Rehabilitation following rotator cuff repair: a systematic review

Littlewood, Chris; Bateman, Marcus; Clark, David; Selfe, James; Watkinson, Duncan; Walton, Mike; Funk, Lennard

doi:10.1177/1758573214567702

Cited by 38 publications

(43 citation statements)

References 31 publications

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“…This lack of progression is despite advancement in surgical technique in terms of less invasive operations and hence less tissue damage and stronger implants resulting in more secure repairs, which should permit earlier mobilization and faster recovery. 5 In the context of the current literature, 5,6 the static nature of the majority approach to rehabilitation following rotator cuff repair is appropriately open to question. A recent systematic review has reported that concerns about adverse outcomes, for example negative patient-reported outcome and increased re-tear rate of the rotator cuff, secondary to more progressive approaches or early mobilization, are not supported by the current literature.…”

Section: Discussionmentioning

confidence: 99%

“…This vignette is based upon the typical inclusion criteria of previously published literature 6 and also clinical feedback, as follows:…”

Section: Data Collectionmentioning

confidence: 99%

“…4 Despite the rising incidence of surgery to repair the rotator cuff, understanding of the most effective approach to postoperative rehabilitation, a critical component of the recovery process, is not well developed. 5,6 Uncertainty around the timing and extent of load permitted at the repair site is apparent; some advocate early mobilization and others advocate prolonged immobilization (>1 month). 5,6 Furthermore, there are those that advocate introducing load early (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…5,6 Uncertainty around the timing and extent of load permitted at the repair site is apparent; some advocate early mobilization and others advocate prolonged immobilization (>1 month). 5,6 Furthermore, there are those that advocate introducing load early (e.g. active exercise) versus those who only recommend passive movement.…”

Section: Introductionmentioning

confidence: 99%

“…active exercise) versus those who only recommend passive movement. 5,6 There is limited information available relating to current rehabilitation practice following rotator cuff repair. Hence, the present study aimed to describe current practice as a pre-cursor to informing and developing a future programme of research.…”

Section: Introductionmentioning

confidence: 99%

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Rehabilitation following rotator cuff repair: a survey of current UK practice

Littlewood

Bateman

2015

Shoulder & Elbow

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Background: Rotator cuff disorders, including rotator cuff tears, are common and can be treated conservatively or surgically. Data suggest that the incidence of surgery to repair the rotator cuff is rising. Despite this rise, the most effective approach to postoperative rehabilitation, a critical component of the recovery process, is not well developed. The present study aimed to describe current practice in the UK in relation to rehabilitation following rotator cuff repair. Methods: An electronic survey was developed and disseminated to UK based physiotherapists and surgeons involved with rotator cuff repair. Results: One hundred valid responses were received. Although there is a degree of variation, current practice for the majority of respondents consists of sling immobilization for 4 weeks to 6 weeks. During this time, passive movement would be commenced before active movement is introduced towards the end of this phase. Resisted exercise begins 7 weeks to 12 weeks postoperatively, alongside return to light work. A progressive resumption of function, including manual work and sport, is advised from approximately 13 weeks. Conclusions: In the context of the current literature, it might be suggested that the current approach to rehabilitation following rotator cuff repair for the majority of respondents is somewhat cautious and has not progressed for over a decade.

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Section: Discussionmentioning

confidence: 99%

“…This vignette is based upon the typical inclusion criteria of previously published literature 6 and also clinical feedback, as follows:…”

Section: Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Rehabilitation following rotator cuff repair: a survey of current UK practice

Littlewood

Bateman

2015

Shoulder & Elbow

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Rehabilitation following rotator cuff repair: A survey of current practice (2020)

Littlewood

Mazuquin

Moffatt

et al. 2020

Musculoskeletal Care

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Introduction Approaches to rehabilitation following rotator cuff repair are variable but typically include 4–6 weeks of immobilisation followed by a gradual introduction of movement and activity. However, research has questioned whether such an approach is optimal. The aim of this study was to undertake an updated survey to understand whether practice has evolved in line with contemporary research. Methods An electronic survey was developed describing three case scenarios (medium‐sized rotator cuff repair [2 cm], large‐sized rotator cuff repair [4 cm] and large‐sized rotator cuff repair with biceps tenodesis). Clinicians involved with rehabilitation following rotator cuff repair were invited to participate. Results 129 responses were received (United Kingdom = 87, other regions [ORs] = 42). Respondents would most commonly recommend four to six weeks of immobilisation for all case scenarios. Passive movement would commence during this period, with active movement recommended from four to six weeks. Resisted exercise would commence between seven to 12 weeks along with return to driving. There were some minor differences in recommendations between respondents from the United Kingdom and ORs, including a greater proportion from the United Kingdom recommending sling immobilisation rather than abduction brace immobilisation. Conclusion For many respondents to this survey, rehabilitation for the three case scenarios was similar and has not evolved in line with contemporary research evidence. The reasons behind this need to be explored and incorporated into the design of future research evaluating rehabilitation following rotator cuff repair.

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Effectiveness of supervised physiotherapy versus home exercise in subjects with rotator cuff disorders treated surgically: A systematic review and meta‐analysis

Gutiérrez-Espinoza

Araya-Quintanilla

Olguín-Huerta

et al. 2022

Physiotherapy Res Intl

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Objective: The aim is to determine the effectiveness of supervised Physiotherapy (PT) versus a home exercise program for functional outcomes in patients with rotator cuff (RC) disorders treated surgically.Type: Systematic review and meta-analysis of randomized clinical trials.Methodology: An electronic search was performed in the MEDLINE, CENTRAL, EMBASE, PEDro, LILACS, CINAHL, SPORTDiscus, and Web of Science databases.The eligibility criteria for selecting studies included randomized clinical trials that compared supervised PT versus home exercises in functional outcomes, such as shoulder or upper limb function, pain intensity, and range of motion, in subjects older than 18 years with RC disorders treated surgically.Synthesis: Six trials met the eligibility criteria, and for the quantitative synthesis, five studies were included. At 3 months, the mean difference (MD) for the Constant-Murley questionnaire (0-100 points) was −0.76 points (95% confidence interval (CI) = −15.64 to 14.12, p = 0.92), while the MD for the visual analog scale (0-10 cm) was −0.87 cm (95% CI = −2.8 to 1.06, p = 0.38). These differences were neither clinically nor statistically significant. Conclusion:There was very low quality of evidence towards no better benefits in shoulder pain and function of supervised PT over home exercises programs in patients older than 18 years with RC disorders treated surgically.

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Rehabilitation following rotator cuff repair: a systematic review

Cited by 38 publications

References 31 publications

Rehabilitation following rotator cuff repair: a survey of current UK practice

Rehabilitation following rotator cuff repair: a survey of current UK practice

Rehabilitation following rotator cuff repair: A survey of current practice (2020)

Effectiveness of supervised physiotherapy versus home exercise in subjects with rotator cuff disorders treated surgically: A systematic review and meta‐analysis

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