Millar AL, Jasheway PA, Eaton E, Gooden F; Andrews University, Lakeland Medical Center. St. Joseph, MI.

Although shoulder dysfunction is one of the more common complaints referred to physical therapy, little data is available regarding the efficacy of physical therapy. PURPOSE: To determine the clinical and functional outcomes of outpatient physical therapy for patients with shoulder dysfunction in a multi-center health system. A database was developed for shoulder patients, identifying data thought to be relevant to the practice of shoulder rehabilitation. SUBJECTS: Records for 275 patients (137 female, 137 male, 1 unspecified) were included in this study. Patients referred to outpatient physical therapy for shoulder dysfunction including post-surgical patients. Clients were classified by type of shoulder dysfunction. METHODS: Prior to data collection, clinical tests and protocols were standardized with all therapists. Seven tests were performed on all clients: 3 active ranges - flexion, abduction and internal rotation, 3 passive ranges -external and internal rotation at 90, and external rotation in adduction. Strength was tested using a manual muscle test. In addition, clients completed a functional, work status, and pain questionnaire, pre and post treatment. ANALYSIS: Pre and post data were analyzed using one and two way ANOVAs. Repeated measures ANOVAs were used to compare responses between shoulder classification groups. Alpha levels of .05 were used to test of significance. Regression analyses were used to identify outcome predictors. RESULTS: Patients fell into the categories of impingement (IMP) 72.7%, rotator cuff tear (RCT) 10.5%, and post-operative repair (PO) 16.7%. The average age of the patients was 53.0+15.1 years, with the impingement group being significantly younger. The average number of treatments was 12.8, ranging from a mean of 9.6 for the IMP group to 24.9 for the PO groups. All groups improved significantly. Impingement patients were significantly different from RCT and PO for function, active flexion, and active abduction, with the majority of the difference due to a lower admission status for the RCT and PC groups. CONCLUSION: Physical Therapy is effective in improving clinical and functional abilities of those with diverse shoulder dysfunction. RELEVANCE: The type of shoulder dysfunction affects prognosis, thus, expected outcomes should be based on initial diagnosis. FUNDING SOURCE: None.

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