Büker Nihal, Kitiş Ali, Akkaya Semih, Akkaya Nuray
Department of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey.
Eklem Hastalik Cerrahisi. 2011 Dec;22(3):134-9.
This study aims to compare the results of supervised exercise program versus standardized home based exercise program after rotator cuff repair with respect to severity of pain, functional status, quality of life, and depression.
Twenty-eight patients (5 males, 23 females; mean age 59.8±9.1 years; range 40 to 83 years) who had rotator cuff repair were evaluated. Patients were divided into two groups and the first group was treated with supervised physiotherapy (n=15) and the second group was treated with home-based exercise program (n=13). Pendulum exercises and passive exercises within pain limits were performed by all patients in the six-week immobilization period with shoulder sling with abduction pillow after rotator cuff repair. After this period, the patients in home-based exercise program were taught to perform active exercises and the patients in supervised physiotherapy group were treated with active shoulder range of motion exercises under the supervision of the physiotherapist. When patients reached to active full range of motion, strengthening exercises were added to exercise program. Patients were assessed preoperatively and at the end of the postoperative third month. Pain was evaluated with visual analog scale (VAS), functional status with Constant shoulder score, quality of life with short form-36 (SF-36), and depressive symptoms with Beck depression inventory (BDI).
There were significant improvements in all evaluation parameters in both groups after rotator cuff repair.
There were no statistical differences between the patients who received exercise program under the supervision of the physiotherapist and the patients who were treated with standardized home-based exercise program for the efficacy of treatment in the evaluation of pain, functional status, quality of life, and depression status. When the rehabilitation programs were analyzed for cost effectiveness, the supervised physiotherapy group was found to have higher costs.
本研究旨在比较肩袖修复术后监督式运动计划与标准化家庭运动计划在疼痛严重程度、功能状态、生活质量和抑郁方面的结果。
对28例接受肩袖修复的患者（5例男性，23例女性；平均年龄59.8±9.1岁；范围40至83岁）进行评估。患者分为两组，第一组接受监督式物理治疗（n = 15），第二组接受家庭运动计划（n = 13）。所有患者在肩袖修复后使用带外展枕的肩吊带进行六周固定期内的钟摆运动和疼痛限度内的被动运动。在此期间后，家庭运动计划组的患者被教导进行主动运动，监督式物理治疗组的患者在物理治疗师的监督下进行主动肩关节活动范围练习。当患者达到主动全关节活动范围时，在运动计划中增加强化练习。在术前和术后第三个月末对患者进行评估。使用视觉模拟量表（VAS）评估疼痛，使用Constant肩关节评分评估功能状态，使用简短健康调查问卷36（SF - 36）评估生活质量，使用贝克抑郁量表（BDI）评估抑郁症状。
肩袖修复后两组的所有评估参数均有显著改善。
在评估疼痛、功能状态、生活质量和抑郁状态方面，接受物理治疗师监督的运动计划的患者与接受标准化家庭运动计划治疗的患者在治疗效果上没有统计学差异。在分析康复计划的成本效益时，发现监督式物理治疗组成本更高。
