Date of Award

2018

Document Type

Dissertation

Degree Name

Doctor of Health Science (DHSc)

College/School

College of Health Sciences

First Advisor

Emily J Slaven, PT, PhD, MS

Second Advisor

Elizabeth S. Moore, PhD

Third Advisor

Frank Bates, PT, DPT, MBA

Fourth Advisor

Laura Santurri, PhD, MPH, CPH

Fifth Advisor

Stephanie Kelly, PT, PhD

Abstract

Rotator cuff repair (RCR) is the most common shoulder procedure for which patients are referred for post-operative physical therapy (PT). Standard PT after RCR frequently consists of modalities, range of motion (ROM), and strength exercises. However, the optimal treatment approach has not been established. Neuromuscular re-education (NMR) is an alternative treatment to standard PT, but it has not been studied after RCR. The purpose of this study was to compare standard PT to standard PT and NMR to determine if NMR impacted selected clinical outcomes post-RCR.

A non-experimental retrospective case-control study was conducted to achieve this purpose. A convenience sample of patients who underwent PT following RCR was identified from electronic medical records. Active ROM (AROM), numeric pain rating scale (NPRS), and the Disability of the Arm Shoulder and Hand questionnaire (DASH) data were collected to determine if there were significant differences in these outcomes between the treatment groups and over time. Additionally, a change score was calculated and compared between treatment groups.

The change in AROM was significantly greater in the NMR group than the standard PT group (p = .024). The NMR group reached a greater level of clinically important change than the standard PT group (p = .006). There were no differences between the two groups for NPRS and DASH scores.

Results of this study suggest that NMR may help optimize AROM after RCR. Further research incorporating evidence-based treatment guidelines for NMR is needed to determine if NMR adds benefit to standard PT after RCR.

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