Impact of combination of therapeutic exercise and psychological intervention for a patient with first-time traumatic shoulder dislocation

Abstract

[Purpose] A young female with first-time traumatic shoulder dislocation showed a good outcome at the 1 year follow-up in returning to work and sports after undergoing a combination of exercise therapy and psychological intervention. [Participant and Methods] A 24-year-old female who worked as an occupational therapist and played badminton for recreation had dislocated her shoulder in a fall. We evaluated her compliance with home-exercise, range of motion, return to work, fear of movement, sports activity level, and instability of shoulder joint using the modified Rowe score at each timepoint necessary. During early sessions of the physical therapy, the range of motion and instability score for the shoulder joint were poor. We treated her using a phase-based approach, and subsequently, added the Watson program to restore normal kinematics. Because of a psychological problem during middle sessions of the physical therapy, we provided psychological education and support. [Results] At the final session of the therapy, her compliance with home-exercise was good. She had achieved almost a full range of motion. The fear of movement decreased, and she could play sports again. The modified Rowe score improved from 5 to 85. [Conclusion] As a conservative treatment for patients with first-time traumatic shoulder instability, a combination of therapeutic exercise and psychological intervention may be useful.