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Updated: Nov 24, 2025
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Rehabilitation following rotator cuff repair: A nested qualitative study exploring the perceptions and experiences of
Gareth Stephens1, Chris Littlewood2,3, Nadine E Foster3
1The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
Objective:
To investigate acceptability, barriers to adherence with the interventions, and which outcome measures best reflect the participants' rehabilitation goals in a pilot and feasibility randomised controlled trial evaluating early patient-directed rehabilitation and standard rehabilitation, including sling immobilisation for four weeks, following surgical repair of the rotator cuff of the shoulder.
Design:
Nested qualitative study.
Setting:
Five English National Health Service Hospitals.
Subjects:
Nineteen patient participants who had undergone surgical repair of the rotator cuff and 10 healthcare practitioners involved in the trial.
Method:
Individual semi-structured interviews. Data were analysed thematically.
Results:
Four themes: (1) Preconceptions of early mobilisation; many participants were motivated to enter the trial for the opportunity of removing their sling and getting moving early. (2) Sling use and movement restrictions; for some, sling use for four weeks was unacceptable and contributed to their pain, rather than relieving it. (3) Tensions associated with early mobilisation; clinical tensions regarding early mobilisation and the perceived risk to the surgical repair were apparent. (4) Processes of running the trial; participants found the trial processes to be largely appropriate and acceptable, but withholding the results of the post-operative research ultrasound scan was contentious.
Conclusion:
Trial processes were largely acceptable, except for withholding results of the ultrasound scan. For some participants, use of the shoulder sling for a prolonged period after surgery was a reported barrier to standard rehabilitation whereas the concept of early mobilisation contributed tension for some healthcare practitioners due to concern about the effect on the surgical repair.
