CONTINUOUS PASSIVE MOTION AFTER REPAIR OF THE ROTATOR CUFF - A PROSPECTIVE OUTCOME STUDY

Despite the apparent success of continuous passive motion after soft-t issue procedures or joint replacements, its effect after repair of the rotator cuff is still unknown, The purpose of this prospective, rando mized outcome study was to compare the results of continuous passive m otion with those of manual passive range-of-motion exercises after rep air of the rotator cuff. Thirty-one patients (thirty-two rotator cuffs ) were randomly assigned to one of two types of postoperative manageme nt: continuous passive motion (seventeen Patients) or manual passive r ange-of-motion exercises (fifteen patients). There were seventeen wome n and fourteen men, and the mean age was sixty-three years (range, thi rty to eighty years). The patients were followed for a mean of twenty- two months (range, six to forty-five mouths). Five tears of the rotato r cuff were small, eighteen were medium, and nine were large. All of t he operations were performed by one surgeon. The patients who were man aged with continuous passive motion used the device for the first four weeks postoperatively, The patients who were managed with manual pass ive range-of-motion exercises were assisted by a trained relative, fri end, or home-care nurse. After the four-week period, the two groups we re managed similarly for two to five months. According to the Shoulder Pain and Disability Index, a valid and reliable self-administered que stionnaire, the treatment was extremely successful in both groups, The overall score was excellent for twenty-seven shoulders (84 per cent), good for two (6 per cent), fair for two (7 per cent), and poor for on e (3 per cent). With the numbers available, me could detect no signifi cant differences (p > 0.05) between the tao groups with respect to the score according to the Index, pain (according to a visual-analog scal e), range of motion, or isometric strength. Manual passive range-of-mo tion exercises were more cost-effective than continuous passive motion . The limited number of physical-therapy visits associated with the ma nual passive range-of-motion exercises in the present study appeared t o be more cost-effective than a traditional physical-therapy schedule of three visits per week, Postoperative therapy with continuous passiv e motion or manual passive range-of-motion exercises appears to field favorable results after repair of a small, medium, or large tear of th e rotator cuff.