Effects of lower extremity physical activity on shoulder biomechanics and functional recovery in the early phase after arthroscopic rotator cuff repair in male patients: a retrospective study

Abstract

Surgeons widely use arthroscopic rotator cuff repair (ARCR) to restore biomechanics and function in patients with rotator cuff tears. However, patients show severe pain early after ARCR, and their physical activity level decreases sharply. This study aimed to determine the effect of lower extremity physical activity on shoulder pain, biomechanics, and functional recovery in the early phase after ARCR. This retrospective study included 103 male patients according to the inclusion criteria. We classified subjects into high physical activity (HPA, n = 49) and low physical activity (LPA, n = 54) groups according to the classification criteria. For analysis, we measured the visual analog scale (VAS) score, range of motion (ROM), American Shoulder and Elbow Surgeons (ASES) score, and grip strength preoperatively and six weeks postoperatively. In comparing the HPA and LPA groups at six weeks postoperatively, the VAS score was significantly lower in the HPA group (p < 0.001). The ROM of forward flexion (p = 0.001), abduction (p = 0.005), and external rotation (p = 0.001) of the shoulder was also significantly greater in the HPA group. In particular, the ASES score (p < 0.001) and grip strength (p < 0.001) showed significant improvement only in the HPA group. Patients with higher levels of physical activity after ARCR showed lower subjective pain and faster biomechanical and functional recovery than those with lower levels of physical activity. Therefore, even if the involved shoulder has restrictions during the early phase after ARCR, it is vital to actively recommend physical activity such as walking, stationary cycling, and climbing stairs using the lower extremities.