Delayed versus early motion after arthroscopic rotator cuff repair: a meta-analysis

Efficacy of informed versus uninformed physiotherapy on postoperative retear rates of medium-sized and large rotator cuff tears

“…15 To measure the stereometry of physiotherapy, we innovatively used an accelerometer to detect vertical acceleration obtained by an orbital shaker to simulate pendulum exercises. By calibration of this device, our study result was compatible to that of Long et al 17 Analyzing the outcome of vertical motion occurring as a loading issue 6,10,11 for physiotherapists to instruct patients 22 in the protocols provided information about safety associated with performing small pendulum exercises. It is commonly observed that patients sometimes produce physiologic tremors to compensate for their lack of strength, whereas at other times they do not.…”

“…The primary goals within the first 6 weeks of physiotherapy after rotator cuff repair are to minimize adhesion and edema, 6,8,13 and to avoid damage to the repaired cuff 15,16 as much as possible. Historically, surgeons have recommended early passive range of motion as well as gentle circle pendulum exercise after rotator cuff repair in an effort to decrease the chances that adhesions will develop and ultimately lead to stiffness in the repaired shoulder.…”

“…10 However, most patients lacked the ability to perform the pendulum exercises as prescribed. Some studies have demonstrated that the early standardized physiotherapeutic protocol is patient oriented and therefore limited in quality outcome, 6 including pendulum exercises. 20 In addition, a number of surgeons would like to avoid strain or micromotion at the repair site during this phase to facilitate healing.…”

“…It is commonly observed that patients sometimes produce physiologic tremors to compensate for their lack of strength, whereas at other times they do not. 6 This phenomenon has been ignored in the current physiotherapy protocol. Backward pulling in a vertical motion is done against the affected extremity as a compensation action on surrounding muscles.…”

“…Observing and reducing the risks of secondary complications can accelerate the restoration of cuff healing in the early postoperative period. 6 Therefore, a therapist should be cautious in interpreting evidence of persistent rotator cuff defects after rotator cuff repair. 1 The high compliance rates (including the outpatient clinic and aquatic therapy 4 ) encourage the informed patient to implement a safe protocol in the early rehabilitation stage.…”