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Effectiveness of early compared with conservative rehabilitation for patients having rotator cuff repair surgery: an overview of systematic reviews
  1. Bruno Fles Mazuquin1,
  2. Andrew Charles Wright2,
  3. Sarah Russell3,
  4. Puneet Monga3,
  5. James Selfe4,
  6. Jim Richards1
  1. 1 Allied Health Research Unit, University Central of Lancashire, Preston, Lancashire, UK
  2. 2 North West Deanery, Manchester, Lancashire, UK
  3. 3 Upper Limb Unit, Wrightington Hospital, Wigan, UK
  4. 4 Department of Health Professions, Manchester Metropolitan University, Manchester, UK
  1. Correspondence to Bruno Fles Mazuquin, Allied Health Research Unit, University of Central Lancashire, Brook Building, BB 107, Victoria Street, Preston, Lancashire PR1 2HE, UK; bfmazuquin{at}uclan.ac.uk

Abstract

Aim/objective The aim is to critically analyse and discuss the current literature and determine the effectiveness of rehabilitation for patients after surgical repair of rotator cuff tears for range of motion (ROM), pain, functional status and retear rates; in addition, an update of new literature is included.

Design Overview of systematic reviews.

Data sources A search was performed with no restrictions to date of publication and language in the following databases: EBSCO, AMED, CINAHL, SPORTDiscus, EMBASE, Cochrane, LILACS, MEDLINE, PEDro, Scielo, SCOPUS and Web of Knowledge. The PRISMA guideline was followed to develop this review and the R-AMSTAR tool was used for critical appraisal of included reviews.

Eligibility criteria Only systematic reviews and randomised controlled trials (RCTs) comparing the effectiveness of early with conservative rehabilitation, after surgical repair of the rotator cuff, were included. Moreover, the studies should report ROM, pain, functional status and/or retears rates before and after 3–24 months of the surgery.

Results 10 systematic reviews and 11 RCTs were included for the final analysis. Conflicting results and conclusions were presented by the systematic reviews, the use of primary studies varied; also the methodological quality of the reviews was diverse. This updated review, with new meta-analysis, showed no difference for function, pain, ROM or retears ratio between early and conservative rehabilitation.

Summary/Conclusions Early mobilisation may be beneficial, particularly for small and medium tears; however, more studies with higher quality are required, especially for patients with large tears who have been given less attention.

  • Shoulder
  • Rotator cuff
  • Rehabilitation
  • Evidence based review

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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