None listed
Conditions
Brief summary
Rotator cuff tears are the most common condition affecting the shoulder. Conservative treatment can involve pain medication, corticosteroid injection, activity modification and physiotherapy. Surgical treatment is considered when conservative management has failed and quality of life is significantly impacted by shoulder dysfunction. In the rehabilitation phase following rotator cuff repair, patients follow a set protocol determined by the surgeon. There is currently no agreement on whether one rehabilitation approach is better than the other. One study found that patients that underwent a shoulder program for 4-6 weeks before surgery had better function and reduced pain in the rehabilitation phase compared to a delayed program group. Pre-operative programs for patients scheduled for spinal surgery and total knee replacements have demonstrated some encouraging results. This type of program has not been used for patients awaiting rotator cuff surgery. The effects of such a program on patient post-operative expectations, function and quality of life have not been investigated. The purpose of this research is to investigate whether the addition of a prehabilitation program to routine pre-operative care will result in better function, quality of life and post-operative expectations for patients awaiting shoulder surgery. The second aim of this research is to study the effect of prehabilitation on pain, shoulder range of movement, strength and exercise endurance. In addition, it may possibly reduce the need for surgery. It is hypothesised that addition of prehabilitation to optimise physical and mental preparation will improve post-operative outcome than usual care (waiting list).
Interventions
PREHABILITATION- 8 week GROUP program
EDUCATION - 1 x one hour per week
EXERCISE - twice per week, one hour sessions
both administered by qualified physiotherapists in a group setting
EDUCATION- topics include shoulder anatomy, operative procedure, patient and therapist expectations, post-operative protocol and exercise technique
EXERCISE - neuromuscular control exercises for rotator cuff and scapular stabilisers (50% of allocated time of one hour) interspersed with moderate intensity (max 6
PREHABILITATION- 8 week GROUP program EDUCATION - 1 x one hour per week EXERCISE - twice per week, one hour sessions both administered by qualified physiotherapists in a group setting EDUCATION- topics include shoulder anatomy, operative procedure, patient and therapist expectations, post-operative protocol and exercise technique EXERCISE - neuromuscular control exercises for rotator cuff and scapular stabilisers (50% of allocated time of one hour) interspersed with moderate intensity (max 60% HR) general fitness exercise (25% of time) and Tai Chi (25% of time) Attendance log will be used to monitor adherence
Sponsors
Dr Judy Chen
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Aged 18 years and over Rotator cuff pathology, calcific tendinitis, rotator cuff tear of any size, subacromial impingement, subscapularis tendon tear; on waiting list for surgery Willingness to give informed consent and to participate and comply with study
Exclusion criteria
Patients with insufficient ability to understand the English language Recent or previous fractures of the shoulder complex Previous shoulder surgery on the affected side or both Radiologically verified malignancy Adhesive capsulitis Symptoms referred from the cervical spine Clinically verified polyarthritis, rheumatoid arthritis, fibromyalgia Failed medical clearance to participate in exercises Unable to agree to participate in the research protocol for 8 weeks
Outcome results
None listed