Physical Therapist Management of Glenohumeral Joint Osteoarthritis

Publication Date: April 28, 2023

Summary of Recommendations

Physical therapist services may benefit patients with glenohumeral joint osteoarthritis who have not undergone total shoulder arthroplasty. (BP)
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History, physical exam, and radiographs can be useful to differentially diagnose GHOA. Specifically, critical shoulder angle on radiographs and age is predictive of the diagnosis. (M)
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Advanced imaging of magnetic resonance imaging is beneficial in the differential diagnosis of GHOA. MRI is helpful to confirm the diagnosis but is less useful to rule out the diagnosis. (S)
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In the absence of reliable evidence, the opinion of the Guideline Development Group is that physical therapist services delivered preoperatively may benefit postoperative outcomes in patients with GHOA who are undergoing TSA. (BP)
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Physical therapist services delivered postoperatively may benefit patient-rated functional outcomes in the management of patients who have undergone TSA for GHOA. (BP)
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Physical therapists should implement the use of a sling with the shoulder in a neutral position and progressive exercises for range of motion (ROM) and strengthening to improve patient-reported outcomes and ROM in patients with GHOA who have undergone TSA. (S)
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Physical therapists should implement the use of a sling with the shoulder in a neutral position for pain management in patients with GHOA who have undergone TSA. (M)
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No one specific intervention is superior to another for patients with GHOA. (BP)
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The timing of the introduction of shoulder ROM exercises by physical therapists may be delayed up to 4 weeks without negatively impacting patient-reported outcomes in patients with GHOA who have undergone TSA. (M)
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Interventions for edema in patients with GHOA who have undergone TSA should be based on best available evidence, clinical expertise, and patient values. (BP)
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Recommendation Grading

Abbreviations

  • GDG: Guideline Development Group
  • GHOA: Glenohumeral Joint Osteoarthritis
  • MRI: Magnetic Resonance Imaging
  • ROM: Range Of Motion
  • TSA: Total Shoulder Arthroplasty

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

Overview

Title

Physical Therapist Management of Glenohumeral Joint Osteoarthritis

Authoring Organization

Publication Month/Year

April 28, 2023

Supplemental Implementation Tools

Document Type

Guideline

Country of Publication

US

Document Objectives

A clinical practice guideline on glenohumeral joint osteoarthritis was developed by an American Physical Therapy Association volunteer guideline development group that consisted of physical therapists and a neurologist. The guideline was based on systematic reviews of current scientific and clinical information and accepted approaches for physical therapist management of glenohumeral joint osteoarthritis.

Target Patient Population

Patients with or suspected of glenohumeral joint osteoarthritis

Target Provider Population

Physical therapists and other providers caring for patients with glenohumeral joint osteoarthritis

Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Ambulatory, Outpatient

Intended Users

Nurse, nurse practitioner, physical therapist, physician, physician assistant

Scope

Assessment and screening, Management, Rehabilitation

Diseases/Conditions (MeSH)

D010003 - Osteoarthritis

Keywords

physical therapy, osteoarthritis, physical therapist, Glenohumeral Joint Osteoarthritis, shoulder, total shoulder arthroplasty

Source Citation

Lori A Michener, PT, ATC, PhD, FAPTA, Jill Heitzman, PT, DPT, PhD, Laurel D Abbruzzese, PT, EdD, Salvador L Bondoc, OTD, OTR/L, FAOTA, Kristin Bowne, PT, DPT, Phillip Troy Henning, OD, Heidi Kosakowski, PT, DPT, PhD, Brian G Leggin, PT, DPT, Ann M Lucado, PT, PhD, Amee L Seitz, PT, DPT, PhD, Physical Therapist Management of Glenohumeral Joint Osteoarthritis: A Clinical Practice Guideline from the American Physical Therapy Association, Physical Therapy, 2023;, pzad041, https://doi.org/10.1093/ptj/pzad041