PURPOSE: The purpose of this study was to assess the impact of a phone assistance nursing program as an adjunct to conventional physiotherapy to increase adherence to a home exercise program on functional outcomes of patients who underwent shoulder instability surgery. METHODS: A randomized controlled study of 70 patients allocated to a phone assistance program (study group n = 36 patients) or conventional postoperative management (control group n = 34 patients) was conducted. All patients in both groups received conventional rehabilitation at the outpatient clinic after surgery. In addition, patients in the study group received phone calls from a nurse (who had access to a physiotherapist) 3 days per week. During the calls these patients received a coaching session about self-care and support with the home exercise program. Evaluations were performed during a follow-up of 12 months for range of motion (ROM), pain (visual analog scale (VAS) score), Disability of the Arm, Shoulder, and Hand (DASH) score, Oxford Shoulder Instability Score (OSIS), and Rowe score. RESULTS: All scores significantly improved from preoperative to the final follow-up in both groups (p = 0.001). At the final follow-up, there were no significant differences between groups in VAS, DASH, or Rowe scores. However, those in the study group had significantly better OSIS (p = 0.013) and ROM (p = 0.001), particularly for anterior forward motion (p = 0.001). Likewise, the study group achieved full motion and function significantly faster than the control group (p = 0.002). The amount of rehabilitation sessions at the outpatient clinic was 1.7 times higher in the control group (p = 0.004) than in the study group. CONCLUSION: The phone assistance nursing program was an effective procedure to significantly improve the outcomes of conventional physiotherapy in patients who have undergone an operation for shoulder instability.

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