Mattar, Luke Thomas
(2023)
Personalized Exercise Therapy Program for the Treatment of Individuals with Symptomatic Rotator Cuff Tears.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Rotator cuff tears continue to present an important clinical problem due to the lack of evidence supporting an optimal initial treatment method. Approximately 30% of the general population develops a rotator cuff tear and the incidence increases with age. Pain and limited capability to perform activities of daily living due to the tear emphasize the importance of determining an optimal initial treatment method. Generally, individuals with rotator cuff tears are initially prescribed non-operative treatment in the form of exercise therapy. Controversary exists where some believe exercise will lead to tear propagation. However, others believe that exercise therapy restores proper function of the surrounding healthy musculature reducing the force on the tear preventing tear propagation.
Developing a better understanding of the effects of exercise therapy for treatment of individuals with symptomatic isolated supraspinatus tears may improve treatment modalities and long-term outcomes. Clinicians can utilize the results of this dissertation to make informed decisions for initial treatment, understand the risks for tear propagation and changes in joint function that occur following exercise therapy. Thus, the overall objective of this dissertation was to determine the effects of a 12-week individualized exercise therapy program for treatment of rotator cuff tears in a large and unique cohort of 109 individuals with symptomatic isolated supraspinatus tears and compare individuals successfully and unsuccessfully treated with exercise therapy.
Aim 1 characterized the baseline presentation of individuals with isolated supraspinatus tears prior to participating in exercise therapy. Individuals had minor limitations in shoulder motion and muscle strength that were not associated with altered glenohumeral kinematics or patient reported outcomes prior to exercise therapy. The combined portions of Aim 2 found that individuals experienced improvements in glenohumeral joint function, patient reported outcomes, range of motion and strength without increases in tear size following exercise therapy. The combined portions of Aim 3 validated subject specific computational models capable of distinguishing differences in joint stability between individuals successfully and unsuccessfully treated with exercise therapy. Future work will investigate the long-term maintenance of the exercise therapy program at 5-year follow-up and determine if modifications to exercise therapy protocols improve outcomes.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| Date: |
13 June 2023 |
| Date Type: |
Publication |
| Defense Date: |
17 March 2023 |
| Approval Date: |
13 June 2023 |
| Submission Date: |
27 March 2023 |
| Access Restriction: |
1 year -- Restrict access to University of Pittsburgh for a period of 1 year. |
| Number of Pages: |
159 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
Swanson School of Engineering > Bioengineering |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
Glenohumeral; rotator cuff tear; kinematics; exercise therapy; computational modeling |
| Date Deposited: |
13 Jun 2023 14:19 |
| Last Modified: |
13 Jun 2024 05:15 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/44331 |
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