Karasuyama Masaki, Gotoh Masafumi, Oike Takuya, Nishie Kenichi, Shibuya Manaka, Nakamura Hidehiro, Ohzono Hiroki, Kawakami Junichi
Department of Rehabilitation, Minamikawa Orthopedic Hospital, Fukuoka, Japan.
Kurume University School of Medicine Graduate School, Kurume, Japan.
Clin Shoulder Elb. 2023 Sep;26(3):296-301. doi: 10.5397/cise.2022.01410. Epub 2023 Jul 4.
A supervised physiotherapy program (SPP) is a standard regimen after surgical rotator cuff repair (RCR); however, the effect of a home-based exercise program (HEP), as an alternative, on postoperative functional recovery remains unclear. Therefore, the purpose of this meta-analysis was to compare the functional effects of SPP and HEP after RCR.
We searched electronic databases including Central, Medline, and Embase in April 2022. The primary outcomes included the Constant score, American Shoulder and Elbow Surgeons score, University of California Los Angeles shoulder score, and pain score. Secondary outcomes included range of motion, muscle strength, retear rate, and patient satisfaction rate. A meta-analysis using random-effects models was performed on the pooled results to determine the significance.
The initial database search yielded 848 records, five of which met our criteria. Variables at 3 months after surgery were successfully analyzed, including the Constant score (mean difference, -8.51 points; 95% confidence interval [CI], -32.72 to 15.69; P=0.49) and pain score (mean difference, 0.02 cm; 95% CI, -2.29 to 2.33; P=0.99). There were no significant differences between the SPP and HEP. Other variables were not analyzed owing to the lack of data.
Our data showed no significant differences between SSP and HEP with regard to the Constant and pain scores at 3 months after RCR. These results suggest that HEP may be an alternative regimen after RCR. Level of evidence: I.
监督下的物理治疗方案(SPP)是肩袖修复术(RCR)后的标准治疗方案;然而,作为一种替代方案的家庭锻炼计划(HEP)对术后功能恢复的影响仍不明确。因此,本荟萃分析的目的是比较RCR后SPP和HEP的功能效果。
我们于2022年4月检索了包括CENTRAL、Medline和Embase在内的电子数据库。主要结局包括Constant评分、美国肩肘外科医师学会评分、加州大学洛杉矶分校肩关节评分和疼痛评分。次要结局包括活动范围、肌肉力量、再撕裂率和患者满意率。对汇总结果进行随机效应模型的荟萃分析以确定显著性。
初步数据库检索产生848条记录,其中五条符合我们的标准。成功分析了术后3个月时的变量,包括Constant评分(平均差,-8.51分;95%置信区间[CI],-32.72至15.69;P=0.49)和疼痛评分(平均差,0.02 cm;95%CI,-2.29至2.33;P=0.99)。SPP和HEP之间无显著差异。由于缺乏数据,未分析其他变量。
我们的数据显示,RCR术后3个月时,SSP和HEP在Constant评分和疼痛评分方面无显著差异。这些结果表明,HEP可能是RCR后的一种替代治疗方案。证据级别:I。