Mazuquin, Bruno, Moffatt, Maria, Realpe, Alba et al. (13 more authors) (2024) Clinical and cost-effectiveness of individualised (early) patient-directed rehabilitation versus standard rehabilitation after surgical repair of the rotator cuff of the shoulder:protocol for a multicentre, randomised controlled trial with integrated Quintet Recruitment Intervention (RaCeR 2). BMJ Open. e081284. ISSN 2044-6055
Abstract
INTRODUCTION: Despite the high number of operations and surgical advancement, rehabilitation after rotator cuff repair has not progressed for over 20 years. The traditional cautious approach might be contributing to suboptimal outcomes. Our aim is to assess whether individualised (early) patient-directed rehabilitation results in less shoulder pain and disability at 12 weeks after surgical repair of full-thickness tears of the rotator cuff compared with current standard (delayed) rehabilitation. METHODS AND ANALYSIS: The rehabilitation after rotator cuff repair (RaCeR 2) study is a pragmatic multicentre, open-label, randomised controlled trial with internal pilot phase. It has a parallel group design with 1:1 allocation ratio, full health economic evaluation and quintet recruitment intervention. Adults awaiting arthroscopic surgical repair of a full-thickness tear are eligible to participate. On completion of surgery, 638 participants will be randomised. The intervention (individualised early patient-directed rehabilitation) includes advice to the patient to remove their sling as soon as they feel able, gradually begin using their arm as they feel able and a specific exercise programme. Sling removal and movement is progressed by the patient over time according to agreed goals and within their own pain and tolerance. The comparator (standard rehabilitation) includes advice to the patient to wear the sling for at least 4 weeks and only to remove while eating, washing, dressing or performing specific exercises. Progression is according to specific timeframes rather than as the patient feels able. The primary outcome measure is the Shoulder Pain and Disability Index total score at 12-week postrandomisation. The trial timeline is 56 months in total, from September 2022. TRIAL REGISTRATION NUMBER: ISRCTN11499185.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ. |
Keywords: | Adult,Humans,Rotator Cuff/surgery,Shoulder,Shoulder Pain/rehabilitation,Cost-Benefit Analysis,Rotator Cuff Injuries/surgery,Treatment Outcome,Arthroscopy/methods,Randomized Controlled Trials as Topic,Multicenter Studies as Topic |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) |
Depositing User: | Pure (York) |
Date Deposited: | 12 Mar 2024 11:30 |
Last Modified: | 11 Jun 2025 11:19 |
Published Version: | https://doi.org/10.1136/bmjopen-2023-081284 |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1136/bmjopen-2023-081284 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:210094 |
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Description: R1_RaCeR 2 protocol_BMJ Open_31.01_clean
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