title: Is rehabilitation effective in massive rotator cuff tears?
abstract: BACKGROUND
  Irreparable massive rotator cuff tears are challenging to treat. Our objective here was to evaluate the efficacy of a specifically designed rehabilitation programme.
  
  
  OBJECTIVE
  We hypothesised that outcomes of the rehabilitation programme would vary with the site of the tears.
  
  
  METHODS
  Patients with irreparable massive rotator cuff tears and shoulder pseudoparalysis were included prospectively. They followed a five-session specific rehabilitation programme. The outcomes were analysed according to the site of the tears.
  
  
  RESULTS
  We included 45 patients with a mean age of 67 years. At last follow-up after rehabilitation, 24 patients had recovered more than 160° of anterior shoulder elevation. Treatment failure was common in patients with massive anterior rotator cuff tears or tears involving three or more tendons. Patients with massive posterior tears, in contrast, often experienced substantial improvements, even in the medium term.
  
  
  CONCLUSIONS
  Outcomes of rehabilitation therapy in patients with irreparable massive rotator cuff tears and shoulder pseudoparalysis vary according to the site and number of the tears. Failure of rehabilitation therapy is common in patients with massive anterior tears or tears involving at least three tendons. In contrast, in patients with isolated massive posterior tears, substantial benefits from rehabilitation therapy can be expected.
  
  
  METHODS
  III.
authors.affiliation: Centre hospitalier privé Saint-Grégoire, 6, boulevard de la Boutière, 35768 Saint-Grégoire cedex, France. Electronic address: collin.ph@wanadoo.fr.
authors.forename: P G
authors.initials: PG
authors.lastname: Collin
authors.affiliation: Centre hospitalier privé Saint-Grégoire, 6, boulevard de la Boutière, 35768 Saint-Grégoire cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Gain
authors.affiliation: Physiothérapie de Cornavin, 11, rue de Cornavin, CH-1201 Geneva, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Nguyen Huu
authors.affiliation: Service de chirurgie orthopédique et traumatologie de l'appareil moteur, hôpitaux universitaires de Genève, 4, rue Gabrielle-Perret-Gentil, CH-1211 Geneva 14, Switzerland; Faculté de médecine, université de Genève, 1, rue Michel-Servet, 1211 Geneva 4, Switzerland; Service de chirurgie orthopédique et traumatologie de l'appareil moteur, hôpital de La Tour, 3, rue J.-D. Maillard, 1217 Meyrin, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Lädermann
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D017006:Rotator Cuff / Q000503:physiopathology; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000534:rehabilitation; D012785:Shoulder Joint / Q000503:physiopathology
keywords: Clinical outcomes; Massive rotator cuff tears; Non-operative treatment; Physiotherapy; Rehabilitation therapy; Shoulder pseudoparalysis