Multimodal Physical Therapy With Exercise in Partial-thickness Rotator Cuff Tears

Effectiveness of Multimodal Physical Therapy Combined With Exercise in Partial-thickness Rotator Cuff Tears: a Prospective Observational Study

The aim of this study is to investigate the early stage effectiveness of multimodal physical therapy with exercise in the conservative treatment of partial thickness rotator cuff tears.

Although partial thickness rotator cuff tear prevalence is greater than those of full-thickness tear, most studies on conservative treatment are associated with full-thickness tears. In general, any physical therapy modality alone is not effective in the treatment of rotator cuff tears. It has been reported that multimodal physiotherapy may be more successful than monotherapy, but evidence in this regard is inadequate. Therefore this observational prospective study aiming to investigate the effectiveness of physiotherapy in the treatment of rotator cuff tears was planned. The null hypothesis of this study is that multimodal physical therapy combined with exercise has no effect on pain and function in the treatment of partial thickness rotator cuff tears. The alternative hypothesis is the opposite.

Patients will be assessed by standardized measures in terms of pain and function (American Shoulder and Elbow Surgeons standardized shoulder form: patient self report section), active range of motion (goniometric measurement) and quality of life (Western Ontario rotator cuff index) at baseline and first, third and 6th months of follow-up.

Inclusion Criteria:

• Symptomatic partial thickness rotator cuff tear verified with magnetic resonance imaging or ultrasound imaging
• Prescription of multimodal physical therapy with exercise by a clinician other than investigators prior to inclusion in the study
• Covered by the social security system
• Giving informed consent to include in the study

Exclusion Criteria:

• Age of under 50
• Full thickness rotator cuff tear
• Radicular pain
• Glenohumeral osteoarthritis
• Calcific tendonitis
• Adhesive capsulitis
• History of physiotherapy in last 6 months
• Prior surgical treatment
• Contraindication to physical therapy and/or exercises