Effectiveness of Exercise Therapy on Reducing Shoulder Pain and Improving Shoulder Function in Patients with Rotator Cuff Injuries

Abstract

Background: Rotator cuff injuries are one of the most common causes of shoulder pain. There are different therapeutic approaches in this disease. The evidence of the positive effect of exercise therapy in this pathology is inconclusive. This study aimed to investigate the effect of a complete exercise protocol on improvement of the patients with rotator cuff injuries. Methods: The patients with shoulder pain received the 12-week exercise protocol in 4 phases if they had confirmed rotator cuff injuries in clinical examination and shoulder MRI. Pain was measured by visual analog scale (VAS) and function was measured by two questionnaires; disabilities of the arm, shoulder and hand (DASH) and western Ontario rotator cuff index (WORC). Range of shoulder joint motion (ROM) was measured in five directions by goniometry. All of the outcomes were evaluated before intervention and in 6, 12, 24 weeks after starting the intervention. Ethic: This study was registered in Iranian Registry of Clinical Trials (IRCT20100718004409N13). A written consent was taken from All participants before the study. Results: In this study Twenty-four patients with rotator cuff tendinopathy and tear were analyzed finally in terms of effectiveness of exercise therapy. The average of their age was 51.7 years old. 14 patients (53.8%) with Supraspinatus tendinopathy, 6 patients (23%) with Supraspinatus tear, 3 patients (12.5%) with Supraspinatus plus biceps tendinopathy, and one patient (4.16%) with Subscapularis plus Biceps tendinopathy were assessed. The pain score (Visual Analog Scale) decreased at all fallow-ups specially after 24 weeks (3±0.1) versus before intervention (8±0.1) (P value < 0.001). Shoulder range of motions by goniometer and also the patients function based on WORC and DASH Questionnaires were improved after 24 weeks versus before intervention that was significant statistically and clinically (P value < 0.001). Conclusion: A 12- week exercise protocol including strengthening, stretching, PNF and dynamic stabilizer exercises was effective on pain reduction and improvement of function and shoulder joint range of motion improvement in the patients with shoulder rotator cuff tendinopathy and partial tear. The improvement of the variables lasted 6 months.