Shoulder pacemaker vs. conventional physiotherapy for acute-on-chronic rotator cuff tears: a novel rehabilitation approach

Background Previous studies on physiotherapy treatment of cuff tears include treatment of acute or degenerative tears, but studies on physiotherapy treatment of acute-on-chronic tears are lacking. The purpose of this study is to describe a new physiotherapy protocol for acute-on-chronic cuff tears with a new device, the Shoulder Pacemaker (SPM). The secondary objective is to describe the results of physiotherapy treatment of cuff injuries treated with SPM and compare them with classical physiotherapy treatment. Methods This is a prospective comparative study performed in a single physiotherapy center in which patients with acute-on-chronic cuff tears were treated in 2 parallel groups. The 2 groups of 20 patients were comparable in terms of demographic characteristics and type of cuff injury. The first group was treated with deltoid rehabilitation program performed for rotator cuff tears;he second was treated with a protocol performed with SPM. Patients were assessed before treatment and at 2 years after physiotherapy by visual analogue scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Constant score, and range of motion. Physiotherapy was considered unsuccessful in patients undergoing surgery and in those dissatisfied with physiotherapy treatment. Results In the group treated with conventional physiotherapy, 50% (10 patients) of the patients found no benefit from physiotherapeutic treatment. Of these 10 patients, 4 underwent surgical repair. In the group treated with the SPM protocol, 95% (19) of the patients were satisfied 2 years after treatment. Only one patient who found no benefit from SPM was referred for surgery. The improvement in clinical scores was significantly higher in the group treated with SPM. At 2 years, a VAS of 1.7, an ASES score of 70, and a Constant score of 62 were observed in the SPM group, while a VAS of 3.6 ( P value=.003), an ASES score of 51 ( P = .001), and a Constant score of 46 ( P = .001) were observed in the group treated with the conventional physiotherapy protocol. Conclusion Physiotherapy with SPM has been shown to be more effective than conventional physiotherapy treatment in improving shoulder function in patients with acute-on-chronic cuff tears. Indeed, patients treated with the SPM showed a 95% satisfaction rate compared to patients treated with classic physiotherapy, who showed a 50% satisfaction rate.