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A Review of Online Rehabilitation Protocols Designated for Rotator Cuff Repairs.
Arthrosc Sports Med Rehabil. 2020 Jun; 2(3):e277-e288.AS

Abstract

Purpose

To compare publicly available rehabilitation protocols designated for rotator cuff (RTC) repairs published online by academic residency programs and private practice institutions.

Methods

A systematic electronic search using the Fellowship and Residency Electronic Interactive Database Access System (FREIDA) was performed for RTC repair rehabilitation protocols. Private practice programs with published rehabilitation protocols that were discovered during the Google search were also included for review, but no comprehensive search for private practice protocols was performed. The main exclusion criteria consisted of non-English-language protocols and protocols without any of the time-based components in question. Included protocols were assessed independently based on the specified RTC tear size (small [≤1 cm], medium [1-4 cm], large or massive [≥5 cm], or no mention of size). Protocols were compared based on the inclusion, exclusion, and timing of certain rehabilitation components.

Results

A total of 96 rehabilitation protocols were included for review, from 39 academic institutions and 28 private practice programs. Specific instructions for concomitant biceps tenodesis were included in 26 protocols (27.1%). Of the 96 protocols, 88 (91.7%) did not place restrictions on early postoperative passive range of motion (PROM) of the shoulder. Isolated PROM with restrictions on active range of motion was most commonly recommended for the first 4 or 6 weeks postoperatively (80.2%). Use of a sling or immobilizer was most frequently recommended for the first 4 or 6 weeks postoperatively (78.1%). Wide variation was noted in recommendations for returning to resistance strengthening, with the highest incidence being 27 protocols recommending returning at 12 weeks (28.1%); this further varied based on the size of the tear. A total of 21 protocols (21.9%) recommended the use of cryotherapy postoperatively.

Conclusions

Although certain rehabilitation components were common, such as duration of PROM and sling or immobilizer use, a large degree of variation remains among published rehabilitation protocols after RTC repair, and this variability is still seen even when subdividing by the size or severity of the RTC tear.

Clinical Relevance

Rehabilitation after RTC repair is crucial to patient outcomes. This study summarizes the variability among online rehabilitation protocols for RTC repair in the United States and emphasizes the importance of appropriate rehabilitation after RTC surgery.

Authors+Show Affiliations

University of Kansas School of MedicineSystematic Review, U.S.A.University of Kansas School of MedicineSystematic Review, U.S.A.University of Kansas School of MedicineSystematic Review, U.S.A.University of Kansas School of MedicineSystematic Review, U.S.A.University of Kansas School of Medicine-Wichita, U.S.A.University of Kansas School of MedicineSystematic Review, U.S.A.University of Kansas School of MedicineSystematic Review, U.S.A.University of Kansas School of MedicineSystematic Review, U.S.A.University of Kansas School of MedicineSystematic Review, U.S.A.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32548593

Citation

Coda, Reed G., et al. "A Review of Online Rehabilitation Protocols Designated for Rotator Cuff Repairs." Arthroscopy, Sports Medicine, and Rehabilitation, vol. 2, no. 3, 2020, pp. e277-e288.
Coda RG, Cheema SG, Hermanns CA, et al. A Review of Online Rehabilitation Protocols Designated for Rotator Cuff Repairs. Arthrosc Sports Med Rehabil. 2020;2(3):e277-e288.
Coda, R. G., Cheema, S. G., Hermanns, C. A., Tarakemeh, A., Vopat, M. L., Kramer, M., Schroeppel, J. P., Mullen, S., & Vopat, B. G. (2020). A Review of Online Rehabilitation Protocols Designated for Rotator Cuff Repairs. Arthroscopy, Sports Medicine, and Rehabilitation, 2(3), e277-e288. https://doi.org/10.1016/j.asmr.2020.03.006
Coda RG, et al. A Review of Online Rehabilitation Protocols Designated for Rotator Cuff Repairs. Arthrosc Sports Med Rehabil. 2020;2(3):e277-e288. PubMed PMID: 32548593.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Review of Online Rehabilitation Protocols Designated for Rotator Cuff Repairs. AU - Coda,Reed G, AU - Cheema,Sana G, AU - Hermanns,Christina A, AU - Tarakemeh,Armin, AU - Vopat,Matthew L, AU - Kramer,Meghan, AU - Schroeppel,John Paul, AU - Mullen,Scott, AU - Vopat,Bryan G, Y1 - 2020/05/29/ PY - 2019/10/06/received PY - 2020/03/26/accepted PY - 2020/6/18/entrez PY - 2020/6/18/pubmed PY - 2020/6/18/medline SP - e277 EP - e288 JF - Arthroscopy, sports medicine, and rehabilitation JO - Arthrosc Sports Med Rehabil VL - 2 IS - 3 N2 - Purpose: To compare publicly available rehabilitation protocols designated for rotator cuff (RTC) repairs published online by academic residency programs and private practice institutions. Methods: A systematic electronic search using the Fellowship and Residency Electronic Interactive Database Access System (FREIDA) was performed for RTC repair rehabilitation protocols. Private practice programs with published rehabilitation protocols that were discovered during the Google search were also included for review, but no comprehensive search for private practice protocols was performed. The main exclusion criteria consisted of non-English-language protocols and protocols without any of the time-based components in question. Included protocols were assessed independently based on the specified RTC tear size (small [≤1 cm], medium [1-4 cm], large or massive [≥5 cm], or no mention of size). Protocols were compared based on the inclusion, exclusion, and timing of certain rehabilitation components. Results: A total of 96 rehabilitation protocols were included for review, from 39 academic institutions and 28 private practice programs. Specific instructions for concomitant biceps tenodesis were included in 26 protocols (27.1%). Of the 96 protocols, 88 (91.7%) did not place restrictions on early postoperative passive range of motion (PROM) of the shoulder. Isolated PROM with restrictions on active range of motion was most commonly recommended for the first 4 or 6 weeks postoperatively (80.2%). Use of a sling or immobilizer was most frequently recommended for the first 4 or 6 weeks postoperatively (78.1%). Wide variation was noted in recommendations for returning to resistance strengthening, with the highest incidence being 27 protocols recommending returning at 12 weeks (28.1%); this further varied based on the size of the tear. A total of 21 protocols (21.9%) recommended the use of cryotherapy postoperatively. Conclusions: Although certain rehabilitation components were common, such as duration of PROM and sling or immobilizer use, a large degree of variation remains among published rehabilitation protocols after RTC repair, and this variability is still seen even when subdividing by the size or severity of the RTC tear. Clinical Relevance: Rehabilitation after RTC repair is crucial to patient outcomes. This study summarizes the variability among online rehabilitation protocols for RTC repair in the United States and emphasizes the importance of appropriate rehabilitation after RTC surgery. SN - 2666-061X UR - https://www.unboundmedicine.com/medline/citation/32548593/A_Review_of_Online_Rehabilitation_Protocols_Designated_for_Rotator_Cuff_Repairs L2 - https://linkinghub.elsevier.com/retrieve/pii/S2666-061X(20)30023-7 DB - PRIME DP - Unbound Medicine ER -
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