Clinically Important Improvements Observed in Patient-Reported Outcomes 2 Years After Exercise Therapy for Patients With Isolated Supraspinatus Tendon Tears.

Objective: To describe and predict patient-reported outcomes (PROs) and to investigate differences between individuals with a rotator cuff tear who were and were not successfully treated with a 12-week exercise therapy program.

Design: Prospective observational cohort.

Setting: Orthopedic sports medicine clinical practice settings and departments of orthopedic surgery, physical therapy, and bioengineering at the University of Pittsburgh.

Participants: Eighty-two individuals, age ≥40 years with a symptomatic isolated supraspinatus tear.

Interventions: Individualized 12-week exercise therapy program and longitudinal follow-ups at 3, 6, 12, and 24 months.

Main outcome measures: (1) PROs: Western Ontario Rotator Cuff (WORC) index (WORC) & Numeric Pain Rating Scale (NPRS), (2) shoulder range of motion (ROM) and strength, (3) rotator cuff tear size and location, (4) glenohumeral kinematics.

Results: Significant improvements in both PROs were observed at all time points when compared with baseline. At the 24-month follow-up, improvement greater than the minimally clinically important difference was noted for 78% of individuals for the WORC and 55% for the NPRS. Baseline predictors for 24-month change in WORC and an overall successful outcome were identified and included the baseline WORC score and the side-to-side difference in ROM for external rotation at 90 degrees abduction.

Conclusions: Individuals with symptomatic, isolated supraspinatus tears, managed with exercise therapy, experienced clinically important improvements in self-reported disability and more than half experienced a similar improvement in pain, at a 2-year follow-up. Baseline patient-reported outcomes measures and side-to-side differences passive ROM predicted 24-month success after exercise therapy. These findings may be useful in plan-of-care decision making.