Date of Award

2019

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Schawnn Decker

Keywords

Rotator Cuff Injuries -- rehabilitation; Case Reports; Comparative Study

Abstract

Background and Purpose: Rotator cuff tears are one of the most common musculoskeletal injuries to occur in the United States. Following a surgical repair, there are two main rehabilitation protocols: early motion and delayed motion. Despite the large number of patients in need of rehab following a rotator cuff tear surgical repair, there is not yet a definitive answer in the literature as far as the best protocol to use.

Case Description: The patient was a 68-year-old male who injured himself while slipping and attempting to catch himself with his right arm. He presented to physical therapy following a surgical repair of a massive rotator cuff tear. His active range of motion and strength were within normal limits on his non-involved upper extremity, though severely limited on the surgical side due to a combination of pain and post-surgical precautions.

Interventions: The patient received therapeutic exercise, ultrasound, E-stim, patient education, and trigger point release manual therapy over the course of physical therapy.

Outcomes: The patient had 18 sessions of physical therapy. By the end, his active range of motion on the surgical arm equaled that of his non-involved extremity, and his strength was making rapid gains as well.

Discussion: Research regarding early versus delayed motion protocols is limited. Further research should be performed studying different patient demographics to see if factors such as age, various pathologies, size of tear, etc., can affect which protocol would provide the most benefits and least risk for them. The patient in this case report demonstrated significant improvements over the course of therapy utilizing the early motion protocol.

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