Early EMG-based Low Supraspinatus Activity Exercises After Arthroscopic Repair of Medium-Sized Rotator Cuff Tears: A Randomized Controlled Trial.

Abstract

Postoperative rehabilitation after arthroscopic rotator cuff repair remains controversial because early mobilization may compromise tendon healing and increase re-tear risk, leading many clinicians to prefer prolonged immobilization. Exercises associated with low supraspinatus muscle activity may enable earlier rehabilitation while minimizing stress on the repaired tendon. The aim of this study to investigate the effects of an electromyography (EMG) based early rehabilitation program consisting of low supraspinatus muscle activity exercises compared with a four-week immobilization protocol following arthroscopic repair of full-thickness, medium-sized rotator cuff tears. Thirty patients who underwent arthroscopic repair of full-thickness, medium-sized rotator cuff tears were randomly assigned to an early rehabilitation group (Group I) or an immobilization group (Group II). Group I initiated EMG-based low supraspinatus activity exercises one week postoperatively for three weeks, while Group II remained immobilized for four weeks. From week 4 onward, both groups followed an identical standardized rehabilitation program until week 12. Outcomes included pain (VAS), shoulder range of motion, muscle strength, function (Constant-Murley Score), quality of life (SF-36), and patient satisfaction (Global Rating of Change), assessed over a 12-month follow-up period. At four weeks postoperatively, Group I reported significantly less night pain (mean difference=2.56, p=.018) and pain during activity (mean difference = 2.73, p=.001) than Group II, with both reductions exceeding the minimal clinically important difference (MCID). At long-term follow-up, no significant differences were observed between groups in range of motion, muscle strength, shoulder function, quality of life, or patient satisfaction. An EMG-based early rehabilitation using low supraspinatus-load exercises offers clinically important short-term pain benefits without impairing long-term results after arthroscopic repair of medium rotator cuff tears. This approach appears to be a safe substitute for postoperative immobilization, especially when early pain control is a priority.