[Comparison of the results of supervised physiotherapy program and home-based exercise program in patients treated with arthroscopic-assisted mini-open rotator cuff repair].

OBJECTIVES This study aims to compare the results of supervised exercise program versus standardized home based exercise program after rotator cuff repair with respect to severity of pain, functional status, quality of life, and depression. PATIENTS AND METHODS Twenty-eight patients (5 males, 23 females; mean age 59.8±9.1 years; range 40 to 83 years) who had rotator cuff repair were evaluated. Patients were divided into two groups and the first group was treated with supervised physiotherapy (n=15) and the second group was treated with home-based exercise program (n=13). Pendulum exercises and passive exercises within pain limits were performed by all patients in the six-week immobilization period with shoulder sling with abduction pillow after rotator cuff repair. After this period, the patients in home-based exercise program were taught to perform active exercises and the patients in supervised physiotherapy group were treated with active shoulder range of motion exercises under the supervision of the physiotherapist. When patients reached to active full range of motion, strengthening exercises were added to exercise program. Patients were assessed preoperatively and at the end of the postoperative third month. Pain was evaluated with visual analog scale (VAS), functional status with Constant shoulder score, quality of life with short form-36 (SF-36), and depressive symptoms with Beck depression inventory (BDI). RESULTS There were significant improvements in all evaluation parameters in both groups after rotator cuff repair. CONCLUSION There were no statistical differences between the patients who received exercise program under the supervision of the physiotherapist and the patients who were treated with standardized home-based exercise program for the efficacy of treatment in the evaluation of pain, functional status, quality of life, and depression status. When the rehabilitation programs were analyzed for cost effectiveness, the supervised physiotherapy group was found to have higher costs.

[1]  B. Vandermeer,et al.  Systematic Review: Nonoperative and Operative Treatments for Rotator Cuff Tears , 2010, Annals of Internal Medicine.

[2]  Burak Sener,et al.  [Results of limited open rotator cuff repair with partial acromioplasty for rotator cuff tears with subacromial impingement syndrome]. , 2010, Eklem hastaliklari ve cerrahisi = Joint diseases & related surgery.

[3]  J. Karlsson,et al.  Early loading in physiotherapy treatment after full-thickness rotator cuff repair: a prospective randomized pilot-study with a two-year follow-up , 2009, Clinical rehabilitation.

[4]  M. Provencher,et al.  Open, mini-open, and all-arthroscopic rotator cuff repair surgery: indications and implications for rehabilitation. , 2009, The Journal of orthopaedic and sports physical therapy.

[5]  R. Wright,et al.  Rotator Cuff Repair Rehabilitation , 2009, Sports health.

[6]  P. Millett,et al.  Rehabilitation of the Rotator Cuff: An Evaluation‐Based Approach , 2006, The Journal of the American Academy of Orthopaedic Surgeons.

[7]  Murat Tonbul,et al.  Rotator manflet y›rt›klar›n›n artroskopik yard›ml› mini-aç›k yöntemle tamiri Arthroscopic-assisted mini-open repair of rotator cuff tears , 2005 .

[8]  G. Murrell,et al.  A randomised clinical trial evaluating the efficacy of physiotherapy after rotator cuff repair. , 2004, The Australian journal of physiotherapy.

[9]  Z. Güven.  [Rehabilitation following anterior acromioplasty]. , 2003, Acta orthopaedica et traumatologica turcica.

[10]  K. Cook,et al.  A randomized controlled trial comparing 2 instructional approaches to home exercise instruction following arthroscopic full-thickness rotator cuff repair surgery. , 2002, The Journal of orthopaedic and sports physical therapy.

[11]  K. Wilk,et al.  Rehabilitation After Rotator Cuff Surgery , 2000 .

[12]  P. LaStayo,et al.  Continuous Passive Motion after Repair of the Rotator Cuff. A Prospective Outcome Study* , 1998, The Journal of bone and joint surgery. American volume.

[13]  J. Brox,et al.  Supervised exercises in relation to rotator cuff disease (impingement syndrome stages II and III): A treatment regimen and its rationale , 1998 .

[14]  J. Zuckerman,et al.  Strength after surgical repair of the rotator cuff. , 1996, Journal of shoulder and elbow surgery.

[15]  C. Sherbourne,et al.  The MOS 36-Item Short-Form Health Survey (SF-36) , 1992 .

[16]  C. Constant,et al.  A clinical method of functional assessment of the shoulder. , 1987, Clinical orthopaedics and related research.

[17]  I Haslock,et al.  Visual analogue scales. , 1982, Annals of the rheumatic diseases.

[18]  A. Beck,et al.  An inventory for measuring depression. , 1961, Archives of general psychiatry.