title: Preoperative physical therapy treatment did not influence postoperative pain and disability outcomes in patients undergoing shoulder arthroscopy: a prospective study.
abstract: BACKGROUND
  There is limited literature investigating preoperative physical therapy (pre-op PT) treatment on pain intensity and disability after musculoskeletal surgery. The purposes of the present cohort study were to describe patient characteristics for those who had and did not have pre-op PT treatment and determine whether pre-op PT influenced the length of postoperative physical therapy (post-op PT) treatment (number of sessions) and 3-month and 6-month postsurgical outcomes, such as pain intensity and disability.
  
  
  METHODS
  A total of 124 patients (mean age =43 years, 81 males) with shoulder pain were observed before and after shoulder arthroscopic surgery. Demographic data, medical history, and validated self-report questionnaires were collected preoperatively and at 3 months and 6 months after surgery. Analysis of variance models were performed to identify differences across measures for patients who had pre-op PT treatment and those who did not and to examine outcome differences at 3 months and 6 months. Alpha was set at the 0.05 level for statistical significance.
  
  
  RESULTS
  Males had less participation in pre-op PT than females (P=0.01). In contrast, age, pain intensity, disability, and pain-associated psychological factors did not differ between pre-op PT treatment groups (P>0.05). Subacromial bursectomies were more commonly performed in patients having pre-op PT treatment (P<0.05). Pre-op PT treatment did not influence length of post-op PT treatment and did not affect 3-month and 6-month pain intensity and disability outcomes. Differences in distribution of pre-op PT for males and females and subacromial bursectomy did not influence 3-month or 6-month postsurgical outcomes.
  
  
  CONCLUSIONS
  Receiving pre-op PT treatment did not influence post-op PT treatment or pain and disability outcomes at 3 months and 6 months. This prospective cohort study provides no evidence of benefit for pre-op PT on post-op PT treatment or postsurgical outcomes. Females or patients receiving certain surgical procedures are more likely to undergo pre-op PT treatment. However, these differences did not influence postoperative outcomes in this cohort.
authors.affiliation: Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute, IN.
authors.forename: Carolina
authors.initials: C
authors.lastname: Valencia
authors.affiliation: Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Rogelio A
authors.initials: RA
authors.lastname: Coronado
authors.affiliation: Department of Physical Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL; Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL.
authors.forename: Corey B
authors.initials: CB
authors.lastname: Simon
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Wright
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Moser
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL.
authors.forename: Kevin W
authors.initials: KW
authors.lastname: Farmer
authors.affiliation: Department of Physical Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL; Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL; Brooks-PHHP Research Collaboration, Jacksonville, FL, USA.
authors.forename: Steven Z
authors.initials: SZ
authors.lastname: George
keywords: postoperative disability; postoperative pain; preoperative physical therapy; shoulder arthroscopy