Rehabilitation following surgical repair of the rotator cuff: a systematic review.

BACKGROUND: Surgery to repair rotator cuff (RC) tears is a commonly performed orthopaedic procedure with the aim of reducing pain and improving function. Surgery is followed by rehabilitation and recommendations for postoperative rehabilitation include; exercise therapy, continuous passive motion machines and aquatic therapy. Currently, there is uncertainty in the literature as to what constitutes best postsurgical rehabilitation.

OBJECTIVE: To systematically review postsurgical research investigations to provide clinical guidance regarding postsurgical management.

DATA SOURCES: A keyword search of Medline, Cinahl, Amed, Embase and Cochrane databases from September 1993 to September 2013.

STUDY SELECTION: Reviewer assessment using inclusion and exclusion criteria of randomised controlled trials.

DATA EXTRACTION: Data pertaining to research design, intervention and subjects was extracted from included papers by one author. The data was grouped by reference to the objectives of the study and collated in themes.

DATA SYNTHESIS: Narrative synthesis of the data was used to describe the effects of the intervention. The methodological quality and risk of bias of the included studies was assessed using the standardised Physiotherapy Evidence Database scale. Eleven studies met the inclusion criteria. All the studies were of fair to good methodological quality. No one rehabilitation protocol was found to be superior to another. The findings of this review suggested that following RC repair, patients should expect improvement in pain, ROM and function.

CONCLUSION: This review concludes that no single rehabilitation protocol is superior to another following RC repair. Studies with larger study populations and longer term follow up are required to investigate this further.