Effects of Supervised Physical Therapy With Early Activation of the Rotator Cuff Versus Home Exercises in Patients After Arthroscopic Subacromial Decompression

Study Overview
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Brief Summary
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The objective of this study was to evaluate and compare two different post-surgical rehabilitation strategies, Rehabilitation supervised by a physical therapist including exercises with progressive early activation of the rotator cuff versus basic home exercises regarding shoulder function, pain, health related quality of life and return to work after arthroscopic subacromial decompression.

Detailed Description
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Patients scheduled for surgery (arthroscopic subacromial decompression)and in the age 25-65 were offered to participate in the study. After surgery they were randomized to either Supervised Physical therapy with early activation of the rotator cuff (PT-group) or to home exercises (H-group). Patients in the PT group met the physical therapist twice a week for exercises and in between these visits they did their exercises at home daily. The H-group did home exercises daily. Shoulder function and pain(primary outcomes)and health related quality of life, returning to work(secondary outcomes)were assessed before surgery, one week after(baseline), 1,2,3 and 6 months after surgery by an independent physical therapist.

Official Title
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Effects of Supervised Physical Therapy With Early Activation of the Rotator Cuff Versus Home Exercises in Patients After Arthroscopic Subacromial Decompression

Conditions
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Subacromial Decompression

Intervention / Treatment
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* Other: Exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subacromial impingement verified with Neer impingement test At least 6 month duration of pain Treated in primary care without satisfactory results for at least three months. Typical history and pain location. Scheduled for surgery (subacromial decompression) Three of these four tests must be positive: Neer impingement test Hawkins-Kennedy impingement sign Jobe supraspinatus test Painful arc 60-120 degree Exclusion Criteria: Radiological findings of malignancy osteoarthritis, fractures Polyarthritis or fibromyalgia Pathological hyper laxity Lack of communication skills that prevent the use of outcome measurements Cervical spine pathology

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 65 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 |
| --- | --- |
| Experimental: Supervised physical therapy focusing of rotatorcuff exercises<br>Patients did specific exercises supervised by a physical therapists twice a week during two months. Focus was on early activation of rotator cuff and scapula stabilizers following different phases in a rehabilitation program Assessments before surgery,1 week after as well as 1,2,3 and 6 months after surgery. | Other: Exercises<br> <br> |
| Active Comparator: Home exercises<br>Patients did home exercises following a programme during three months. Assessment considering shoulder function and pain was done before surgery, 1w after as well as 1,2,3 and 6 months after surgery, | Other: Exercises<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Shoulder function and pain |  | before surgery, 1 w (baseline, 1,2,3 and 6 month after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Health related quality of life and returning to work |  | before surhery and 1 w(baseline)1,2,3 and 6 months after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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arthroscopic subacromial decompression, exercise, physical therapy, rotator cuff, shoulder impingement syndrome, Subacromial impingement after arthroscopic subacromial decompression