Nonoperative treatment of chronic, massive irreparable rotator cuff tears: a systematic review with synthesis of a standardized rehabilitation protocol

Analysis of Functional Recovery and Subjective Well-Being after Arthroscopic Rotator Cuff Repair

“…What determines the effectiveness of rehabilitation? It is quite clear that both the complexity of the surgical intervention [ 5 , 6 , 8 , 18 ] and the means of rehabilitation and motivation of the patient [ 7 , 9 , 10 , 11 ] are most significant. In our study, the improvements of arm/hand motor function and SWB of the patient were collected over time in all stages, even though the long-term period in our study was relatively short compared to other studies over a 6-, 12- or 48- month follow-up period [ 10 , 26 ].…”

“…Furthermore, an increase of ROM shows a better correlation to pain relief in II and III periods, which confirms that integrated rehabilitation measures are effective in reducing pain and restoring arm motor function. The overall success and effective recovery of motor function depends on the rehabilitation treatment protocol, which is characterised by the requirement of some supervised physical therapy, often requiring 12 weeks or more, focusing on supine exercises with gradual progression to upright [ 7 ]. To obtain significant improvements in strength and ROM, the physical exercises used in the rehabilitation program should be continued as a home exercise program [ 6 ].…”

“…However, if this management is unsuccessful, surgical repair has been shown to relieve pain and improve function in >90% of patients [ 6 ]. People with RC tears very often experience significant changes in their ability to be independent in their daily and professional activities and are often forced to undergo shoulder surgery due to the resulting pain, decreased muscle strength and range of motion (ROM) [ 7 ]. Arthroscopic debridement or partial RC reconstruction achieves good results in shoulder joint function [ 5 ], but massive shoulder dysfunction does not always produce good treatment and functional recovery results and unfortunately, significant limitations of shoulder function remain present [ 5 , 6 ].…”

“…According to previous research, a successful outcome is very dependent on surgical technique, as it is on rehabilitation [ 10 ]. There are a number of different rehabilitation protocols for RC tear, and they all aim to do the same—protect the shoulder—while increasing ROM and muscular endurance and strength to return to daily activities [ 7 ], and decreasing pain and improving the quality of life [ 11 ]. Mostly, rehabilitation protocols for an RC tear does not differ much regarding methods, but may differ in the period of performance—early passive motion, starting as soon as possible postoperatively, and delayed active motion, usually starting at five to six weeks postoperatively [ 12 ].…”

Large to massive rotator cuff tendon tears: a protocol for a systematic review investigating the effectiveness of exercise therapy on pain, disability and quality of life

“…In addition the exercise intervention was not quantified by type, duration or frequency ( Jeanfavre et al , 2018 ). Two recent systematic reviews focusing on conservative management of massive irreparable rotator cuff tears ( Kovacevic et al , 2020 ; Shepet et al , 2020 ) again highlighted the lack of high quality comparative studies to help inform treatment recommendations. Shepet et al (2020) utilised efficacious non operative treatment to collate and provide a synthesised rehabilitation program for this population cohort to help guide the treating clinicians, something which has never been completed for large rotator cuff tears.…”