The addition of aquatic therapy to rehabilitation following surgical rotator cuff repair: a feasibility study

Background and Purpose. Rotator cuff tears are frequently encountered in medical outpatient settings and often require surgical repair to achieve desirable functional outcomes. However, the optimal form of post-operative rehabilitation of rotator cuff repairs remains unidentified by the research literature. The aim of this study was to determine the feasibility of implementing and investigating the effect of a combined aquatic and land-based rehabilitation programme in the post-operative rehabilitation of rotator cuff tears. Methods. A cohort of 18 subjects undergoing rotator cuff repair were examined over a treatment period of 12 weeks. Twelve subjects participated in a combined aquatic and land-based programme, while six subjects received a standard land-based protocol. Passive range of motion and the Western Ontario Rotator Cuff Index outcomes were measured pre-operatively and at three, six and 12 weeks, post-operatively. Subjective responses on patient's assurance and confidence in the value of the exercises (questionnaire using an 11-point Visual Analogue Scale (VAS)) were collected at 12 weeks for both groups. Results. There was a significant improvement in both range of motion and Western Ontario Rotator Cuff scores in all subjects with treatment (p < 0.001). Furthermore, participation in aquatic therapy significantly improved passive flexion range of motion measures at three weeks (mean 468, 95% CI 17-75, p = 0.005) and six weeks (308, 95% CI 8-51,p = 0.01). There was no significant difference in the attendance rates (80% in both groups) or patients perceptions of the programmes (100% confidence and assurance in both groups). Conclusion. The implementation of a combined aquatic and land-based physiotherapy programme following surgical repair of the rotator cuff is feasible and presents a potential viable alternative to conventional land-based exercise with comparable outcomes. Copyright (C) 2008 John Wiley & Sons, Ltd.