Clinical effect of a new mode of early rehabilitation with ERAS concept on rotator cuff injury after arthroscopy

doi:10.3877/cma.j.issn.2095-5790.2021.04.013

Abstract

Abstract:

Background

Rotator cuff injury, also known as rotator cuff tear (RCT) , is a common shoulder joint injury. Currently there is no unified standard for arthroscopic rehabilitation for RCT injury in terms of improving shoulder function, relieving pain and improving quality of life.

Objective

To explore the effect of medical care patient integration with enhanced recovery after surgery (ERAS) rehabilitation model on self-efficacy and rehabilitation effect of functional rehabilitation training of affected limbs after shoulder arthroscopy in patients with RCT.

Methods

From April 2020 to April 2021, a randomized controlled study with 60 patients was completed, and the follow-up period was 3 months (daily-nursing group: n=29; ERAS rehabilitation group: n=31) . Postoperative rehabilitation of patients in the two groups was carried out by daily nursing regimen and medical-patient integration ERAS protocol, respectively. The clinical effects of the two groups were evaluated by physical examination, self-efficacy for rehabilitation outcome scale (SER) , Constant-Murley scale.

Results

Three months after operation, the total scores of exercise self-efficacy, coping self-efficacy and rehabilitation self-efficacy in the two groups at last follow-up were higher than preoperatively, the experimental group was significantly higher than that in the control group (P < 0.05) ; in the score of Constant-Murley scale 1-week and 3-months after surgery, the ERAS rehabilitation group was significantly higher than that in the Daily-nursing group, and the difference was statistically significant (P < 0.05) ; the compliance of functional exercise in the experimental group was significantly higher than that in the control group 3 months after operation (P < 0.05) .

Conclusion

The integrated ERAS rehabilitation model of medical care and patients is helpful to improve the self-efficacy level of upper limb rehabilitation training after arthroscopic treatment of rotator cuff injury, enhance the compliance of rehabilitation exercise, and quickly restore the function of affected limbs.

Key words: Rotator cuff tears, Arthroscopy, ERAS, Integration of medical care and patients, Self-efficacy

Yang Wang, Lihui Liu, Wei Liu, Hongmei Tian, Yongpeng Mao, Xuyang Li, Ran Cao, Zhenwei Wang, Di Ai, Teng Zhang, Zimu Mao, Shuangpeng Jiang. Clinical effect of a new mode of early rehabilitation with ERAS concept on rotator cuff injury after arthroscopy[J]. Chinese Journal of Shoulder and Elbow(Electronic Edition), 2021, 09(04): 360-364.

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References 20

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组别	例数	应对自我效能		锻炼自我效能		SER总分
组别	例数	术前	术后3个月	术前	术后3个月	术前	术后3个月
DN组	29	32.41±9.81	51.17±11.39	29.90±7.90	34.34±5.89	62.03±17.15	85.52±12.35
ER组	31	33.17±9.68	60.14±9.51	31.55±8.89	38.10±5.29	63.69±18.81	98.24±10.49
t值		-0.815	-3.153	-1.621	-2.493	-1.621	-4.127
P值		0.422	0.004	0.116	0.019	0.116	<0.001

组别	例数	应对自我效能		锻炼自我效能		SER总分
组别	例数	术前	术后3个月	术前	术后3个月	术前	术后3个月
DN组	29	32.41±9.81	51.17±11.39	29.90±7.90	34.34±5.89	62.03±17.15	85.52±12.35
ER组	31	33.17±9.68	60.14±9.51	31.55±8.89	38.10±5.29	63.69±18.81	98.24±10.49
t值		-0.815	-3.153	-1.621	-2.493	-1.621	-4.127
P值		0.422	0.004	0.116	0.019	0.116	<0.001

组别	例数	术前	术后1周	术后3个月
DN组	29	46.69±7.39	61.83±9.08	75.79±7.25
ER组	31	46.31±8.46	69.10±8.83	81.34±8.53
t值		0.345	-3.701	-2.422
P值		0.733	0.001	0.022

组别	例数	术前	术后1周	术后3个月
DN组	29	46.69±7.39	61.83±9.08	75.79±7.25
ER组	31	46.31±8.46	69.10±8.83	81.34±8.53
t值		0.345	-3.701	-2.422
P值		0.733	0.001	0.022

组别	例数	术后1周	术后3个月
DN组	29	4.10±1.14	2.93±1.56
ER组	31	4.03±1.15	3.76±1.12
t值		0.372	-2.117
P值		0.712	0.043

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