Article

OBJECTIVE: To compare two different rehabilitation strategies, primary passive
motion versus early isometric loading of the rotator cuff. DESIGN: Prospective
randomized controlled observer-blinded pilot study.
SETTING: Institute of
Physical Medicine and Rehabilitation. SUBJECTS:
Thirty patients after rotator
cuff surgery. INTERVENTION:
All participants were randomly assigned to one of the
two outpatient treatment groups: primary passive motion versus early isometric
loading of the rotator cuff. Both groups were treated for 12 weeks and performed
additionally a home exercise program. MAIN MEASURES: The primary outcome measure
for functional assessment was the Constant Murley score. The secondary outcome
measures were the Disabilities of the Arm, Shoulder and Hand score (DASH), active
range of motion, pain level and strength. Patients were assessed before, 6, 12
and 24 weeks after surgery. RESULTS: Repeatedly measured metric variables were
compared by the Quade rank analysis of covariance and revealed substantially
better Constant Murley scores in the early activated group at all 3 assessments
(6 weeks: 41 [31;45] versus 30 [23;37]; 12 weeks: 68 [56;77] versus 59 [53;62];
24 weeks: 79 [76;81] versus 66 [62;74]; data as median [25%;75%]). Postoperative
changes of Constant score were in favour of the active group with the biggest
difference at week 12 (28 [38;12] versus 9 [27;-4]). Maximal pain levels showed
clear more reduction 6 and 24 weeks after surgery in the early activated group.
CONCLUSIONS: This pilot study with early isometric loading of the rotator cuff
shows better function and less maximal pain. Further research is warranted to
confirm our results.

Langue : ANGLAIS