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Original Research

Open Access

Effects of lower extremity physical activity on shoulder biomechanics and functional recovery in the early phase after arthroscopic rotator cuff repair in male patients: a retrospective study

  • Moonyoung Choi1
  • Jinwook Chung1,*,

1Department of Sports Science Convergence, Dongguk University, 04620 Seoul, Republic of Korea

DOI: 10.22514/jomh.2023.021 Vol.19,Issue 4,April 2023 pp.40-50

Submitted: 23 August 2022 Accepted: 17 January 2023

Published: 30 April 2023

*Corresponding Author(s): Jinwook Chung E-mail: cjw826@dongguk.edu

Abstract

Surgeons widely use arthroscopic rotator cuff repair (ARCR) to restore biomechanics and function in patients with rotator cuff tears. However, patients show severe pain early after ARCR, and their physical activity level decreases sharply. This study aimed to determine the effect of lower extremity physical activity on shoulder pain, biomechanics, and functional recovery in the early phase after ARCR. This retrospective study included 103 male patients according to the inclusion criteria. We classified subjects into high physical activity (HPA, n = 49) and low physical activity (LPA, n = 54) groups according to the classification criteria. For analysis, we measured the visual analog scale (VAS) score, range of motion (ROM), American Shoulder and Elbow Surgeons (ASES) score, and grip strength preoperatively and six weeks postoperatively. In comparing the HPA and LPA groups at six weeks postoperatively, the VAS score was significantly lower in the HPA group (p < 0.001). The ROM of forward flexion (p = 0.001), abduction (p = 0.005), and external rotation (p = 0.001) of the shoulder was also significantly greater in the HPA group. In particular, the ASES score (p < 0.001) and grip strength (p < 0.001) showed significant improvement only in the HPA group. Patients with higher levels of physical activity after ARCR showed lower subjective pain and faster biomechanical and functional recovery than those with lower levels of physical activity. Therefore, even if the involved shoulder has restrictions during the early phase after ARCR, it is vital to actively recommend physical activity such as walking, stationary cycling, and climbing stairs using the lower extremities.


Keywords

Rotator cuff repair; Physical activity; Shoulder pain; Range of motion; Functional recovery; Grip strength


Cite and Share

Moonyoung Choi,Jinwook Chung. Effects of lower extremity physical activity on shoulder biomechanics and functional recovery in the early phase after arthroscopic rotator cuff repair in male patients: a retrospective study. Journal of Men's Health. 2023. 19(4);40-50.

References

[1] Minagawa H, Yamamoto N, Abe H, Fukuda M, Seki N, Kikuchi K, et al. Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: from mass-screening in one village. Journal of Orthopaedics. 2013; 10: 8–12.

[2] Boykin RE, Heuer HJ, Vaishnav S, Millett PJ. Rotator cuff disease–basics of diagnosis and treatment. Rheumatology Reports. 2010; 2: e1.

[3] Nikolaidou O, Migkou S, Karampalis C. Rehabilitation after rotator cuff repair. The Open Orthopaedics Journal. 2017; 11: 154–162.

[4] Tokish JM, Hawkins RJ. Current concepts in the evolution of arthroscopic rotator cuff repair. JSES Reviews, Reports, and Techniques. 2021; 1: 75–83.

[5] Duquin TR, Buyea C, Bisson LJ. Which method of rotator cuff repair leads to the highest rate of structural healing? A systematic review. The American Journal of Sports Medicine. 2010; 38: 835–841.

[6] Randelli P, Cucchi D, Ragone V, de Girolamo L, Cabitza P, Randelli M. History of rotator cuff surgery. Knee Surgery, Sports Traumatology, Arthroscopy. 2015; 23: 344–362.

[7] Uquillas CA, Capogna BM, Rossy WH, Mahure SA, Rokito AS. Postoperative pain control after arthroscopic rotator cuff repair. Journal of Shoulder and Elbow Surgery. 2016; 25: 1204–1213.

[8] Tonotsuka H, Sugaya H, Takahashi N, Kawai N, Sugiyama H, Marumo K. Preoperative pain control in arthroscopic rotator cuff repair: does it matter? Clinics in Orthopedic Surgery. 2019; 11: 192–199.

[9] Morris BJ, Mir HR. The opioid epidemic: impact on orthopaedic surgery. Journal of the American Academy of Orthopaedic Surgeons. 2015; 23: 267–271.

[10] Garimella V, Cellini C. Postoperative pain control. Clinics in Colon and Rectal Surgery. 2013; 26: 191–196.

[11] Naugle KM, Naugle KE, Fillingim RB, Samuels B, Riley JL 3rd. Intensity thresholds for aerobic exercise-induced hypoalgesia. Medicine & Science in Sports & Exercise. 2014; 46: 817–825.

[12] Mork PJ, Vasseljen O, Nilsen TI. Association between physical exercise, body mass index, and risk of fibromyalgia: longitudinal data from the Norwegian Nord-Trøndelag Health Study. Arthritis Care & Research. 2010; 62: 611–617.

[13] Bring DK, Kreicbergs A, Renstrom PAFH, Ackermann PW. Physical activity modulates nerve plasticity and stimulates repair after achilles tendon rupture. Journal of Orthopaedic Research. 2007; 25: 164–172.

[14] Van Der Meijden OA, Westgard P, Chandler Z, Gaskill TR, Kokmeyer D, Millett PJ. Rehabilitation after arthroscopic rotator cuff repair: current concepts review and evidence-based guidelines. International Journal of Sports Physical Therapy. 2012; 7: 197–218.

[15] Lannersten L, Kosek E. Dysfunction of endogenous pain inhibition during exercise with painful muscles in patients with shoulder myalgia and fibromyalgia. Pain. 2010; 151: 77–86.

[16] Wassinger CA, Lumpkins L, Sole G. LOWER EXTREMITY AEROBIC EXERCISE AS A TREATMENT FOR SHOULDER PAIN. International Journal of Sports Physical Therapy. 2020; 15: 74–80.

[17] Daniels SD, Stewart CM, Garvey KD, Brook EM, Higgins LD, Matzkin EG. Sex-based differences in patient-reported outcomes after arthroscopic rotator cuff repair. Orthopaedic Journal of Sports Medicine. 2019; 7: 232596711988195.

[18] Rizvi SMT, Bishop M, Lam PH, Murrell GAC. Factors predicting frequency and severity of postoperative pain after arthroscopic rotator cuff repair surgery. The American Journal of Sports Medicine. 2021; 49: 146–153.

[19] Park J, Jang S, Oh K, Li YJ. Radiolucent rings around bioabsorbable anchors after rotator cuff repair are not associated with clinical outcomes. Archives of Orthopaedic and Trauma Surgery. 2017; 137: 1539–1546.

[20] Karjalainen TV, Jain NB, Page CM, Lähdeoja TA, Johnston RV, Salamh P, et al. Subacromial decompression surgery for rotator cuff disease. The Cochrane Database of Systematic Reviews. 2019; 1: CD005619.

[21] Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Medicine & Science in Sports & Exercise. 2003; 35: 1381–1395.

[22] Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett DR Jr, Tudor-Locke C, et al. 2011 compendium of physical activities: a second update of codes and MET values. Medicine & Science in Sports & Exercise. 2011; 43: 1575–1581.

[23] Veitch WG, Climie RE, Gabbe BJ, Dunstan DW, Owen N, Ekegren CL. Agreement between the international physical activity questionnaire and accelerometry in adults with orthopaedic injury. International Journal of Environmental Research and Public Health. 2020; 17: 6139.

[24] Güler T, Sivas F, Yurdakul FG, Çelen E, Utkan A, Başkan B, et al. Early improvement in physical activity and function after total hip arthroplasty: predictors of outcomes. Turkish Journal of Physical Medicine and Rehabilitation. 2019; 65: 379–388.

[25] Katz J, Melzack R. Measurement of pain. Surgical Clinics of North America. 1999; 79: 231–252.

[26] Norkin CC, White DJ. Measurement of joint motion: a guide to goniometry. 5th edn. FA Davis: Philadelphia, PA. 2016.

[27] Michener LA, McClure PW, Sennett BJ. American shoulder and elbow surgeons standardized shoulder assessment form, patient self-report section: reliability, validity, and responsiveness. Journal of Shoulder and Elbow Surgery. 2002; 11: 587–594.

[28] Wylie JD, Beckmann JT, Granger E, Tashjian RZ. Functional outcomes assessment in shoulder surgery. World Journal of Orthopedics. 2014; 5: 623–633.

[29] Horsley I, Herrington L, Hoyle R, Prescott E, Bellamy N. Do changes in hand grip strength correlate with shoulder rotator cuff function? Shoulder & Elbow. 2016; 8: 124–129.

[30] Mandalidis D, O’Brien M. Relationship between hand-grip isometric strength and isokinetic moment data of the shoulder stabilisers. Journal of Bodywork and Movement Therapies. 2010; 14: 19–26.

[31] Alizadehkhaiyat O, Fisher AC, Kemp GJ, Vishwanathan K, Frostick SP. Shoulder muscle activation and fatigue during a controlled forceful hand grip task. Journal of Electromyography and Kinesiology. 2011; 21: 478–482.

[32] Sgroi TA, Cilenti M. Rotator cuff repair: post-operative rehabilitation concepts. Current Reviews in Musculoskeletal Medicine. 2018; 11: 86–91.

[33] Tashjian RZ, Deloach J, Porucznik CA, Powell AP. Minimal clinically important differences (MCID) and patient acceptable symptomatic state (PASS) for visual analog scales (VAS) measuring pain in patients treated for rotator cuff disease. Journal of Shoulder and Elbow Surgery. 2009; 18: 927–932.

[34] Koltyn KF. Exercise-induced hypoalgesia and intensity of exercise. Sports Medicine. 2002; 32: 477–487.

[35] Sluka KA, O’Donnell JM, Danielson J, Rasmussen LA. Regular physical activity prevents development of chronic pain and activation of central neurons. Journal of Applied Physiology. 2013; 114: 725–733.

[36] Koltyn KF, Brellenthin AG, Cook DB, Sehgal N, Hillard C. Mechanisms of exercise-induced hypoalgesia. The Journal of Pain. 2014; 15: 1294–1304.

[37] Peltz CD, Dourte LM, Kuntz AF, Sarver JJ, Kim S, Williams GR, et al. The effect of postoperative passive motion on rotator cuff healing in a rat model. The Journal of Bone and Joint Surgery-American Volume. 2009; 91: 2421–2429.

[38] Parsons BO, Gruson KI, Chen DD, Harrison AK, Gladstone J, Flatow EL. Does slower rehabilitation after arthroscopic rotator cuff repair lead to long-term stiffness? Journal of Shoulder and Elbow Surgery. 2010; 19: 1034–1039.

[39] Zhang S, Li H, Tao H, Li H, Cho S, Hua Y, et al. Delayed early passive motion is harmless to shoulder rotator cuff healing in a rabbit model. The American Journal of Sports Medicine. 2013; 41: 1885–1892.

[40] Namdari S, Yagnik G, Ebaugh DD, Nagda S, Ramsey ML, Williams GR, et al. Defining functional shoulder range of motion for activities of daily living. Journal of Shoulder and Elbow Surgery. 2012; 21: 1177–1183.

[41] Schmidt S, Ferrer M, González M, González N, Valderas JM, Alonso J, et al. Evaluation of shoulder-specific patient-reported outcome measures: a systematic and standardized comparison of available evidence. Journal of Shoulder and Elbow Surgery. 2014; 23: 434–444.

[42] Cvetanovich GL, Gowd AK, Liu JN, Nwachukwu BU, Cabarcas BC, Cole BJ, et al. Establishing clinically significant outcome after arthroscopic rotator cuff repair. Journal of Shoulder and Elbow Surgery. 2019; 28: 939–948.

[43] Oosterwijk AM, Nieuwenhuis MK, van der Schans CP, Mouton LJ. Shoulder and elbow range of motion for the performance of activities of daily living: a systematic review. Physiotherapy Theory and Practice. 2018; 34: 505–528.

[44] Godeau D, Fadel M, Descatha A. Factors associated with limitations in daily life and at work in a population with shoulder pain. BMC Musculoskeletal Disorders. 2022; 23: 777.

[45] Bigoni M, Gorla M, Guerrasio S, Brignoli A, Cossio A, Grillo P, et al. Shoulder evaluation with isokinetic strength testing after arthroscopic rotator cuff repairs. Journal of Shoulder and Elbow Surgery. 2009; 18: 178–183.

[46] Gulotta LV, Rodeo SA. Growth factors for rotator cuff repair. Clinics in Sports Medicine. 2009; 28: 13–23.

[47] Lobo CC, Morales CR, Sanz DR, Corbalán IS, Romero EAS, Carnero JF, et al. Comparison of hand grip strength and upper limb pressure pain threshold between older adults with or without non-specific shoulder pain. PeerJ. 2017; 5: e2995.

[48] Andersen LL, Blangsted AK, Nielsen PK, Hansen L, Vedsted P, Sjøgaard G, et al. Effect of cycling on oxygenation of relaxed neck/shoulder muscles in women with and without chronic pain. European Journal of Applied Physiology. 2010; 110: 389–394.

[49] Andersen LL, Kjaer M, Søgaard K, Hansen L, Kryger AI, Sjøgaard G. Effect of two contrasting types of physical exercise on chronic neck muscle pain. Arthritis & Rheumatism. 2008; 59: 84–91.

[50] Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL 3rd. Sex, gender, and pain: a review of recent clinical and experimental findings. The Journal of Pain. 2009; 10: 447–485.


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