A randomized controlled trial comparing 2 instructional approaches to home exercise instruction following arthroscopic full-thickness rotator cuff repair surgery.
METHODS
A prospective unblinded randomized clinical trial.


OBJECTIVE
To compare the effectiveness of 2 types of home program instruction, videotape versus personal instruction by a physical therapist, on subjective outcomes and exercise compliance following arthroscopic repair of a full-thickness rotator cuff tear.


BACKGROUND
Advances in orthopedic surgery and rehabilitation have placed increased emphasis on home exercise programs. Therefore, assessing the effectiveness of different methods of home program instruction is important.


METHODS
Patients who consented to undergo surgical repair were randomly assigned to either a videotape or personal instruction group. A self-reported compliance log categorized subjects as fully compliant, partially compliant, or noncompliant. The Shoulder Pain and Disability Index and the University of Pennsylvania Shoulder Scale scores were obtained from subjects preoperatively and at 12, 24, and 52 weeks postoperatively. The null hypotheses that neither group would have better outcomes as measured by 2 shoulder outcome scales at any level of compliance over 4 levels of time, were assessed by 2 separate 2x3x4 multiple analyses of variances (MANOVAs), 1 for each outcome measure (alpha = 0.025).


RESULTS
Neither MANOVA was significant and the null hypotheses were not rejected. The main effect of time (number of weeks postsurgery) was significant across all time intervals for both outcome measures (P < 0.0005).


CONCLUSIONS
With a therapist available for questions, patients who utilized the videotape method for their home program instruction had self-reported outcomes equal to patients instructed in their home program personally by a physical therapist. Self-reported compliance with the rehabilitation program had little effect on the outcomes.
Roddey
Toni S
TS
School of Physical Therapy, Texas Woman's University, Houston 77030, USA. Troddey@TWU.edu
Olson
Sharon L
SL
Gartsman
Gary M
GM
Hanten
William P
WP
Cook
Karon F
KF
D000328:Adult; D000368:Aged; D001182:Arthroscopy; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000503:physiopathology / Q000601:surgery*; D012648:Self Care; D012720:Severity of Illness Index; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014743:Videotape Recording