Rehabilitation following rotator cuff repair: A nested qualitative study exploring the perceptions and experiences of participants in a randomised controlled trial

Stephens, Gareth; Littlewood, Chris; Foster, Nadine E.; Dikomitis, Lisa

Abstract

Objective: To investigate acceptability, barriers to adherence with the interventions, and which outcome measures best reflect the participants' rehabilitation goals in a pilot and feasibility randomised controlled trial evaluating early patient-directed rehabilitation and standard rehabilitation, including sling immobilisation for four weeks, following surgical repair of the rotator cuff of the shoulder.

Design: Nested qualitative study.

Setting: Five English National Health Service Hospitals.

Subjects: Nineteen patient participants who had undergone surgical repair of the rotator cuff and 10 healthcare practitioners involved in the trial.

Method: Individual semi-structured interviews. Data were analysed thematically.

Results: Four themes: (1) Preconceptions of early mobilisation; many participants were motivated to enter the trial for the opportunity of removing their sling and getting moving early. (2) Sling use and movement restrictions; for some, sling use for four weeks was unacceptable and contributed to their pain, rather than relieving it. (3) Tensions associated with early mobilisation; clinical tensions regarding early mobilisation and the perceived risk to the surgical repair were apparent. (4) Processes of running the trial; participants found the trial processes to be largely appropriate and acceptable, but withholding the results of the post-operative research ultrasound scan was contentious.

Conclusion: Trial processes were largely acceptable, except for withholding results of the ultrasound scan. For some participants, use of the shoulder sling for a prolonged period after surgery was a reported barrier to standard rehabilitation whereas the concept of early mobilisation contributed tension for some healthcare practitioners due to concern about the effect on the surgical repair.

Citation

Stephens, G., Littlewood, C., Foster, N. E., & Dikomitis, L. (2021). Rehabilitation following rotator cuff repair: A nested qualitative study exploring the perceptions and experiences of participants in a randomised controlled trial. Clinical Rehabilitation, 35(6), 911-919. https://doi.org/10.1177/0269215520984025

• Journal Article Type: Article
• Acceptance Date: Dec 27, 2020
• Online Publication Date: Dec 27, 2020
• Publication Date: 2021-06
• Deposit Date: Nov 15, 2024
• Publicly Available Date: Nov 15, 2024
• Journal: Clinical Rehabilitation
• Print ISSN: 0269-2155
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 35
• Issue: 6
• Pages: 911-919
• DOI: https://doi.org/10.1177/0269215520984025
• Keywords: physical therapy, Qualitative study, rehabilitation, shoulder pain