This preliminary study aimed to investigate the effect of RCR on shoulder proprioception and pain in the acute phase, and to explore the relationship between shoulder proprioception and pain, shoulder function, and fear avoidance.
Sixteen participants undertaking a rotator cuff repair operation at an orthopedic hospital volunteered (female:male=10:6; Mean age=56.2 years old, range from 42-68; Height=163.8±6.7cm; Weight=64.5±6.6kg). Pre-operation shoulder function was assessed by using Constant-Muley outcome score and fear avoidance was measured by using Fear Avoidance Beliefs Questionnaire (FABQ). The intensity of pain was assessed by using visual analog scale (VAS), and shoulder proprioception was quantified by using the Active Movement Extent Discrimination Apparatus (AMEDA), where participants were asked to discriminate between shoulder abduction movements of 24, 26, 28, and 30 degrees in a standing position, without visual cues. The shoulder pain and proprioception were assessed prior to RCR and 3 days post operation.
Pre-operation shoulder function Constant-Muley outcome scores were 64.4±16.6 and FABQ scores were 27.8±5.7. Pain increased after the operation, although it was not statistically significant (from 3.7±2.0 to 5.0±2.5, p>0.05). Shoulder proprioceptive discrimination sensitivity scores improved significantly from 0.766±0.05 to 0.809±0.65 (MD=0.04, t=2.440, p=0.028) after operation. Pearson’s correlation analysis showed that pre-operation shoulder proprioception was not significantly associated with shoulder function Constant-Muley scores or FABQ scores. However, the post-operation improvement in shoulder proprioception scores was negatively, moderately correlated with pre-operation pain intensity (r=-0.55, p=0.026).
RCR may improve shoulder abduction proprioception. Lower pre-operation shoulder pain intensity was significantly associated with greater post-operation shoulder proprioception improvement.
The findings from this preliminary, acute phase study suggest that pre-operation pain management is important, because it may contribute to a greater improvement in post-operation shoulder proprioception. Although pain intensity was not statistically increased after RCR, physiotherapists still play a critical role in managing post-operation pain. Improvement in shoulder proprioception after RCR may provide an optimal physiological basis for physiotherapy intervention to enhance shoulder stability and dynamic movement control. A long-term follow-up study is needed to determine whether improved shoulder proprioception after surgery is associated with better shoulder function and less fear avoidance.
Rotator Cuff
Pain Management
