Prehabilitation, Rehabilitation, Rotator Cuff
Conditions
Keywords
prehabilitation, rotator cuff repair, shoulder pain
Brief summary
A rotator cuff tear is a structural injury to one or more tendons of the rotator cuff, ranging from degenerative changes to partial or complete tears. Rotator cuff tears are among the most common causes of shoulder pain and disability, particularly in middle-aged and older adults, and their prevalence increases with age. Population studies report a prevalence of complete tears around 20% to 22%, while in cohorts of individuals over 70 years of age, it can exceed 50%. The risk of tearing is associated with advanced age, dominant arm involvement, trauma, heavy labor, and male sex.
Detailed description
Physiological stress and adverse psychological factors can negatively interfere with postoperative recovery. To address this challenge, prehabilitation emerges as a comprehensive strategy that actively prepares patients before surgery, aiming to improve physical condition, optimize nutritional status, and implement cognitive interventions to reduce stress and anxiety. However, the application of prehabilitation in musculoskeletal injuries remains controversial. The main interventions in musculoskeletal injuries are based on strengthening exercises, balance and proprioceptive work, combined to a lesser extent with preoperative education and the use of neuromuscular electrical stimulation.
Interventions
OTHERPrehabilitation
Two 60-minute prehabilitation sessions were conducted one week prior to surgery by kinesiologist specializing in musculoskeletal rehabilitation. The first session consisted of a power point presentation covering: (1) postoperative stages; (2) biopsychosocial factors influencing pain management; (3) the correct use of the sling and abduction cushion. The second session required participants to bring a companion for demostrations and practice of: (1) strategies for performing activities of daily living; (2) permitted movements and restrictions during the first postoperative weeks; (3) distal mobility exercises and (4) sleep hygiene strategies.
Sponsors
Laura Castillo Vejar
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Intervention model description
A two-arm parallel randomized clinical trial with repeated measures
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Men or women * Over 50 years of age * Awaiting arthroscopic surgery for rotator cuff repair of one or more tendons * Signed informed consent.
Exclusion criteria
* Patients with a history of previous shoulder surgery ( in the contralateral shoulder) * Patients with a massive irreparable rotator cuff tears * Patientes with a history of infiltration in an injured shoulder * Uncontrolled or undiagnosed sleep disorders * The presence of mental or neurological illness, inability to read or follow instructions.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Western Ontario Rotator Cuff (WORC) | 4,8 and 12 week | It consists of 21 questions, addressing physical symptoms, sports and recreation, work and recreation, work, life studies and emotions. All dimensions were calculated and will be reported as a percentage. The WORC (Western Ontario Rotator Cuff Index) has an absolute maximum score of 2100 points, representing the worst possible symptoms or the highest level of shoulder disability. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain intensity | 4,8 and 12 week | The intensity of the pain is assessed considering a scale from 0 to 10. 0 being no pain and 10 being the maximum pain perceived. |
| Kinesiophobia (TSK-11) | 4,8 and 12 week | The tampa Kinesiophobia scale (TSK-11) will be used, being a valid, self-reported assessment instrument of 44 point. The maximum score is 44 points correlates with higher kinesiophobia |
| Catastrophizing (PCS) | 4,8 and 12 week | A 13-item self-administered questionnaire will be used, designed to measures a person is tendency to magnify, ruminate, or feel helpless in the face of pain. The maximum score on the Pain Catastrophizing Scale (PCS) is 52 points. |
| Disability (QUICKDASH) | 4,8 and 12 week | Evaluates disability and symptom severity for conditions affecting the arm, shoulder, and hand. 11 items rates on a 5-point likert scale (requiring at least 10 answered items to calculate). The maximum score on the QuickDASH questionnaire is 100 points, indicating the highest level of disability or functional limitation in the upper extremity. |
| Grip Strength | 4,8 and 12 week | A dynamometer will be used to quantify the grip strength of both arms. |
| Mobility (ROM) | 4,8 and 12 week | A goniometer is used to measure the degrees of arm movement |
| Sleep quality (PSQI) | 4,8 and 12 week | The Pittsburgh sleep quality index is a questionnaire that measures sleep quality and its disturbances in the last month. The maximum score on the Pittsburgh Sleep Quality Index (PSQI) is 21 points. Each component is rated on a scale of 0 to 3, where 0 means no difficulty and 3 represents a serious problem. |
Countries
Chile
Contacts
PRINCIPAL_INVESTIGATORLaura Castillo, Msc
Clinica Mayor RedSalud Temuco
Outcome results
None listed