The Relationship between early and late stimulation of the deltoid muscle in patients undergoing reverse total shoulder arthroplasty. A systematic review with meta-analysis.

Study Summary

Four randomized controlled trials including 565 patients undergoing reverse total shoulder arthroplasty (RTSA) were included in this systematic review, with three studies contributing to the meta-analysis comparing early vs delayed deltoid stimulation. Pooled outcomes included functional performance, pain, functional capacity, range of motion (ROM), muscle strength, and adverse events. Early stimulation improved flexion ROM at 3, 6, and 12 months and improved abduction and external rotation ROM at selected time points, whereas delayed stimulation produced greater internal rotation ROM. Functional performance, pain, and most muscle-strength outcomes were similar between groups. Overall, early deltoid stimulation appeared to provide modest ROM benefits without compromising recovery, although confidence in these findings was limited by low to very low certainty of evidence.