This article is more than 5 years old. Information may no longer be current.
Rehabilitation prior to arthroscopic rotator cuff repair yields range of motion benefits
A rehabilitation program before arthroscopic rotator cuff repair helped patients achieve faster recovery, but only through 3 postoperative weeks.
Click Here to Manage Email Alerts
 Mehmet Demirhan |
Preoperative rehabilitation programs for arthroscopic rotator cuff repair patients were found effective for increasing postoperative range of motion, but only during the first 3 weeks of recovery, according to a study presented at the 8th Biennial ISAKOS 2011 Congress.
“After the patients undergo arthroscopic rotator cuff repair, the progress of that rehabilitation may provide a faster recovery, at least in the early postoperative period,” Aksel Seyahi, MD, in the Department of Orthopaedics and Traumatology at the American Hospital in Istanbul, Turkey, told Orthopaedics Today Europe.
From their study of 168 patients, Seyahi and colleagues found that while results of the preoperative rehabilitation program in the first 3 weeks after surgery were associated with greater improvement in range of motion (ROM) vs. those patients who completed only regular postoperative rehabilitation, there were no significant differences between the two groups’ functional outcomes at the 12 week and 12.4 month follow-ups.
Therefore, they concluded in their abstract that after 6 weeks there was no significant benefit to preoperative rehabilitation.
Avoiding further tears
Senior investigator Mehmet Demirhan, MD, however, told Orthopaedics Today Europe that patients with poor rotator cuff ROM should participate in a rehabilitation program prior to surgery.
“The preoperative range of motion in patient activity and the strength of the rotator cuff are very important in the postoperative period,” he said. “For that reason, in any patient with a preoperative range of motion restriction we should not operate before getting a good preoperative rehabilitation. This is actually the main result of our study.”
|
Image: Seyahi A |
Prior to surgery, 113 study patients enrolled in rehabilitation sessions lasting about 1.5 hours where they performed passive ROM and periscapular muscle strengthening exercises, and strengthening exercises with resistance bands.
“After [stopping] the supervised rehabilitation program, they continued a home-based exercise program for 15 minutes per day until the date of surgery,” Seyahi said.
Results by tear size
The control group, which consisted of 55 patients, completed standard postoperative rehabilitation.
For their analysis, investigators further divided the preoperative exercise group into three groups based on the size of their cuff tears — small < 2 cm, medium 2 cm to 4 cm, and large > 4 cm. They compared preoperative and postoperative Visual Analog Scale, DASH and Constant scores to identify any differences in outcome scores. Seyahi and colleagues used the Mann-Whitney U and Wilcoxon tests for statistical analysis, finding both groups had similar outcome scores in all areas and also had a similar mean age (55.3 years).
A possible study weakness was the fact the team did not use the WOMAC score in their investigation, Seyahi said. – by Jeff Craven
Reference:
- Seyahi A, Canbulat N, Koyuncu LO, et al. The effect of preoperative rehabilitation on the outcomes of arthroscopic rotator cuff repair. Paper #38. Presented at the 8th Biennial ISAKOS 2011 Congress. May 15-19. Rio de Janeiro.
- Aksel Seyahi, MD, and Mehmet Demirhan, MD, can be reached at the Department of Orthopaedics and Traumatology, VKV Amerikan Hastanesi, Tevikiye Mh. Güzelbahçe Sokak 5, Istanbul, Turkey; +90 212 311 2000; email: aseyahi@gmail.com.
- Disclosures:Seyahi and Demirhan have no relevant financial disclosures.