Move It or Lose It? The Effect of Early Active Movement on Clinical Outcomes Following Rotator Cuff Repair: A Systematic Review With Meta-Analysis

• Published in: The journal of orthopaedic and sports physical therapy 2021-07, Vol.51 (7), p.1-344
• Main Authors: Silveira, Anelise, Luk, Joel, Tan, Maria, Kang, Sung Hyun, Sheps, David M, Bouliane, Martin, Beaupre, Lauren
• Format: Article
• Language: English
• ISSN: 0190-6011; 1938-1344
• DOI: 10.2519/jospt.2021.9634

To assess the effect of early active shoulder movement after rotator cuff repair compared to delayed active shoulder movement on clinical outcomes, rotator cuff integrity and return-to-work. Intervention systematic review. We searched 9 databases in November 2017 and updated the search in December 2018 and February 2020. We included comparative studies that assessed the effect of early active shoulder movement versus delayed active shoulder movement following rotator cuff repair. Means and standard deviations were used to calculate weighted mean differences (WMDs) and 95% CIs for outcomes of interest. Sensitivity analysis used only RCTs and was performed when heterogeneity among studies was statistically significant. Eight studies including 756 participants (379 early active shoulder movement; 377 delayed active shoulder movement) were included. There was high certainty evidence favoring early active movement for forward flexion (6-weeks), abduction (6-weeks) and external rotation (6-weeks, 3- and 6-months) post-surgery. There was moderate certainty evidence of worse Western Ontario Rotator Cuff Index (6-weeks) for the early active movement group, and no difference in rotator cuff integrity between early or delayed active movement groups. There were no group differences for all other outcomes. Patients who commenced active shoulder movement early after rotator cuff repair had greater shoulder range of motion and worse shoulder-specific quality of life after surgery than patients who delayed active shoulder movement. However, the group differences did not appear clinically important and rotator cuff integrity appears similar. .