Rotator cuff unloading versus loading exercise program in the conservative treatment of patients with rotator cuff tear: protocol of a randomised controlled trial

Abstract

IntroductionAtraumatic and degenerative rotator cuff tears are common in individuals over 55 years of age. This condition can have a high impact on social life and is associated with chronic pain, weakness and dysfunction of the upper limb. There is evidence that conservative approaches should be the first treatment option. Conservative treatment usually addresses a variety of therapeutic behaviours without providing scientific arguments for the choice and progression of exercises.ObjectiveTo compare the effects of two different exercise programmes based on the load of the rotator cuff on a population with shoulder pain and rotator cuff tears.Methods and analysisThis is a controlled, randomised, blinded clinical trial. Seventy-eight individuals with shoulder pain and presence of atraumatic and degenerative rotator cuff tear will participate and will be randomly distributed between two groups. The primary outcome will be quality of life (The Western Ontario Rotator Cuff Index), and secondary outcomes will include pain, function (Disabilities of the Arm, Shoulder and Hand), fear avoidance beliefs (Fear Avoidance Beliefs Questionnaire-Brazil), kinesiophobia (Tampa Scale), Pain Catastrophizing Scale, muscle strength of abductors, external and internal rotators of the shoulder, range of motion of arm elevation and patient satisfaction. The treatment will be performed for 12 weeks (2 x/week) acording to the selected group (Rotator Cuff Unloading x Rotator Cuff Loading Exercise Programme).Ethics and disseminationThe study protocol was approved by the Institutional Review Board. The findings of the trial will be disseminated through peer-reviewed journals and scientific conferences.Trial registration numberNCT03962231.

Comparative Analysis of Various Rotator Cuff Stretching Techniques: Efficacy and Recommendations for Gym Enthusiasts

“…Ribeiro et al, in a study, provided physical therapists with a basis for treating patients with rotator cuff injuries, where participants learned to modify postures and motions that exacerbate shoulder pain. They receive a set of home exercises aimed at improving quality of life and upper limb function [ 28 ]. In the realm of sports and athletics, dynamic stretching has demonstrated numerous benefits.…”

“…Dynamic stretching is a crucial tool in injury prevention and rehabilitation, particularly for athletes and individuals with shoulder problems. Ribeiro et al in their research emphasize its therapeutic potential in improving quality of life and upper limb function for those with rotator cuff injuries [ 28 ]. Çelik in his study introduces cyclic stretching into sports and athletic performance, offering athletes a balanced approach that optimizes performance [ 29 ].…”

Understanding Fibrous Tissue in the Effective Healing of Rotator Cuff Injury

“…The continuous evolvement of surgical procedures aspires to incorporate less invasive methods, which enable quicker and less painful recovery time, simultaneously minimizing scar tissue development. Consequently, a considerable number of patients necessitate surgical intervention for tendon repair to alleviate pain and restore shoulder function following unsuccessful conservative management [ 58 ].…”

Current Biological Strategies to Enhance Surgical Treatment for Rotator Cuff Repair

“…However, the effect of conservative treatment is not ideal, only 8% of patients showed some degree of improvement (Safran et al, 2011). Most patients still need surgical repair on the torn tendons to relieve the pain and restore shoulder function after failed conservative treatment (Schemitsch et al, 2019;Ribeiro et al, 2020). Surgical repair of the rotator cuff tendon can be performed by either open surgery or arthroscopic-assisted repair.…”