Advice Plus Physical Therapy No Better Than Just Advice for Shoulder Dislocation

THURSDAY, Jan. 25, 2024 (HealthDay News) -- For adults with a first-time traumatic shoulder dislocation, advice plus physical therapy appears to be no better than advice with the option to self-refer to physical therapy, according to a study published online Jan. 17 in The BMJ.

Rebecca S. Kearney, Ph.D., from the University of Bristol in the United Kingdom, and colleagues examined the effects of an additional program of physical therapy in 242 adults with a first-time traumatic shoulder dislocation compared with 240 adults with a single session of advice, supporting materials, and option to self-refer to physical therapy in a pragmatic, multicenter, randomized controlled trial. The primary outcome, measured six months after treatment allocation, was the Oxford shoulder instability score.

Overall, 180 participants allocated to advice only and 174 allocated to advice and physical therapy completed the primary outcome score. The researchers found that for the primary intention-to-treat adjusted analysis, there was no significant difference between advice and advice with physical therapy (between-group difference favoring physical therapy, 1.5; 95 percent confidence interval, −0.3 to 3.5); no significant differences were seen at three-month or six-week time points. The two groups had similar complication profiles.

"We acknowledge that additional supervised physical therapy will be appropriate in some circumstances; however, as a default referral pathway, this treatment option is not superior to a single session of advice, supporting materials, and option to self-refer to physical therapy intervention," the authors write.

Several authors disclosed ties to the medical device and medical technology industries.

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