Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Does physiotherapy after rotator cuff repair require supervision by a physical therapist?: a meta-analysis

  • Masaki Karasuyama (Department of Rehabilitation, Minamikawa Orthopedic Hospital) ;
  • Masafumi Gotoh (Department of Orthopedic Surgery, Kurume University Medical Center) ;
  • Takuya Oike (Department of Rehabilitation, Tahara Orthopedic Clinic) ;
  • Kenichi Nishie (Department of Respiratory Medicine, Iida Municipal Hospital) ;
  • Manaka Shibuya (Department of Rehabilitation, Kitasato University Hospital) ;
  • Hidehiro Nakamura (Department of Orthopedic Surgery, Kurume University Medical Center) ;
  • Hiroki Ohzono (Department of Orthopedic Surgery, Kurume University Medical Center) ;
  • Junichi Kawakami (Department of Physical Therapy, Kyushu Nutrition Welfare University)
  • Received : 2022.12.07
  • Accepted : 2023.02.21
  • Published : 2023.09.01
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Abstract

Background: A supervised physiotherapy program (SPP) is a standard regimen after surgical rotator cuff repair (RCR); however, the effect of a home-based exercise program (HEP), as an alternative, on postoperative functional recovery remains unclear. Therefore, the purpose of this meta-analysis was to compare the functional effects of SPP and HEP after RCR. Methods: We searched electronic databases including Central, Medline, and Embase in April 2022. The primary outcomes included the Constant score, American Shoulder and Elbow Surgeons score, University of California Los Angeles shoulder score, and pain score. Secondary outcomes included range of motion, muscle strength, retear rate, and patient satisfaction rate. A meta-analysis using random-effects models was performed on the pooled results to determine the significance. Results: The initial database search yielded 848 records, five of which met our criteria. Variables at 3 months after surgery were successfully analyzed, including the Constant score (mean difference, -8.51 points; 95% confidence interval [CI], -32.72 to 15.69; P=0.49) and pain score (mean difference, 0.02 cm; 95% CI, -2.29 to 2.33; P=0.99). There were no significant differences between the SPP and HEP. Other variables were not analyzed owing to the lack of data. Conclusions: Our data showed no significant differences between SSP and HEP with regard to the Constant and pain scores at 3 months after RCR. These results suggest that HEP may be an alternative regimen after RCR. Level of evidence: I.

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References

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