Limited physical therapy utilization protocol does not affect impairment and disability in Workers' Compensation patients after rotator cuff repair: A short-term follow-up study

摘要

Background: Treatment of rotator cuff tears in injured workers is associated with poorer outcomes and abnormally high utilization of clinical services. This study evaluates the effect on impairment and disability rates after the implementation of an accelerated independent rehabilitation protocol on injured workers undergoing mini-open rotator cuff repair. Materials and methods: Seventy-one primary rotator cuff repairs in injured workers were reviewed at least 1 year after claim closure. Outcomes based on permanent partial disability and impairment were compared among 28 patients using traditional outpatient physical therapy (group A) and 43 patients using an accelerated protocol-driven independent exercise program (group B). The number of physical therapy visits attended, disability, and impairment rates were compared between the 2 groups. Results: Group B used a median of 16 physical therapy visits, which were 9 fewer visits per patient than group A (P < .001). This constituted a 36% reduction in the median number of physical therapy visits without negatively affecting disability and impairment rates. The difference between the 2 groups in time to release to work or time to claim closure was not significant. Conclusions: The implementation of an accelerated, independent, exercise protocol reduced physical therapy utilization to levels below national best-practices benchmarks without negatively affecting impairment or disability rates in Workers' Compensation patients undergoing mini-open rotator cuff repair.