Physiotherapist-led exercise versus usual care (waiting-list) control for patients awaiting rotator cuff repair surgery: A pilot randomised controlled trial (POWER).


Littlewood, Chris ORCID: 0000-0002-7703-727X, Moffatt, Maria ORCID: 0000-0002-8385-7418, Beckhelling, Jacqueline, Davis, Daniel, Burden, Adrian, Pitt, Lisa, Lalande, Stacey, Maddocks, Catrin, Stephens, Gareth ORCID: 0000-0001-9373-0026, Tunnicliffe, Helen et al (show 5 more authors) (2023) Physiotherapist-led exercise versus usual care (waiting-list) control for patients awaiting rotator cuff repair surgery: A pilot randomised controlled trial (POWER). Musculoskeletal science & practice, 68. 102874-. ISSN 2468-8630, 2468-7812

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Abstract

<h4>Background</h4>Once a decision to undergo rotator cuff repair surgery is made, patients are placed on the waiting list. It can take weeks or months to receive surgery. There has been a call to move from waiting lists to 'preparation' lists to better prepare patients for surgery and to ensure it remains an appropriate treatment option for them.<h4>Objective</h4>To evaluate the feasibility, as measured by recruitment rates, treatment fidelity and follow-up rates, of a future multi-centre randomised controlled trial to compare the clinical and cost-effectiveness of undertaking a physiotherapist-led exercise programme while waiting for surgery versus usual care (waiting-list control).<h4>Design</h4>Two-arm, multi-centre pilot randomised controlled trial with feasibility objectives in six NHS hospitals in England.<h4>Method</h4>Adults (n = 76) awaiting rotator cuff repair surgery were recruited and randomly allocated to a programme of physiotherapist-led exercise (n = 38) or usual care control (n = 38).<h4>Results</h4>Of 302 eligible patients, 76 (25%) were randomised. Of 38 participants randomised to physiotherapist-led exercise, 28 (74%) received the exercise programme as intended. 51/76 (67%) Shoulder Pain and Disability Index questionnaires were returned at 6-months. Of 76 participants, 32 had not received surgery after 6-months (42%). Of those 32, 20 were allocated to physiotherapist-led exercise; 12 to usual care control.<h4>Conclusions</h4>A future multi-centre randomised controlled trial is feasible but would require planning for variable recruitment rates between sites, measures to improve treatment fidelity and opportunity for surgical exit, and optimisation of follow-up. A fully powered, randomised controlled trial is now needed to robustly inform clinical decision-making.

Item Type: Article
Uncontrolled Keywords: Rotator Cuff, Humans, Pilot Projects, Adult, Waiting Lists, England, Multicenter Studies as Topic, Physical Therapists
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Population Health
Faculty of Health and Life Sciences > Institute of Population Health > School of Health Sciences
Depositing User: Symplectic Admin
Date Deposited: 21 May 2024 14:52
Last Modified: 06 Dec 2024 14:17
DOI: 10.1016/j.msksp.2023.102874
Open Access URL: https://doi.org/10.1016/j.msksp.2023.102874
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3181809
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