title: Does adding a 12-month exercise programme to usual care after a rotator cuff repair effect disability and quality of life at 12 months? A randomized controlled trial.
abstract: OBJECTIVE
  To compare a 12-month home-based exercise programme with usual care for disability and health-related quality of life after rotator cuff repair.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Outpatient physical and rehabilitation medicine clinic.
  
  
  METHODS
  Consecutive patients (n=67, mean age 54 years) who underwent rotator cuff repairs were randomized into an experimental group (EG) or a usual care group (UCG).
  
  
  METHODS
  The UCG received ordinary postoperative instructions, while the EG were given advice and instructions on a shoulder muscle strengthening programme to be undertaken at home.
  
  
  METHODS
  Disability was assessed with the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), and quality of life with the Short-Form 36 Health Survey (SF-36).
  
  
  RESULTS
  At the follow-up, no between-group differences were observed in any of the outcomes. The mean (SD) ASES score improved by 21 points (95% CI, 16 to 26, p<0.001) in the EG from the baseline 74 (14) and by 25 points (95% CI, 20 to 31, p<0.001) in the UCG from the baseline 70 (18). Both groups exhibited significant improvements (p<0.001) in the SF-36 physical component score. In the UCG, improvements were observed in the Social Functioning (p=0.034) and Role Emotional (p=0.003) dimensions. In the EG, 57% of the patients completed the exercises twice weekly for the first six months, after which training adherence declined.
  
  
  CONCLUSIONS
  The home exercise programme and usual care were equally effective in improving disability and quality of life after rotator cuff repair. The extra time involved in teaching the home exercise programme is not warranted.
authors.affiliation: Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyvaskyla, Finland kirsi.piitulainen@jyu.fi.
authors.forename: Kirsi
authors.initials: K
authors.lastname: Piitulainen
authors.affiliation: Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyvaskyla, Finland.
authors.forename: Arja
authors.initials: A
authors.lastname: Häkkinen
authors.affiliation: Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyvaskyla, Finland.
authors.forename: Petri
authors.initials: P
authors.lastname: Salo
authors.affiliation: Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland Department of General Practice, University of Helsinki, Helsinki, Finland Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.affiliation: Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyvaskyla, Finland.
authors.forename: Jari
authors.initials: J
authors.lastname: Ylinen
mesh_terms: D005081:Exercise Therapy; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016059:Range of Motion, Articular; D000070636:Rotator Cuff Injuries; D020069:Shoulder Pain / Q000209:etiology / Q000628:therapy; D013708:Tendon Injuries / Q000150:complications / Q000534:rehabilitation* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Rotator cuff repair; disability; exercise; quality of life; randomized controlled trial