title: Limited physical therapy utilization protocol does not affect impairment and disability in Workers' Compensation patients after rotator cuff repair: a short-term follow-up study.
abstract: BACKGROUND
  Treatment of rotator cuff tears in injured workers is associated with poorer outcomes and abnormally high utilization of clinical services. This study evaluates the effect on impairment and disability rates after the implementation of an accelerated independent rehabilitation protocol on injured workers undergoing mini-open rotator cuff repair.
  
  
  METHODS
  Seventy-one primary rotator cuff repairs in injured workers were reviewed at least 1 year after claim closure. Outcomes based on permanent partial disability and impairment were compared among 28 patients using traditional outpatient physical therapy (group A) and 43 patients using an accelerated protocol-driven independent exercise program (group B). The number of physical therapy visits attended, disability, and impairment rates were compared between the 2 groups.
  
  
  RESULTS
  Group B used a median of 16 physical therapy visits, which were 9 fewer visits per patient than group A (P < .001). This constituted a 36% reduction in the median number of physical therapy visits without negatively affecting disability and impairment rates. The difference between the 2 groups in time to release to work or time to claim closure was not significant.
  
  
  CONCLUSIONS
  The implementation of an accelerated, independent, exercise protocol reduced physical therapy utilization to levels below national best-practices benchmarks without negatively affecting impairment or disability rates in Workers' Compensation patients undergoing mini-open rotator cuff repair.
  
  
  METHODS
  Level IV, Retrospective Case Series, Prognostic Study.
authors.affiliation: Occupational Orthopedics, LLC, Tualatin, OR 97035, USA. johndipaola@occortho.com
authors.forename: John
authors.initials: J
authors.lastname: Di Paola
mesh_terms: D000328:Adult; D002985:Clinical Protocols; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009922:Oregon; D026741:Physical Therapy Modalities / Q000191:economics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D013708:Tendon Injuries / Q000191:economics* / Q000534:rehabilitation*; D014942:Workers' Compensation / Q000706:statistics & numerical data*