Effects of different positions on rehabilitation after rotator cuff repair under shoulder arthroscopy

Shoulder arthroscopic rotator cuff tear repair is currently the main treatment for full-thickness rotator cuff tears, and postoperative rehabilitation training is essential. However, pain and limitation of activity during the rehabilitation process will lead to poor results. Hence, identifying rehabilitation approaches is crucial. This study aimed to compare patient's rehabilitation outcomes and experience between rehabilitation in the supine position and in the standing position. This prospective study included patients diagnosed with full-thickness rotator cuff tears who underwent shoulder arthroscopic double-row rivet repair at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from March 2019 to September 2021. The patients were randomly assigned to the standing rehabilitation exercise group (group A) and the supine rehabilitation exercise group (group B). All patients were followed up for 6 months to record and compare the visual analog scale (VAS) scores, shoulder range of motion, and rehabilitation compliance. Altogether, 86 patients participated in the study, of whom 79 patients completed the 6-month follow-up. Groups A and B had 39 and 40 patients, respectively. Before operation, the VAS score, forward flexion and extension angle, and abduction angle were comparable between groups A and B. After operation, the patients in groups A and B all experienced a significant improvement in the VAS score, forward flexion and extension angle, and abduction angle (p < 0.05). In addition, patients in group B had better VAS score (4.58 ± 0.87 vs. 5.21 ± 1.13, p = 0.0068; 2.15 ± 0.66 vs. 2.51 ± 0.51, p = 0.0078; 0.78 ± 0.86 vs. 1.33 ± 0.81, p = 0.0015), forward flexion and extension angle (109.30 ± 2.87 ° vs. 102.33 ± 3.74°, p = 0.0001; 109.53 ± 3.39° vs. 104.18 ± 2.76°, p = 0.0001; 125.22 ± 6.05° vs. 117.59 ± 2.27°, p = 0.0001), and abduction angle (91.78 ± 2.77° vs. 82.92 ± 2.12°, p = 0.0001; 91.62 ± 2.78° vs. 82.82 ± 1.45°, p = 0.0001; 109.48 ± 3.37° vs. 100.10 ± 2.94°, p = 0.0001) at 2 wk, 6 wk and 6 m postoperatively. After 6 months of follow-up, the patients who performed rehabilitation exercises in the supine position achieved better rehabilitation outcomes than those who performed rehabilitation exercises while standing.