The Physical Therapy Management Of A Patient With Chronic Shoulder Dislocations And Chronic Inflammatory Demyelinating Polyneuropathy: A Case Report

Background and Purpose: While current literature has studied the role of physical therapy interventions when treating multi-directional shoulder instability, most evidence has focused on younger athletes with no co-morbidities. There is less research on older adults with shoulder instability, and no research on the effects of a fatigue dominant progressive neuropathy, such as Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), on the management of recurrent shoulder dislocations. The purpose of this case report is to describe the physical therapy management and recovery of an individual with chronic shoulder instability/dislocations and CIDP. Case Description: The patient was a 62-year- old female who came to physical therapy initial examination at a hospital based outpatient rehabilitation clinic with complaints of pain and decreased function in the right shoulder following her 5th humerus dislocation one month ago. The physical therapy plan of care included upper extremity active assistive range of motion, active range of motion, upper extremity strengthening and scapular stabilization. Outcomes: After 12 visits, the patient showed increased shoulder range of motion, upper extremity strength, and decreased levels of pain. She also reported significantly higher levels of function with daily life activities such as cleaning, dressing, and bathing. Discussion: This case report supports the use of upper extremity range of motion and strengthening exercises and scapular stabilization for a patient with recurrent shoulder dislocations. Further research is recommended to examine a greater variety of interventions, specifically therapeutic exercise utilizing shoulder abduction and external rotation planes of motion, and their role in the care of patients with chronic shoulder dislocations and CIDP