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Early loading in physiotherapy treatment after full-thickness rotator cuff repair: a prospective randomized pilot-study with a two-year follow-up

Department of Physiotherapy, Sahlgrenska University Hospital, ingrid.hultenheim-klintberg{at}vgregion.se, Department of Orthopaedics and Institute of Neuroscience and Physiology/Physiotherapy, Sahlgrenska Academy at University of Gothenburg

Ann-Christine Gunnarsson

Department of Physiotherapy, Sahlgrenska University Hospital, and Department of Orthopaedics, Sahlgrenska Academy at University of Gothenburg

Ulla Svantesson

Department of Physiotherapy, Sahlgrenska University Hospital, Department of Orthopaedics and Institute of Neuroscience and Physiology/Physiotherapy, Sahlgrenska Academy at University of Gothenburg

Jorma Styf

Department of Orthopaedics, Sahlgrenska Academy at University of Gothenburg, Sweden

Jòn Karlsson

Department of Orthopaedics, Sahlgrenska Academy at University of Gothenburg, Sweden

Objective: To describe the clinical changes following two different physiotherapy treatment protocols after rotator cuff repair.

Design: A prospective, randomized pilot study with a two-year follow-up.

Subjects: Five women and nine men, 55 (40—64) years old, were included.

Intervention: The progressive group (n = 7) started with dynamic, specific muscle activation of the rotator cuff the day after surgery as well as passive range of motion. After four weeks of immobilization the loading to the rotator cuff increased and in a progressive manner throughout the rehabilitation. In the traditional group (n = 7) the rotator cuff was protected from loading. Patients were immobilized for six weeks and started with passive range of motion the day after surgery. No specific exercises to the rotator cuff were introduced during this period.

Main measures: A clinical evaluation was made preoperatively, 3, 6, 12 and 24 months after surgery. Pain rating during activity and at rest, patient satisfaction, active range of motion and muscle strength, Constant score, hand in neck, hand in back and pour out of a pot, as well as Functional Index of the Shoulder were used.

Results: At two years follow-up, the progressive group and traditional group scored pain during activity visual analogue scale (VAS) 2/0 mm and pain at rest 0/0 mm, respectively. The groups attained 170/175° in active abduction in standing and 70/90° in passive external rotation while lying in supine. Using Constant score, the groups attained 82/77 points respectively.

Conclusion: The present study showed that the progressive protocol produced no adverse effects compared with the traditional protocol.

This version was published on July 1, 2009

Clinical Rehabilitation, Vol. 23, No. 7, 622-638 (2009)
DOI: 10.1177/0269215509102952


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