Clinically Important Improvements Observed in Patient-Reported Outcomes 2 Years After Exercise Therapy for Patients With Isolated Supraspinatus Tendon Tears.

OBJECTIVE

To describe and predict patient-reported outcomes (PROs) and to investigate differences between individuals with a rotator cuff tear who were and were not successfully treated with a 12-week exercise therapy program.

DESIGN

Prospective observational cohort.

SETTING

Orthopedic sports medicine clinical practice settings and departments of orthopedic surgery, physical therapy, and bioengineering at the University of Pittsburgh.

PARTICIPANTS

Eighty-two individuals, age ≥40 years with a symptomatic isolated supraspinatus tear.

INTERVENTIONS: Individualized 12-week exercise therapy program and longitudinal follow-ups at 3, 6, 12, and 24 months.

MAIN OUTCOME MEASURES: (1) PROs: Western Ontario Rotator Cuff (WORC) index (WORC) & Numeric Pain Rating Scale (NPRS), (2) shoulder range of motion (ROM) and strength, (3) rotator cuff tear size and location, (4) glenohumeral kinematics.

RESULTS

Significant improvements in both PROs were observed at all time points when compared with baseline. At the 24-month follow-up, improvement greater than the minimally clinically important difference was noted for 78% of individuals for the WORC and 55% for the NPRS. Baseline predictors for 24-month change in WORC and an overall successful outcome were identified and included the baseline WORC score and the side-to-side difference in ROM for external rotation at 90 degrees abduction.

CONCLUSIONS

Individuals with symptomatic, isolated supraspinatus tears, managed with exercise therapy, experienced clinically important improvements in self-reported disability and more than half experienced a similar improvement in pain, at a 2-year follow-up. Baseline patient-reported outcomes measures and side-to-side differences passive ROM predicted 24-month success after exercise therapy. These findings may be useful in plan-of-care decision making.