Adherence Patterns and Dose Response of Physiotherapy for Rotator Cuff Pathology: Longitudinal Cohort Study

Area of Science:

• Orthopedics
• Physical Therapy
• Rehabilitation Medicine

Background:

• Physiotherapy is crucial for managing rotator cuff pathology.
• Patient adherence to physiotherapy and its impact on recovery remain unclear.

Purpose of the Study:

• To measure physiotherapy participation rates and patterns for rotator cuff disorders.
• To assess the dose-response relationship between physiotherapy activity and patient recovery.
• To identify patient factors predicting physiotherapy participation.

Main Methods:

• Prospective longitudinal study of 42 patients with rotator cuff pathology.
• Smartwatch inertial sensors tracked physiotherapy exercise performance (clinic and home).
• Machine learning analyzed participation; primary outcomes included pain and disability scores (Disabilities of the Arm Shoulder and Hand).

Main Results:

• Mean weekly participation: 11 minutes (clinic), 33 minutes (home).
• Patients participated on 41% of assigned days; home participation declined over time.
• Higher cumulative physiotherapy participation correlated with reduced pain and disability at 8 and 12 weeks.
• Low patient expectations and self-efficacy were linked to reduced participation.

Conclusions:

• Low adherence to home physiotherapy exercises was observed.
• A significant dose-response relationship exists between physiotherapy participation and improved outcomes for rotator cuff pathology.
• Novel strategies are needed to enhance physiotherapy adherence and effectiveness.