Early Versus Delayed Motion After Arthroscopic Rotator Cuff Repair: What Two Meta-Analyses of Randomized Trials Found

Physical therapists and physical therapist assistants working in outpatient orthopedic settings who see patients after arthroscopic rotator cuff repair and follow postoperative protocols that specify when passive and active motion begin.

Physical therapists and physical therapist assistants in outpatient orthopedics, including clinicians who receive patients on surgeon-written postoperative rotator cuff protocols. Physical therapist assistants work under the direction of the supervising physical therapist; evaluation, diagnosis, and plan-of-care decisions remain with the physical therapist.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course reports two systematic reviews with meta-analysis of randomized controlled trials in patients who underwent arthroscopic rotator cuff repair.

Hu CW, Tsai SHL, and colleagues. Early versus delayed passive and active range of motion rehabilitation after arthroscopic rotator cuff repair: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskeletal Disorders, 2023. doi:10.1186/s12891-023-07075-5

Chen Y, Li Y, Liang H. Early versus delayed rehabilitation after arthroscopic rotator cuff repair: a systematic review and meta-analysis of randomized controlled trials, 2024. A DOI was not included in the source material supplied for this course.

All findings, counts, and conclusions in this course are drawn from these two sources and are attributed to the source that reported them.

After completing this course, you will be able to:

1. Describe what the thirteen-trial review reported for range of motion, retear rate, and function when early passive or early active motion was compared with delayed motion after arthroscopic rotator cuff repair.
2. State what the nine-trial review concluded about shoulder function, pain, tendon healing, and retear at six and twelve months, and how its authors judged whether a difference was large enough to matter to patients.
3. Explain where the two reviews agree, where their emphases diverge, and what the nine-trial authors said about progressing rehabilitation according to clinical criteria rather than the calendar.

1. Start Here
2. Part One: Early Versus Delayed Passive and Active Motion After Arthroscopic Rotator Cuff Repair
3. Who Was Enrolled in the Thirteen Randomized Trials
4. Separating Passive Protocols From Active Protocols
5. Motion, Retear, and Function in the Pooled Trials
6. What the Authors Concluded, and What the Review Could Not Settle
7. Part Two: Rehabilitation Timing and Whether the Differences Matter to Patients
8. The Nine Randomized Trials and the Patients in Them
9. Judging Change Against What Patients Notice
10. Pain, Function, Motion, Healing, and Retear at Six and Twelve Months
11. The Case for Criterion-Based Progression and Its Limits
12. Bringing It Together
13. Where the Two Reviews Agree
14. Where They Diverge, and Which Review Found What
15. Deciding When to Progress Motion in the Clinic
16. What the Evidence Still Cannot Answer
17. Key Takeaways
18. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 1.0 contact hour (60 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. Hu CW, Tsai SHL, Chen CH, Tang HC, Su CY, Tischler EH, Yang YC, Chan YS, Chiu CH, Chen ACY. Early versus delayed mobilization for arthroscopic rotator cuff repair (small to large sized tear): a meta-analysis of randomized controlled trials. BMC Musculoskeletal Disorders. 2023;24(1):938. doi:10.1186/s12891-023-07075-5
2. Chen Y, Meng H, Li Y, Zong H, Yu H, Liu H, Lv S, Huai L. The effect of rehabilitation time on functional recovery after arthroscopic rotator cuff repair: a systematic review and meta-analysis. PeerJ. 2024;12:e17395. doi:10.7717/peerj.17395