Shoulder pacemaker therapy improved outcomes for posterior shoulder instability
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ATLANTA — Compared with conventional physical therapy, physical therapy enhanced with a shoulder pacemaker yielded improved clinical outcomes for patients with functional posterior shoulder instability, according to presented results.
“History has shown in orthopedics [that] every time you introduce a new device to the market initially the results tend to be very positive – probably fueled by confirmation bias and commercial interests,” Phillipp Moroder, MD, said in his presentation at the American Shoulder and Elbow Surgeons Annual Meeting, here. “In the long run, often these devices fail to keep their promise, and they don’t show the nice results they initially showed if you analyze them on a more sound, significant basis. This is why we set out to perform a German nation randomized control trial.”
Moroder and colleagues analyzed 59 patients with type B1 functional posterior shoulder instability who were randomly assigned to either to a 6-week conventional physical therapy (PT) protocol or the same 6-week protocol with simultaneous shoulder pacemaker stimulation physical therapy (SPM-PT). The primary outcome measure was Western Ontario Shoulder Instability Index (WOSI) score, which was collected at 6 weeks, 3 months, 6 months and 1 year after intervention.
At 3 months, patients in the SPM-PT group had “significantly better” WOSI scores compared with patients in the conventional group (64% vs. 51%, respectively). Moroder also said patients who were dissatisfied with conventional PT and switched to SPT-PT had an immediate increase in WOSI scores at 3 months. Researchers reported there was subjective symptom improvement for 95% of the patients in the SPM-PT group compared with 63% of patients in the patients in the conventional group.
“To conclude, shoulder pacemaker-enhanced physiotherapy can lead to statistically significant and clinically relevant improvement of outcomes in patients with functional posterior shoulder instability,” Moroder said. “Even patients with failed prior conventional physiotherapy can benefit from this treatment.”
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Moroder P, et al. Paper 1. Presented at: American Shoulder and Elbow Surgeons Annual Meeting; Oct. 6-9, 2022; Atlanta.
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