title: The Effect of Early Range of Motion on Quality of Life, Clinical Outcome, and Repair Integrity After Arthroscopic Rotator Cuff Repair.
abstract: OBJECTIVE
  To compare the effect of early versus delayed motion protocols on quality of life, clinical outcomes, and repair integrity in patients who have undergone arthroscopic single-tendon rotator cuff repair.
  
  
  METHODS
  This was a prospective, randomized, investigator-blinded clinical trial. Seventy-three patients from a single surgeon's practice who underwent arthroscopic repair of a single-tendon rotator cuff tear were randomized to either an early motion protocol (starting 2 to 3 days after surgery) or a delayed motion protocol (starting 28 days after surgery). The primary outcome measure was the Western Ontario Rotator Cuff index (WORC). Secondary outcome measures included clinical outcome scores, integrity of the repair on 6-month magnetic resonance imaging scans, pain scores, physical examination data, and ultrasonography. Study participants were followed up at 3, 6, and 12 weeks; 6 months; and 1 year postoperatively.
  
  
  RESULTS
  There was no statistically significant difference in WORC scores at 6 months (529 ± 472 in delayed group vs 325 ± 400 in early group, P = .08). Mixed-effects analysis indicated the early group maintained lower WORC scores throughout the postoperative period (estimated difference of 191, P = .04). The proportions of patients with tears on the 6-month postoperative magnetic resonance imaging scan were comparable (31% in delayed group vs 34% in early group, P = .78).
  
  
  CONCLUSIONS
  There was no difference between the delayed and early motion groups in WORC scores at 6 months after surgery. Early motion was associated with lower WORC scores throughout the postoperative period; however, both groups had a similar trajectory of improvement, suggesting both protocols have the same effect on patient-reported improvement. Although failure rates were similar between the groups, the sample size was not sufficient to support a statement regarding the relation between tear morphology and the rehabilitation protocol.
  
  
  METHODS
  Level II, lesser-quality randomized controlled trial.
authors.affiliation: University of Connecticut Health Center, Farmington, Connecticut, U.S.A.
authors.forename: Augustus D
authors.initials: AD
authors.lastname: Mazzocca
authors.affiliation: University of Connecticut Health Center, Farmington, Connecticut, U.S.A.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Arciero
authors.affiliation: University of Connecticut Health Center, Farmington, Connecticut, U.S.A.
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Shea
authors.affiliation: University of Connecticut Health Center, Farmington, Connecticut, U.S.A.
authors.forename: John M
authors.initials: JM
authors.lastname: Apostolakos
authors.affiliation: University of Connecticut Health Center, Farmington, Connecticut, U.S.A.
authors.forename: Olga
authors.initials: O
authors.lastname: Solovyova
authors.affiliation: University of Connecticut Health Center, Farmington, Connecticut, U.S.A.
authors.forename: Gregg
authors.initials: G
authors.lastname: Gomlinski
authors.affiliation: University of Connecticut Health Center, Farmington, Connecticut, U.S.A.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Wojcik
authors.affiliation: University of Connecticut Health Center, Farmington, Connecticut, U.S.A.
authors.forename: Vincent
authors.initials: V
authors.lastname: Tafuto
authors.affiliation: University of Connecticut Health Center, Farmington, Connecticut, U.S.A.
authors.forename: Harlan
authors.initials: H
authors.lastname: Stock
authors.affiliation: University of Connecticut Health Center, Farmington, Connecticut, U.S.A.. Electronic address: mcote@uchc.edu.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Cote
mesh_terms: D001182:Arthroscopy; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000000981:diagnostic imaging / Q000601:surgery*; D000070636:Rotator Cuff Injuries / Q000000981:diagnostic imaging / Q000523:psychology / Q000601:surgery*; D016037:Single-Blind Method; D016896:Treatment Outcome