Patients with symptomatic non-traumatic partial thickness rotator cuff tear treated with multimodal physical therapy with exercise

Multimodal physical therapy will compose of thermotherapy (hot pack or cold pack) and electrotherapy (transcutaneous electrical nerve stimulation or interferential current) and therapeutic ultrasound (at least two of them). Therapeutic exercise will compose of combination of range of motion, stretching, strengthening,neuromuscular and task specific exercises according to the clinical condition of patient under the supervision of a physiotherapist. Additionally, all patients will be allowed to carry on home exercise program.

Pain and function are assessed by Turkish version of American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, patient self-report section. It consists of two subscales including pain (one item) and function section (ten items). Pain and function subscales range between 0 and 50 with a maximum total score of 100. Lower pain subscale score means more pain, and lower function subscale score means more functional loss. The Turkish version of ASES standardized shoulder form:patient self reported section has been reported as reliable and valid.

Disease specific health-related quality of life is assessed by Turkish version of Western Ontario Rotator Cuff Index.The Turkish version of the WORC index has been found a reliable and valid measurement tool. WORC index consists of 5 subscales including physical symptoms (6 items), sports and recreation (4 items), work (4 items), life style (4 items) and emotions (3 items). Each item is estimated based on 0-100 mm visual analogue scale. By summating the item scores, subscale scores and total scores are computed (possible total maximum score is 2100). Lower scores represents higher quality of life.

All active range of motion measurements of affected shoulder joint will be performed with a standard universal goniometer. While active range of motion of abduction and flexion (in degrees) will be measured in prone position, internal and external rotation measurement (in degrees) will be carried out in seating position while the shoulder is in 90 degrees abduction and elbow is in 90 degrees flexion.