Investigation the effects of motor control exercises delivered via telerehabilitation on shoulder function and quality of life in patients undergoing rotator cuff surgery.

Aim: The aim of this study was to investigate the effects of motor control (MC) exercises delivered via telerehabilitation on shoulder function and quality of life in patients who underwent rotator cuff (RC) surgery. Materials and Methods: Participants were evaluated preoperatively, and at 6 and 12 weeks postoperatively for pain (Visual Analog Scale - VAS), range of motion (ROM), active internal rotation (IR), Lateral Scapular Slide Test (LSST), function [Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire, American Shoulder and Elbow Surgeons Score (ASES)], sleep quality [Pittsburgh Sleep Quality Index (PSQI)], kinesiophobia [Tampa Scale of Kinesiophobia (TSK)], and quality of life [Western Ontario Rotator Cuff Index (WORC)]. Muscle strength (shoulder muscle strength, grip strength) was assessed preoperatively and at 12 weeks postoperatively. Participants were divided into two groups: Standard Rehabilitation Group (STD) and Motor Control Group (MC). Both groups received training via telerehabilitation twice a week for 12 weeks. Results: A total of 34 participants (29 women, 5 men) were included in the study (STD=17, MC=17). According to the findings, nighttime VAS scores at the 6th postoperative week were significantly lower in the MC group compared to the STD group (p=0.011). Shoulder external rotation (ER) ROM was significantly higher in the MC group at 12 weeks post-surgery (p=0.039). The differences in LSST values between the scapulae at all three positions (0°, 45°, and 90° abduction) were significantly smaller in the MC group at week 12 compared to the STD group (p<0.001). Additionally, a significant group × time interaction was observed for the scapular difference values at each position (p<0.05). The number of participants with scapular dyskinesis was significantly lower in the MC group at both 6 and 12 weeks postoperatively (p<0.001). Muscle strength in the affected shoulder for flexion and elevation in the scapular plane was significantly greater in the MC group at week 12 (p=0.027, p=0.039, respectively). DASH scores were significantly better in the MC group at both week 6 and week 12 (p<0.05). The WORC score was also better in the MC group at 12 weeks (p<0.05). No significant differences were found between the groups regarding patient satisfaction levels (p>0.05). Conclusion: According to our findings, the addition of motor control exercises to standard telerehabilitation is more effective than standard telerehabilitation alone in improving scapular mobility, increasing shoulder flexion and scapular plane muscle strength, and improving sleep quality in the acute period.