Supervised strengthening exercises versus home-based movement exercises after arthroscopic acromioplasty : A randomized clinical trial

• Objective: To evaluate and compare the efficacy of 2 rehabilitation strategies after arthroscopic acromioplasty: supervised physical therapy focusing on strengthening exercises of the rotator cuff and scapula stabilizers (PT-group) vs home-based movement exercises (H-group). Design: A randomized, single-blinded, clinically controlled study. Patients: Thirty-six patients entered the study. Thirteen in the PT-group and 16 in the H-group fulfilled all the assessments. Methods: For 12 weeks following surgery, patients performed either supervised physical therapy or home exercises. Follow-ups were conducted periodically for 6 months after surgery to evaluate shoulder function, pain (Constant-Murley (CM) and Disabilities of the Arm, Shoulder, and Hand (DASH) scores), and health-related quality of life. Results: The PT-group exhibited significantly greater improvements in CM (p  =0.02) and DASH (p = 0.05) scores. After treatment, the between-group mean difference in CM scores was 14.2 p (95% confidence interval 2-26). At the 6-month follow-up, the between-group mean difference in DASH scores was 13.4 p (95% confidence interval 0.1-23). Conclusion: PT-supervised rehabilitation with strengthening exercises of the rotator cuff and scapula stabilizers seems to be superior to home exercises focusing on mobility for improving shoulder function after arthroscopic acromioplasty.

Nyckelord

arthroscopic acromioplasty; exercise; rehabilitation; rotator cuff; subacromial impingement; physical therapy.

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