postoperative care protocol – in the hope there is one. In the early phase of passive range of motion, the primary goal is to be free of pain and to maintain mobility; in the later phase, the focus is on regaining muscle control and stability.

Photo: Christiane Adamczewski at stage; Copyright: beta-web/Dindas

Christiane Adamczewski speaks at MEDICA PHYSIO CONFERENCE about the opitmal patient care; © beta-web/Dindas

What does a functional rehabilitation for shoulder replacement patients look like?

Adamczewski: A functional rehabilitation takes the ICF (International Classification of Functioning) into account. It means that aside from the structure, both the activity and patient’s participation are integrated into the treatment. In addition, next to the timeline of the specified postoperative care protocol, milestone markers should be applied. That is to say, a patient can only start a new treatment phase such as muscle strengthening exercises, if he/she has reached a milestone, for instance, being free of inflammation.

Why is it so important that physical therapy is represented as a topic at the MEDICA medical technology trade fair?

Adamczewski: I believe it is important to be a part of this trade fair because it promotes interdisciplinary collaboration. The goal is to achieve optimal patient care. Having said that, this can only be attained with this type of collaboration and teamwork. To do this, the different representatives of these medical specialties – physicians, medical technology, physical therapists – need to know about each other to learn from each other. That’s why these kinds of events are important because they are often missing in normal everyday work.

Photo: Nadine Lormis; Copyright: B. Frommann

© B. Frommann

The interview was conducted by Nadine Lormis and translated by Elena O'Meara.
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