Home-based and supervised shoulder rehabilitations may yield similar outcomes
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Key takeaways:
- Both home-based and supervised physical therapies were effective for rehabilitation after rotator cuff repair surgery.
- Both cohorts had similar functional and mobility improvements at latest follow-up.
Patients who had home-based physical therapy after arthroscopic rotator cuff repair of a massive rotator cuff tear had similar improvements in functional outcomes as those who had supervised physical therapy, according to published results.
Javier Ardebol, MD, an orthopedic research fellow at the Oregon Shoulder Institute, and colleagues performed a retrospective case series comparison of data from 61 patients who received supervised physical therapy and 38 patients who received home-based physical therapy after arthroscopic rotator cuff repair for a massive rotator cuff tear.
According to the study, the latest postoperative follow-up was 53 months for patients who received supervised therapy and 55 months patients who received home-based therapy. Outcomes included American Shoulder and Elbow Surgeon scores, subjective shoulder value scores, VAS pain scores and range of motion (ROM).
At 3 months, Ardebol and colleagues found ASES scores (71.4 vs. 61.2) and forward flexion (135° vs. 118°) were significantly higher in the home-based cohort compared with the supervised cohort. However, they noted all patient-reported outcomes and ROM measurements were similar between the cohorts at 6 months, 1 year and at latest follow-up. They also noted both cohorts achieved the minimal clinically important difference and patient-accepted symptomatic state for ASES, subjective shoulder value and VAS scores at every postoperative time point.
According to the study, patient satisfaction, complications, tendon healing and return to work rates were also similar between the cohorts.
“Although some factors have been correlated with poor outcomes after [arthroscopic rotator cuff repair of massive rotator cuff tears] ARCR of MRCTs including fatty infiltration and tear size, the impact of [physical therapy] PT type remains to be elucidated,” Ardebol and colleagues wrote in the study.
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