title: A prospective randomized controlled trial comparing occupational therapy with home-based exercises in conservative treatment of rotator cuff tears.
abstract: BACKGROUND
  This pilot study evaluates the outcome after occupational therapy, compared to home-based exercises in the conservative treatment of patients with full thickness rotator cuff tears.
  
  
  METHODS
  Forty-three adult subjects (range, 18-75 years), who had a full thickness rupture of the rotator cuff which was verified by magnetic imaging tomography, with clinical signs of a chronic rotator cuff impingement, and who were available for follow-up, were randomized to occupational therapy or to independent home-based exercises using a booklet. After drop-out, 38 patients were available for full examination at follow-up. Before therapy and after 2 months of conservative treatment, pain intensity, the Constant-Murley score, isokinetic strength testing in abduction and external rotation, functional limitation, clinical shoulder tests and health-related quality of life (EQ-5D) were evaluated.
  
  
  RESULTS
  Two-thirds of the patients improved in clinical shoulder tests, regardless of the therapy group. There were no significant differences between the groups with reference to pain, range of motion, maximum peak force (abduction, external rotation), the Constant-Murley score, and the EQ-5D index. The only significant difference observed was the improvement in the self-assessed health- related quality of life (EQ-5D VAS) favoring home-based exercises.
  
  
  CONCLUSIONS
  Home-based exercise, on the basis of an illustrated booklet with exercises twice a day, supplies comparable results to formal occupational therapy in the conservative treatment of rotator cuff tears. The results of this pilot study suggest some potential advantages related to psychological benefits using home-based treatment.
authors.affiliation: Institute of Research in Rehabilitation Medicine at Ulm University, Wuhrstrasse 2/1, Bad Buchau, Germany. gert.krischak@uni-ulm.de
authors.forename: Gert
authors.initials: G
authors.lastname: Krischak
authors.forename: Florian
authors.initials: F
authors.lastname: Gebhard
authors.forename: Heiko
authors.initials: H
authors.lastname: Reichel
authors.forename: Benedikt
authors.initials: B
authors.lastname: Friemert
authors.forename: Florian
authors.initials: F
authors.lastname: Schneider
authors.forename: Christoph
authors.initials: C
authors.lastname: Fisser
authors.forename: Rainer
authors.initials: R
authors.lastname: Kaluscha
authors.forename: Michael
authors.initials: M
authors.lastname: Kraus
mesh_terms: D000328:Adult; D000368:Aged; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy; D010865:Pilot Projects; D011446:Prospective Studies; D000070636:Rotator Cuff Injuries; D012648:Self Care; D012647:Self-Assessment; D013708:Tendon Injuries / Q000534:rehabilitation*; D016896:Treatment Outcome
keywords: Level II; Randomized Controlled Trial; Rotator cuff tear; Treatment Study; conservative treatment; exercise therapy; occupational therapy; physiotherapy