닫기
Search

BIO DESIGN

pISSN 1225-8962
eISSN 2287-982X

Article

Article Tools

Share this article on :

Starts or metrics

Related articles in PTK

Article

Original Article

Split Viewer

Phys. Ther. Korea 2024; 31(3): 219-226

Published online December 20, 2024

https://doi.org/10.12674/ptk.2024.31.3.219

© Korean Research Society of Physical Therapy

Preoperative Comparison of Shoulder Muscle Strength and Functional Outcomes in Rotator Cuff Tear Patients

Jin-seong Kim1 , PT, MS, Ui-jae Hwang2 , PT, PhD, Il-kyu Ahn3 , PT, BPT, Oh-yun Kwon2,3 , PT, PhD

1Department of Physical Therapy, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, 2Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, 3Department of Physical Therapy, The Graduate School, Yonsei University, Kinetic Ergocise Based on Movement Analysis Laboratory, Wonju, Korea

Correspondence to: Oh-yun Kwon
E-mail: kwonoy@yonsei.ac.kr
https://orcid.org/0000-0002-9699-768X

Received: November 21, 2024; Revised: December 2, 2024; Accepted: December 3, 2024

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Go to

Background: Rotator cuff tears often cause shoulder pain and functional limitations that may require conservative treatment or surgical intervention. Identifying preoperative differences in muscle strength and function can aid in treatment decisions.
Objects: This study aimed to compare the preoperative shoulder muscle strength and functional outcomes between patients undergoing arthroscopic rotator cuff repair and those receiving conservative treatment.
Methods: A retrospective review was conducted of 315 patients with rotator cuff tears, including 145 who underwent surgery and 170 who received conservative treatment. Shoulder isokinetic muscle strength (external rotator, internal rotators, abductor, and adductors) and functional scores (American Shoulder and Elbow Surgeons [ASES] and Constant-Murley shoulder scores) were measured. The conservative treatment group was assessed during a hospital visit, whereas the surgery group was tested on the morning of the surgery. An independent t-test was used to evaluate the preoperative shoulder strength and functional scores.
Results: The conservative treatment group showed lower deficits in external (11.3 ± 23.9) and internal (11.7 ± 15.5) rotators compared to the surgery group (26.3 ± 33.8 and 17.1 ± 26.1, respectively; p = 0.001). Abductor and adductor deficits (18.2 ± 25.3 and 9.8 ± 16.8) were also lower in the conservative treatment group (30.7 ± 31.6 and 21.9 ± 28.4, respectively; p = 0.036 and p = 0.001). The external per internal rotator ratio (50.9 ± 16.8; p = 0.003) and ASES scores were higher (74.5 ± 14.8; p = 0.047) was higher in the conservative treatment group.
Conclusion: The conservative treatment group had lower shoulder strength deficits, better muscle balance, and higher ASES scores than the surgery group, indicating superior functional outcomes. These findings suggest that assessing preoperative muscle strength and function might provide valuable insights into treatment planning for patients with rotator cuff tears.

Keywords: Conservative treatment, Muscle strength, Rehabilitation, Rotator cuff injuries

Article

Original Article

Phys. Ther. Korea 2024; 31(3): 219-226

Published online December 20, 2024 https://doi.org/10.12674/ptk.2024.31.3.219

Copyright © Korean Research Society of Physical Therapy.

Preoperative Comparison of Shoulder Muscle Strength and Functional Outcomes in Rotator Cuff Tear Patients

Jin-seong Kim1 , PT, MS, Ui-jae Hwang2 , PT, PhD, Il-kyu Ahn3 , PT, BPT, Oh-yun Kwon2,3 , PT, PhD

1Department of Physical Therapy, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, 2Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, 3Department of Physical Therapy, The Graduate School, Yonsei University, Kinetic Ergocise Based on Movement Analysis Laboratory, Wonju, Korea

Correspondence to:Oh-yun Kwon
E-mail: kwonoy@yonsei.ac.kr
https://orcid.org/0000-0002-9699-768X

Received: November 21, 2024; Revised: December 2, 2024; Accepted: December 3, 2024

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Rotator cuff tears often cause shoulder pain and functional limitations that may require conservative treatment or surgical intervention. Identifying preoperative differences in muscle strength and function can aid in treatment decisions.
Objects: This study aimed to compare the preoperative shoulder muscle strength and functional outcomes between patients undergoing arthroscopic rotator cuff repair and those receiving conservative treatment.
Methods: A retrospective review was conducted of 315 patients with rotator cuff tears, including 145 who underwent surgery and 170 who received conservative treatment. Shoulder isokinetic muscle strength (external rotator, internal rotators, abductor, and adductors) and functional scores (American Shoulder and Elbow Surgeons [ASES] and Constant-Murley shoulder scores) were measured. The conservative treatment group was assessed during a hospital visit, whereas the surgery group was tested on the morning of the surgery. An independent t-test was used to evaluate the preoperative shoulder strength and functional scores.
Results: The conservative treatment group showed lower deficits in external (11.3 ± 23.9) and internal (11.7 ± 15.5) rotators compared to the surgery group (26.3 ± 33.8 and 17.1 ± 26.1, respectively; p = 0.001). Abductor and adductor deficits (18.2 ± 25.3 and 9.8 ± 16.8) were also lower in the conservative treatment group (30.7 ± 31.6 and 21.9 ± 28.4, respectively; p = 0.036 and p = 0.001). The external per internal rotator ratio (50.9 ± 16.8; p = 0.003) and ASES scores were higher (74.5 ± 14.8; p = 0.047) was higher in the conservative treatment group.
Conclusion: The conservative treatment group had lower shoulder strength deficits, better muscle balance, and higher ASES scores than the surgery group, indicating superior functional outcomes. These findings suggest that assessing preoperative muscle strength and function might provide valuable insights into treatment planning for patients with rotator cuff tears.

Keywords: Conservative treatment, Muscle strength, Rehabilitation, Rotator cuff injuries

Fig 1.

Download
Figure 1.Flowchart of study enrollment.
Physical Therapy Korea 2024; 31: 219-226https://doi.org/10.12674/ptk.2024.31.3.219

Fig 2.

Download
Figure 2.Isokinetic muscle strength test for internal and external rotator.
Physical Therapy Korea 2024; 31: 219-226https://doi.org/10.12674/ptk.2024.31.3.219

Fig 3.

Download
Figure 3.Isokinetic muscle strength test for abductor and adductor.
Physical Therapy Korea 2024; 31: 219-226https://doi.org/10.12674/ptk.2024.31.3.219

Table 1 . Baseline characteristics of patients with and without arthroscopic rotator cuff repair (N = 315).

VariableSurgery group (n = 145)Non-surgery group (n = 170)p-value
Sex (Male/female)91 (63)/54 (37)99 (58)/71 (42)None
Age (y)56.0 ± 9.350.9 ± 9.90.075
Height (cm)163.5 ± 9.1165.5 ± 8.10.142
Weight (kg)67.1 ± 12.565.1 ± 10.40.228
Body mass index (kg/m2)23.7 ± 4.824.9 ± 5.60.064

Values are presented as number (%) or mean ± standard deviation..

Table 2 . Comparison of isokinetic muscle strength test for external and internal rotator between the two groups (N = 315).

Surgery group (n = 145)Non-surgery group (n = 170)p-value
External rotator peak torque12.1 ± 7.315.1 ± 7.30.539
External rotator PT/BW (%)17.7 ± 9.722.7 ± 9.20.984
External rotator deficit (%)26.3 ± 33.811.3 ± 23.90.001*
Internal rotator peak torque27.6 ± 11.729.6 ± 11.60.474
Internal rotator PT/BW (%)41.1 ± 16.845.2 ± 14.60.083
Internal rotator deficit (%)17.1 ± 26.111.7 ± 15.50.001*
External/internal rotator ratio44.2 ± 19.650.9 ± 16.80.003*

Values are presented as mean ± standard deviation. PT/BW, peak torque per body weight. *The mean difference is significant at the 0.05 level..

Table 3 . Comparison of isokinetic muscle strength test for abductor and adductor between the two groups (N = 315).

Surgery group (n = 145)Non-surgery group (n = 170)p-value
Abductor peak torque19.3 ± 11.324.4 ± 18.70.269
Abductor PT/BW (%)28.2 ± 15.334.7 ± 15.90.959
Abductor deficit (%)30.7 ± 31.618.2 ± 25.30.036*
Adductor peak torque45.8 ± 21.951.2 ± 19.30.127
Adductor PT/BW (%)67.7 ± 31.281.0 ± 60.90.986
Adductor deficit (%)21.9 ± 28.49.8 ± 16.80.001*
Abductor/adductor ratio41.5 ± 23.046.8 ± 23.00.984

Values are presented as mean ± standard deviation. PT/BW, peak torque per body weight. *The mean difference is significant at the 0.05 level..

Table 4 . Comparison of shoulder function scores between the two groups (N = 315).

ScoreSurgery group
(n = 145)		Non-surgery group (n = 170)p-value
ASES57.5 ± 16.274.5 ± 14.80.047*
Constant-Murley64.3 ± 9.667.4 ± 10.30.980

Values are presented as mean ± standard deviation. ASES, American Shoulder and Elbow Surgeons. *The mean difference is significant at the 0.05 level..