The Effect of Cross-Education on Shoulder Arthroscopy

Study Overview
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Brief Summary
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The purpose of this study is to examine the effectiveness of a strength training protocol on the uninjured upper extremity either alone or with the addition of blood flow restriction (BFR) training on subjects who have undergone shoulder arthroscopy.

Detailed Description
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The purpose of this study is to examine the effectiveness of a strength training protocol on the uninjured limb either alone or with the addition of blood flow restriction (BFR) training on the status of the injured limb post shoulder arthroscopy. Patients will be randomized into one of three standardized physical therapy (PT) groups after shoulder arthroscopy: Control group (CON), Strength Training on the uninvolved shoulder (STR), strength training with the BFR on the uninvolved shoulder (BFR). All three patient groups will follow a standardized PT rehab protocol that is usual standard of care on the involved shoulder. The STR and BFR group will follow a typical standard of care rehab protocol to the uninvolved side to investigate the potential effects of cross-education. Isometric strength will be assessed utilizing handheld dynamometry (HHD) at Kerlan-Jobe during their regularly scheduled pre-operative and follow-up visits. Patients age 18 and older undergoing shoulder arthroscopy for rotator cuff repair and/or biceps tenodesis. The study includes 3 visits which are standard of care pre-operative and post-operative visits. The duration of the study will be 14 weeks. 2 weeks to allow for a pre-op baseline strength assessment and 12 weeks post-op for the final assessment during the patients routine follow-up visit. Physical Therapy will be standardized for all three groups in terms of frequency and rehabilitation protocol. The only exercises that will be added will be to the intervention groups on the uninvolved side. Patients will present to physical therapy 2-3 times/week during the duration of the study regardless of their group allocation.

Official Title
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The Effects of Cross-Education and Blood Flow Restriction Study on Patients Undergoing Shoulder Arthroscopy

Conditions
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Rotator Cuff Tears, Rotator Cuff Injuries, Rotator Cuff Repair

Intervention / Treatment
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* Other: Cross-Education
* Other: Blood-Flow Restriction Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years and older Diagnosed with rotator cuff injury Scheduled for rotator cuff surgery via shoulder arthroscopy Exclusion Criteria: Less than 18 years old History of previous contra-lateral surgery or injury Previous ipsi-lateral upper extremity surgery History of shoulder osteoarthritis

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control Group<br>This group will undergo a standardized rehabilitation protocol of the involved shoulder only. | |
| Experimental: Cross-Education Group<br>This group will undergo a standardized rehabilitation protocol of the involved shoulder with the addition of upper extremity strengthening exercises to the uninvolved side. | Other: Cross-Education<br>* 1) Cross-Education: The effect that exercising the uninvolved upper extremity will have a positive effect on the involved upper extremity.<br>|
| Experimental: Cross-Education + Blood-Flow Restriction Group<br>This group will undergo a standardized rehabilitation protocol of the involved shoulder with the addition of upper extremity strengthening exercises to the uninvolved side with blood-flow restriction simultaneously. | Other: Cross-Education<br>* 1) Cross-Education: The effect that exercising the uninvolved upper extremity will have a positive effect on the involved upper extremity.<br>Other: Blood-Flow Restriction Training<br>* 1) Blood Flow Restriction: A type of resistance training using a blood-pressure like cuff that partially occludes venous blood flow to induce various neurohormonal effects and allows strength gains to be achieved at very low loads of resistance.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in strength of the shoulder at 6 weeks and 12 weeks | Strength of the shoulder will be assessed via hand-held dynamometer | pre-operative visit, 6 week post-operative visit, 12-week post-operative visit | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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biceps tenodesis, Cross-Education, Blood-Flow Restriction Training