Supervised Physiotherapy vs Home Exercise After Rotator Cuff Repair: A Meta-Analysis

Area of Science:

• Orthopedic Surgery
• Physical Therapy
• Rehabilitation Medicine

Background:

• Rotator cuff repair surgery necessitates effective postoperative rehabilitation.
• Choosing between supervised physiotherapy and home exercise programs impacts patient outcomes.
• Understanding the comparative effectiveness of different rehabilitation strategies is crucial.

Purpose of the Study:

• To compare supervised physiotherapy with home exercise programs for rotator cuff repair.
• To evaluate the relative effectiveness on postoperative pain, functional outcomes, and shoulder range of motion.

Main Methods:

• Systematic literature search of major databases (PubMed, Scopus, Cochrane, Google Scholar).
• Inclusion of six studies comparing supervised physiotherapy and home exercise programs post-rotator cuff repair.
• Extraction and synthesis of outcomes including pain scores (VAS), functional measures (SSV, ASES, Constant-Murley), and range of motion (external rotation, forward flexion).

Main Results:

• No significant differences were found in postoperative pain or functional outcomes between the two rehabilitation strategies.
• External rotation range of motion was comparable between supervised physiotherapy and home exercise programs.
• Supervised physiotherapy demonstrated a statistically significant, albeit modest, advantage in forward flexion range of motion.

Conclusions:

• Supervised physiotherapy does not offer superior pain reduction compared to home exercise programs after rotator cuff repair.
• Functional outcomes are comparable between supervised and home-based rehabilitation models.
• Home-based rehabilitation is a viable and effective alternative, while supervised therapy may benefit specific patient groups needing closer monitoring or at risk of stiffness.