Keywords
osteoarthritis
algorithm
shoulder joint
physical therapy
rehabilitation
How to Cite
Abstract
Objective. To characterize the structure of comorbid conditions in patients with shoulder osteoarthritis and assess their significance in predicting clinical outcomes of the combined application of extracorporeal shock wave therapy and McKenzie physical rehabilitation methods.
Materials and Methods.Clinical outcomes of combined extracorporeal shock wave therapy and McKenzie rehabilitation methods were analyzed in 34 patients with shoulder osteoarthritis (39 cases). The mean age was 57.69 ± 11.38 years. Treatment outcomes were assessed using the Oxford Shoulder Score. Comorbidities were evaluated using the Charlson Comorbidity Index. Statistical analysis was performed using StatSoft Statistica 13, with significance set at p ≤ 0.05.
Results. Factors significantly associated with poorer long-term outcomes included heart failure (τ = −0.55, p = 0.0000008), peripheral vascular disease (τ = −0.34, p = 0.002), transient ischemic attacks (τ = −0.24, p = 0.03), bronchial asthma (τ = −0.23, p = 0.04), chronic obstructive pulmonary disease (τ = −0.28, p = 0.01), gastric and/or duodenal ulcer disease (τ = −0.27, p = 0.02), liver cirrhosis without portal hypertension (τ = −0.31, p = 0.006), uncomplicated diabetes mellitus (τ = −0.46, p = 0.00004), and higher Charlson Comorbidity Index values (τ = −0.68, p = 0.000000001). Predictors of excellent outcomes included low Charlson Comorbidity Index values (OR = 5.69, CI 1.31–24.63, p = 0.01). Good outcomes were associated with heart failure (OR = 10.21, CI 1.07–97.46, p = 0.01) and diabetes mellitus without peripheral complications (OR = 8.63, CI 1.35–54.95, p = 0.01). Satisfactory outcomes were associated with chronic obstructive pulmonary disease (OR = 23.25, CI 1.77–305.46, p = 0.007) and high Charlson Comorbidity Index values (OR = 23.25, CI 1.77–305.46, p = 0.007).
Conclusions. Combined use of extracorporeal shock wave therapy and McKenzie physical rehabilitation methods is highly effective in the treatment of degenerative-dystrophic shoulder joint diseases. Assessment of comorbidities is advisable when selecting the optimal treatment strategy.
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