Telerehabilitation-Based Motor Control Exercises After Rotator Cuff Surgery: Effects on Shoulder Function and Quality of Life.

Abstract

To investigate the effects of motor control (MC) exercises delivered via telerehabilitation on shoulder function and quality of life in patients undergoing arthroscopic rotator cuff (RC) surgery. Patients who underwent arthroscopic RC surgery were included in the study. Participants were evaluated pain (Visual Analog Scale, VAS), active range of motion (AROM), lateral scapular slide test (LSST), shoulder girdle and handgrip muscle strength, function (American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, ASES), kinesiophobia (Tampa Scale for Kinesiophobia, TSK), and quality of life (Western Ontario Rotator Cuff Index, WORC). Participants were randomly allocated into two groups: the Standard Rehabilitation (STD) group and the Motor Control (MC) group. Both groups received telerehabilitation sessions twice weekly for 12 weeks. Between-group comparisons and within-group time-dependent analyses were performed. A total of 34 participants (29 females, 5 males; STD=17, MC=17) were included. Postoperatively, both groups demonstrated significant improvements over time in pain, AROM, muscle strength, and functional scores (p<0.05). In the MC group, night pain was significantly lower at week 6, and shoulder external rotation (ER) AROM was significantly higher at week 12 (p<0.05). Differences, changes, and rates of scapular dyskinesis in all three positions (0°, 45°, and 90° abduction) of the LSST were significantly better in the MC group (p<0.001), with a significant group×time interaction (p<0.05). Muscle strength and strength gains in shoulder flexion, abduction, and scapular elevation were significantly greater in the MC group (p<0.05). No significant between-group differences were observed in ASES, TSK, or WORC scores or their changes (p>0.05). According to our findings, the addition of motor control exercises delivered via telerehabilitation to standard rehabilitation is more effective than standard rehabilitation alone in improving scapular mobility and increasing muscle strength in shoulder flexion, abduction, and scapular plane elevation.