Comparison of the results of supervised physiotherapy program and home-based exercise program in patients treated with arthroscopic-assisted mini-open rotator cuff repair
Nihal Büker1, Ali Kitiş1, Semih Akkaya2, Nuray Akkaya3
1Pamukkale Üniversitesi Fizik Tedavi ve Rehabilitasyon Yüksekokulu, Denizli, Türkiye;
2Pamukkale Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı
3Fizik Tedavi ve Rehabilitasyon Anabilim Dalı, Denizli, Türkiye
Keywords: Cost analysis; home based exercises program; mini-open repair; physiotherapy; rotator cuff; shoulder arthroscopy.
Objectives: This study aims to compare the results of supervised exercise program versus standardized home-based exercise program after rotator cuff repair with respect to severity of pain, functional status, quality of life, and depression.
Patients and methods: Twenty-eight patients (5 males, 23 females; mean age 59.8±9.1 years; range 40 to 83 years) who had rotator cuff repair were evaluated. Patients were divided into two groups and the first group was treated with supervised physiotherapy (n=15) and the second group was treated with home-based exercise program (n=13). Pendulum exercises and passive exercises within pain limits were performed by all patients in the six-week immobilization period with shoulder sling with abduction pillow after rotator cuff repair. After this period, the patients in homebased exercise program were taught to perform active exercises and the patients in supervised physiotherapy group were treated with active shoulder range of motion exercises under the supervision of the physiotherapist. When patients reached to active full range of motion, strengthening exercises were added to exercise program. Patients were assessed preoperatively and at the end of the postoperative third month. Pain was evaluated with visual analog scale (VAS), functional status with Constant shoulder score, quality of life with short form-36 (SF-36), and depressive symptoms with Beck depression inventory (BDI).
Results: There were significant improvements in all evaluation parameters in both groups after rotator cuff repair.
Conclusion: There were no statistical differences between the patients who received exercise program under the supervision of the physiotherapist and the patients who were treated with standardized home-based exercise program for the efficacy of treatment in the evaluation of pain, functional status, quality of life, and depression status. When the rehabilitation programs were analyzed for cost effectiveness, the supervised physiotherapy group was found to have higher costs.